Infection Control Passport Program
By Corinne Cameron-Watson, Senior Infection Control Prevention & Control Nurse, Barking Havering and Redbridge Acute NHS Trust

Over the last few years many hospitals in England have seen increasing numbers of Clostridium difficile infection (CDI) with increased mortality rates. This trend has been reported similarily in America and Canada.

Thus, infection prevention and control (IP&C) has never had such a high profile globally, yet so little of the basic issues are understood by either the public or practiced by clinical staff. The high and mighty, the press, the politicians, they all have a view on IP&C. They speak with such expertise that the true experts appear mute. A subject that is based on science, knowledge and years of training is now used as a political football to score points for political gain, sell newspapers and play games of ‘name, shame and blame’.

In early 2005, my hospital group – Barking Havering Redbridge Acute NHS Trust (1500 beds) – experienced an average of 15 new CDI cases a day, and by necessity, a 14 bed ward was converted into a CDI isolation cohort area. This compelled us to address the training that nurses and other healthcare workers received in topics related to infection prevention and control, and take a new initiative that has proven very successful, the Infection Control Passport.

Development Of The Infection Control Passport
As part of the management program to reduce the number of CDI within the trust and to improve patient care outcomes, the Infection Control Team (ICT) devised a nursing educational program – the Infection Control Passport – to support the principles of standard infection control practice and precautions, which had hitherto not been fully understood or practiced by clinical staff.

The program was originally developed to be delivered over five, non-consecutive days, a one-hour session each day. Components of the Infection Control Passport include correct hand decontamination, appropriate use of personal protective clothing, effective environmental hygiene and decontamination, waste management, including sharps and clinical equipment and practice. The epidemiology and management of infections of significance – such as Methicillin resistant Staphylococcus aureus (MRSA), Clostridium difficile, norovirus and blood borne viruses are also covered with the principles of the Standard applied to practice. In order to minimize disruption to the clinical team, and maximize patient benefit, employees were given a six-week period to complete their Passport. On completion of the first 30 passports in the pilot project, and a comprehensive evaluation of the program, and documented evidence of a reduction in Clostridium difficile infection rates, the infection control team proposed an extension of the program to a further four clinical areas.

Following the success of the revised program, additional evaluation was undertaken and further reduction of CDI, the Infection Control Passport has now developed into a fully day of theory delivered by the infection control team and consultant microbiologists. The participants still have six weeks to complete their competencies with an infection control nurse. On completion of the training, staff are viewed as champions and role models for excellence in infection prevention and control within their clinical areas.

To date over 400 clinical staff out of a total of 2000 have completed the passport and the passport has become a mandatory educational program for all newly appointed nurses. Since June 2008 the Infection Control Passport has been further developed in order to expand into other departmental specialties and grades of staff such as phlebotomy and junior doctors.