IPC policy adherence audits
Health Boards should ensure that adherence to infection prevention and control polices, for example C. difficile and Loose Stools Policies, is audited at least annually.
- The Scottish Government's response detailed national and local surveillance data collection, including mandatory CDI surveillance (started 2006 for patients aged 65+, extended April 2009 to all aged 15+). The LDP standard requires CDI rates of 0.32 or less per 1,000 total occupied bed days.
- Scotland achieved a CDI rate of 0.27 per 1,000 occupied bed days in the year ending December 2018, meeting the target with a decreasing year-on-year trend of 7.5% between 2014 and 2018.
- The requirement that adherence to IPC policies including CDI policies is audited at least annually is addressed through national surveillance systems operated by ARHAI Scotland (formerly Health Protection Scotland) and local audit requirements within the HAI Standards.
- The HCAI Strategy 2023-2025 maintains surveillance and reporting as core elements of Scotland's approach to HAI reduction (Scottish HCAI Strategy 2023-2025 (https://www.gov.scot/publications/scottish-healthcare-associated-infection-hcai-strategy-2023-2025/)).
How was this evidence gathered?
Response
Accepted
Response
AcceptedSection 3.3 of the Scottish Government's response states that quality improvement uses a range of methods, such as audit, to deliver change and improve outcomes. Section 2.1 details that a robust HAI scrutiny regime is in place, with the Healthcare Environment Inspectorate (HEI) carrying out regular, often unannounced, inspections to check adherence to national standards and guidance. NHS boards are also responsible for monitoring and reporting hand hygiene compliance and ensuring suitable quality assurance processes are in place, with performance against revised HAI standards forming part of HEI inspections from June 2015.
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
HIS IPC Standards (2022) Standard 4 (Assurance and Monitoring) requires systematic auditing of IPC policy adherence. NIPCM provides audit tools for download. National compliance monitoring through HIS inspections.
View detailed findings
Standard 4 specifically addresses auditing of IPC practices. Audit tools are available through the NIPCM website for use by all health boards.