News from FOPH: national strategies StAR, NOSO, GRIPS

Transcription

14.09.2015
Département fédéral de l'intérieur DFI
Office fédéral de la santé publique OFSP
Unité de direction santé publique
StAR: mandate
News from FOPH:
national strategies
StAR, NOSO, GRIPS
Revised federal law on Control of Communicable Diseases of humans (Epidemic law), Art. 5
and law on Agriculture Art. 187 d, paragraph 2
Elaboration of strategy on mandate of Federal Councilors
A. Berset and J. Schneider-Ammann
Overarching domains (human, animal, agriculture,
environment), together, One Health engagement
Virginie Masserey, head of section
Vaccinations and control measures
Nouvelles de l’OFSP: stratégies nationales STAR, NOSO, GRIPS
Maladies transmissibles, V. Masserey
03.09.15
Overall strategy and domains
What does the strategy aim to achieve?
Overall aim(s)
•
Insure on the long-term that antibiotics remain effective in
maintaining the health of humans and animals.
Overall strategy
Need for action
• Context description
• Strategic orientation
Fields of action
•
Investigate the impact of antibiotic use on the environment.
•
The overall strategy on antibiotic resistance, as well as the
way to go in the human, animal and agricultural domains are
supported by the main stakeholders.
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• Key measures
Strategic aims and
Key measures
• Frame conditions for implementation
Human
Animal
Agriculture
Implementation in domains
Implementation
Implementation
Implementation
• Implementation planning
• Domain-specific implementation and
concretisation
• Responsibilities and financing
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Elaboration timeline – with the participation of actors
StAR Project timeline
2013
Q1
Q2
2014
Q3
Q4
Q1
Q2
Pre-project Elaboration of strategy with participation of actors
Q1
2015
Q2
2014
Consolidation/consultations
WS
Key measures
Stakeholder-Workshops
and expert groups
October 2014: 1st Consultation of
federal offices
WS
Strategic aims
Need for action/
Fields of action
Kick-Off
WS
Q4
Q3
Audition
Q1
Analysis,
Report
2015
Q3
Strategy elaboration
Revisions
StAR
Q4
Q1
Audition
Q2
Q3
Q4
Q1
2016
Q2
Analysis,
Report
Revisions
StAR
Approval Fede- Implementation
ral Council
More Information on www.bag.admin.ch/star
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Eight fields of action
Resistance control
Information and
training
Prevention
Research and
Development
Frame conditions
Appropriate use of
antibiotics
Cooperation
Prevention
One strategic goal per field of action - example
Surveillance
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Q2
The need for application of antibiotics is reduced thanks to the use
of targeted preventive measures and effective alternatives.
Structural measures, in particular in the areas of management,
hygiene, organisation and information support the achievement of
the goals.
Example of measure: develop and implement surveillance,
prevention and control of nosocomial infections
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Example from the human domain: surveillance
One Health is reflected in the measures
•
Develop and manage a comprehensive surveillance of
antibiotic resistance and use
e.g. common report
•
Appropriate application of antibiotics in all domains
e.g. develop guidelines for the use of antibiotics and
restrict use.
•
Coordinated implementation
e.g. coordination platform overarching the different
domains
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Existing structures should be strengthened and expanded.
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•
Expand of the national center for surveillance of trends in the
antibiotic resistance situation as well as in the antibiotic use
(anresis.ch).
•
National center for early detection of new resistances and early
detection of changes in trends.
•
Develop a network of reference labs for diagnosis and early
detection.
•
Evaluate a mandatory report of public health relevant
resistances.
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NOSO strategy : starting point
• Reduction of nosocomial
infections – a political health
challenge.
• New legal basis: revised
epidemic law (Art. 5, 9, 11,
12 and 19)
•
More Information on:
www.bag.admin.ch/star
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NOSO strategy : field of application
•
Hospitals and nursing homes
•
Nosocomial infections are infections that are acquired during
the stay in a healthcare institution.
NOSO strategy : overall objective
To reduce nosocomial infections:
to increase the safety of patients and healthcare workers
to improve the protection of the population
to decrease resulting costs
+ outpatient domain (as a 2nd part)
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NOSO strategy intends …
to expand on existing
structures
to join efforts
to close gaps
schliessen
Further activities of the Confederation in
the field: national pilot programmes as part
of the quality strategy
1. „Safe surgery“ (full adherence in the application
of the checklist in operation theatres)
2. Increasing safety of medication at interfaces
3. Reduction of the use of urinary tract catheters and
thereby decrease of the risk of infection
More information on www.patientensicherheit.ch
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Situation analysis
NOSO strategy : project timeline
Content:
2014
Trimester 1
Trimester 2
Concept
• Legal bases
2015
