My experience is that although a few staff may feel that monitoring IPC standards in practice is more about a blame culture, particularly following an outbreak or serious incident; a majority of staff I feel are now aware that setting clinical standards and regular monitoring (using audit) is more about "Quality improvement and patient safety".
My view is that in healthcare we must always be about improving the quality of our care and care environment for patients, with the intention "to do the sick no harm" (Florence Nightingale) and also to manage/control the foreseeable risks related to the care we give. For example managing the risks associated with surgery means performing this procedure in a clean environment with instruments and medical equipment that are sterile or have been correctly decontaminated, by staff who are trained to undertake the procedure safely and hygienically, thus preventing an HCAI (SSI).
Infections are distressing, dangerous and of course costly in financial terms so all staff and medics must have adequate training in IPC so that IPC can be embedded in their everyday practices. To do this and create a safety culture for our patients it will always be important to undertake continual monitoring by regular checks and audits in clinical areas and to collate rates of infection. Organisations need to bench mark their rates against other similar establishments; which is also an important element of their quality and governance frameworks. To facilitate a proactive IPC programme in healthcare IPC teams must have enough resources and expertise to set standards, provide education/training, undertake surveillance and monitor performance through an audit schedule.
Audit results and rates of HCAIs must be used positively (internally) to indicate specific areas for improvement and where further targeted training is required. They should never be used as "a stick to beat staff" unless it can be proven that gross negilience has occurred which then has to dealt with swiftly and decisively by senior management. We are all human after all so errors will occur; but we must learn to accept that lessons must be learnt. Equally important is that a full investigation of serious incidents/outbreaks must get to the underlying causal factors; which can often include organisational failures or omissions with the aim that they can be tackled head on with clear, time weighted. action plans for improvement.
