COVID-19 has been an incredibly challenging time for nursing homes. Although many nursing homes had good functional systems in place, these systems were never really challenged to the same extent that COVID-19 presented. The COVID-19 Nursing Homes Expert Panel Report published in August 2020, identified that effective Infection Prevention and Control (IPC) measures played a central role in preventing and controlling the transmission of COVID-19 to nursing homes and in tackling the spread of COVID-19 in facilities where the virus is present. The following month, Health Information and Quality Authority (HIQA) published COVID-19 – An assurance framework for registered providers – preparedness planning and Infection prevention and control measures. This framework recognises that enhanced and additional IPC measures are now required by nursing homes to ensure they have an effective IPC system in place.
In this blog post we discuss why it is essential that nursing homes incorporate Infection Prevention and Control into the Governance Model and we offer guidance on how to do this.
HIQA COVID-19 Assurance Framework – what is involved?
HIQA’s COVID-19 Assurance Framework builds on the National Standards for Infection Prevention and Control in Community Services (2018). Although an effective set of standards, the assurance framework recognises that specific focus is required for COVID-19, in particularly the governance model that is going to drive the effectiveness of our response to COVID-19.
The COVID-19 Assurance Framework aims to assist registered providers to focus on the critical aspects of care so that they can be assured of the efficacy of:
- infection prevention and control governance and management arrangements:
- preparedness and contingency plans,
- staffing arrangements,
- the knowledge and confidence of staff in implementing infection prevention and control measures,
- audit and review arrangements.
Incorporating IPC in the Governance Model
IPC requires a strong commitment at senior level to ensure that it filters down throughout the organisation. Below are the types of outputs HIQA would expect to see in a nursing home which illustrates their commitment to IPC.
IPC Responsibilities at Senior Level
- Allocation of overall accountability, responsibility and authority for IPC and Antimicrobial Stewardship within the residential home to the Registered Provider (detailed within the RP Job Description).
- Senior Management Team structure reflects an appropriately resourced Infection Prevention and Control Team. This should be reflected within:
- Organisational Team Chart illustrates IPC Team
- Terms of Reference for IPC Team
- Agenda for IPC Team
IPC as a Strategic Focus
- IPC requirements incorporated within Strategic and Operational Planning activities
- IPC responsibilities incorporated into the Senior Management Team TOR & Agenda
- IPC appropriately detailed within the Safety Statement
- KPI’s set for IPC & Antimicrobial Stewardship
- Development, Resource and Monitoring of an Infection Prevention and Control Programme
- IPC Lead Resourced
- Appropriate IPC training provided to IPC Lead and staff to support effective IPC application
- Ensure IPC is central to everyone’s roles and responsibilities.
How can HCI help?
HCI can conduct an independent audit of your nursing home’s current system of IPC against HIQA’s COVID-19 Assurance Framework and the National Standards for infection prevention and control in community services (2018). An IPC Audit will establish the current baseline of your system of IPC and form a strategy for improvement.
HCI’s audit would be comprehensive, utilising a triangulation approach of document review, process observation and staff interviews. The outcome of the audit would be a report detailing areas of good practice and areas for improvement with respect to IPC. The report would also set out Quality Improvement Plans (QIPs) to address the areas for improvement.
Other supports HCI can offer include:
- Infection Prevention and Control Strategy Development
- Infection Prevention and Control Education and Training
- Infection Prevention and Control Policies and Procedures (see HCICaretools.com)
HIQA’s COVID-19 Assurance Framework isn’t just about managing the COVID-19 crisis, it also requires registered providers to look at a wider framework, taking a long term perspective to ensure that the new enhanced IPC measures are embedded within the organisation so that when a new challenge comes along in the future nursing homes are better prepared.
HCI is a provider of professional services in relation to resident safety, quality improvement, and regulatory compliance. We have over 15 years’ experience in supporting nursing homes in improving the quality and safety of services. HCI has the necessary expertise to help you develop and embed this assurance framework to ensure the ongoing safety of your residents and staff.