Trimesterl 3
Trimester 4
Trimester 1
Trimester 2
Trimester 3
Consolidation
Elaboration of strategy
Elaboration of strategy with stakeholders and
experts
Feedback from
stakeholders
Trimester 4
Approval
• Existing structures and programmes
Survey among hospitals, nursing homes and cantons
• Training
Federal
Council
• Main actors
Until September 14
www.bag.admin.ch/fr/NOSO
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Is there in your institution a nursing professional or an
academic professional with special training in hospital
epidemiology or hospital hygiene?
Hospitals – national measures & programmes
All hospitals
WHO Safe Surgery Saves Lives
Hospitals
Nursing homes
3%
Progress!Sichere Chirurgie
26%
CleanHands St. Gallen
13%
71%
Händehygienekampagne WHO
44%
Ja
Influenzakampagne BAG
55%
Nein
Unklar
Wundinfektionen KISS
Ja
Nein
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87%
Wundinfektionen Swissnoso/ANQ
Ja
Nein
19
0
20
40
60
80
100
Prozent
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Hospitals– local prevention measures
Nosokomiale Pneumonien
Results of survey among cantonal health directors
• 3 cantons with comprehensive cantonal programmes
All hospitals
4%
• 6 cantons with individual cantonal measures
Nosokomiale Urininfektionen
51%
45%
heterogenous portrait
Nosokomiale Bakteriämien
Ja
Postoperative Wundinfektionen
Nein
Unklar
Händehygieneprogramm
0
20
40
60
Prozent
80
100
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Structure of the strategy
NOSO strategy - model
1 overall objective
Increase safety of
patients, residents,
personel
Imprrove
protection of
population
Decrease
resulting costs
Overall objective
4 fields of action
12 strategic goals
Reduce healthcare associated infections
Monitoring
32 key measures
Prevention &
Control
Training and
Research
Gouvernance
Develop and multiply knowledge
Fields of action
Establish standards (best practice) based on evidence
Support implementation
Confederation, cantons, municipalities, hospitals, nursing homes, insurances,
specialists and professional associations, other stakeholders
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Actors
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Example 1: Monitoring (M)
Example 2: Prevention and Control (PC)
3 goals (M1-3)
Strategic goal PC-1 Personel, patients, residents and
Strategic goal M-1 A national system is developed and
visitors of hospitals and nursing homes are aware of the problem
of HAI and its importance. They understand the measures to take
and contribute to their implementation.
managed to monitor healthcare associated infections and the
factors that influence them (structures and processes).
Key measures to PC-1
Key measures to M-1
PC-1-1 Elaborate and implement a communication concept to
inform the public
M-1-2 Determine the needed data, methods and standards
PC-1-2 Encourage an internal learning and dialogue culture to the
topic in hospitals and nursing homes
M-1-4 Insure quality of monitoring
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National strategy for the
prevention of seasonal
influenza (GRIPS) 20152018
GRIPS elaboration
2012
T3
2013
T4
T1
Concept
More information on
www.bag.admin.ch/fr/NOSO
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T2
2014
T3
T4
Elaboration
WS
WS
T2
Consolidation
2015
T4
T3
Approval.
T1
T2
Planing &
implementation
WS
Drafts
27
T1
Consultation
of actors
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Overall objectives and priorities of GRIPS
Public Health Research
Goals:
Field of action 1
Public Health
Research
1. Estimate the disease burden
• Morbidity (a. o. by a hospital sentinel system)
Field of action 2
Field of action 3
Patient
protection
Promotion of
vaccination
• Mortality
• Costs
2. Estimate the efficacy of prevention measures
• Vaccination coverage
Overall objective
• Measures in cantons
The number of cases of severe disease due to
seasonal influenza, especially in persons at
increased risk of complications, is reduced.
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• Prevention measures in healthcare facilities
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Patient protection
Promotion of flu vaccination
-> Institutions engage actively
-> Disseminate knowledge
- Initiate exchange platforms with/for health institutions regarding
their prevention measures
− Stakeholder-workshop to develop a communication
concept, describing the responsibilities and main messages
for all actors
- Strengthen coordination of measures with cantons
− Update existing promotion material and recommend the use
by actors (Printed material, training material and website
www.impfengegengrippe.ch)
- Evaluate: nosocomial influenza and vaccination coverage of
HCWs as quality indicator?
- Integrate the topic of (flu) vaccination in the education of HCW
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Promotion of flu vaccination
More information on:
www.bag.admin.ch/influenza
-> Motivate
Thank
you
- Disseminate experiences of cantons with measures to
encourage low threshold access to vaccination.
- Evaluate encouragement of access and incentives for flu
vaccination of target groups
- Coordination with e-Health: electronic reminders for target
groups in electronic patient dossier (EPD)
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News from FOPH: national strategies StAR, NOSO, GRIPS

Transcription

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