A Day In The Life Of An APIC Board Member

In 2008 there are more countries with dedicated local and/or national programs designed to reduce or eliminate healthcare associated infections (HAIs) than at any other time in history. Interestingly the global infection control stage is becoming more crowded as non-traditional players including claim infection control expertise at either individual or organisational level. High level campaigns of global magnitude are becoming more common and regional organisations such as the Asia-Pacific Society of Infection Control (APSIC) continue to grow in membership size and influence. Additionally, the WHO has signalled its intention to establish multiple Infection Control Collaborating Centres. More interestingly, some see US-based organisations such as the Association for Practitioners in Infection Control and Hospital Epidemiology (APIC) and the Centers for Disease Control and Prevention (CDC) as continuing to have substantial influence in shaping our profession. Recent provocative US lead initiatives such as the impending change to reimbursement and the promulgation of the title “Infection Preventionist” will inevitably also influence the growth and direction of Australian infection control. I would strongly encourage all Australian ICPs to stay abreast of recent, critical global infection prevention trends and initiatives as well as they will inevitable impact us.      

What a great event the New Zealand (NZ) National Division of Infection Control Nurses hosted from 13^th-15^th August in Hamilton in the North Island. NZ Infection Control Practitioners (ICPs) are a really enthusiastic group of professionals. I first attended their annual conference in the early 1990s and have had the distinct pleasure of being invited back several times since. This 2008 conference was fantastic and a testimony to how much progress the ICPs have made in the past few years.

While infection prevention practice in NZ is similar to that here in Australia, the NZ ICPs have faced and conquered some unique challenges different to ours. NZ geography means that getting together for face-to-face meetings can be difficult. As a result many members make the effort to attend the annual conference and to use that as their best opportunity to network and update on cutting edge research and trends.

Being such a small country in terms of population (the old joke goes something along the lines of there are more sheep in NZ than people!) it means that NZ is an even smaller dot on the global medical industry market than Australia.  Australia is less than 1% of the global market so NZ must be closer to zero. Given that figure it is difficult for NZ to garner any overwhelming support from medical manufacturers although several do generously support the Division year after year. Interestingly, NZ does not yet have tough regulations regarding medical devices. Australia has a statutory body, the Therapeutic Goods Administration, (TGA) which tests medical devices and supportive claims prior to approving them for marketing and use in Australia. The TGA operates similarly to the US FDA. Without this safeguard NZ is often seen by manufacturers as the perfect test site – easy to enter and reasonably well developed to be useful in predicting trends. This can mean that ICPs in NZ have to be extra vigilant in their efforts to keep up with products used in their facilities to prevent inadvertent use of unsafe or harmful equipment or products. In the very near future Australia and NZ will join and harmonise their approach to medical device regulation and both countries will benefit from that process.

And there are many more stories about ICPs from “across the ditch”. Our Kiwi friends are some of the friendliest ICPs in the world. They love to party and every year their conference social event is a themed dinner. This year’s theme was “Showboat”. I have never seen so much taffeta, silk, ribbons,  bows  and ICPs all in the same place. What a great night it was.

We were also blessed to have the Immediate Past APIC President, Denise Murphy, as one of the keynote speakers at the conference. What a great job she did in “bridging the gap” too. No doubt opportunities for ICPs all around the world to meet and share their experiences will increase over the next few decades. Given it’s strong history and this most recent example, I have no doubt that the NZ annual conference will remain a constant source of inspiration to local and international ICPs. Visit them next year from 26-29^th August and you too can experience the WOW of NZ.

The July 23rd, 2008 edition of The Sydney Morning Herald (see image above) carried a lead story about the intentions of the New South Wales Health Minister to publically release identifying healthcare associated infections (HAIs) data and rates from NSW Public hospitals. What an incredible piece of news and what far reaching implications it could have for Australian and regional infection prevention.

Many of you will be aware of efforts in the US over the past few years where various legislature has been enacted compelling states to submit and publically release their specific HAI data. You may also note that APIC through its leadership, membership and Government Affair’s experts, has continued to raise public and political awareness about HAIs and infection prevention. The APIC website details this recent history well at www.apic.org It is likely that Australian progress will be similar but not identical to our US and British infection prevention peers. However this unfolds I can’t help but recognise that Australian infection prevention is on the cusp of its most recent wave - may it be a great ride.

Below I have copied the content of a recent posting I made to our AICA E-discussion List in relation to this development. Few AICA members have commented but I am sure that each has a response to this initiative.

Since yesterday afternoon two very important infection prevention events have occured. Each will have national impact. The first is the release by the Australian Commission on Safety and Quality on Health Care (ACSQHC) of their Surveillance Report. I have reproduced part of an e-mail sent by the Commission to stakeholders yesterday. I would also strongly encourage AICA members to provide comment to ACSQHC individually and collectively from your state and national perspectives. This is a critical opportunity to influence the future direction of Australian infection prevention efforts.The second event is a frontline story in today’s Sydney Morning Herald where the NSW Minister of Health has responded to the Commission’s publication by indicating that within 3 months NSW will release hospital-identifying healthcare associated infections (HAI) data. Many of you will know that NSW Health has had this information available to it for all public hospitals since January 2003. Whilst there are undoubtably methodological issues which impact the validity and reliability of the NSW data (like every other large HAI data collection system in the world) this is a monumental development.It has the potential to change the way we do business and especially to change the expectations of healthcare consumers. I have closely watched the US public reporting debate unfold since late 2004 and I suspect Australia’s path will be equally challenging. If NSW does release this data routinely every other jurisdiction will likely follow. Our profession is under the microscope well and truly.