• Ensuring the core principles of infection control are supported in all countries and settings, including water, sanitation and hygiene.
• Preventing infections through vaccinations.
• Reducing exposure to antibiotics unrelated to treating human disease.
• Minimising the use of antibiotics when they are not necessary to improve human health—such as treating viral infections.
• Maintaining investment in the development pipeline for new antibiotics.

This article looks at an infection prevention and control (IPC) campaign called 'keep it simple', which was recognised as outstanding work. Focusing on six themes; surveillance, invasive devices, multidisciplinary groups, PPE, lessons learnt and environmental cleanliness, the campaign used simple messaging to communicate the importance of IPC to patients, staff and visitors.

A multifaceted approach (page 25)

This article looks at the IPC improvement work that led to CQC conditions being lifted. Dr Sara Mumford shares how they used video to engage with staff around PPE, including producing a version in Nepali to reflect the needs of their workforce. She also talks about the importance of decluttering wards, improving patient flow and turnaround.

Using domestic air purifiers to reduce Covid-19 transmission (page 30)

This article looks as how domestic air purifiers were used to clear the air quickly in poorly ventilated spaces, reducing the risk of Covid-19 transmission.

Follow the link below to read the articles in full.

• inadequate cleaning before sterilisation (34%)
• immediate-use steam sterilisation (also known as flash sterilisation) issues (12%)
• holes in wrappers (11%)
• instruments not sterilised in time for case (10%)
• vendor instrument issue (9%).

Of the events in which inadequate cleaning before sterilisation was identified as a factor, the instruments were identified as the following (percentages do not add up to 100% because of rounding):

• Complex instrument (39%)
• Cannulated or lumened instrument (35%)
• Simple noncomplex instrument (9%)
• Other or unidentified (16%).

ECRI Institute PSO recommends the following:

• Emphasise to all personnel involved in reprocessing (cleaning and disinfection or sterilisation) reusable medical devices—including clinical and central sterile department staff—that omitting any of the cleaning steps in the reprocessing protocol can lead to deadly infections.
• Assess the organisation's reprocessing program to identify and rectify factors that could contribute to poor instrument cleaning.
• Review reprocessing procedures to ensure that they are comprehensive and easily accessible to all personnel involved in the cleaning process.
• Review procedures periodically to confirm that they are aligned with current manufacturer recommendations for cleaning.
• Review compliance with reprocessing procedures to ensure that they are being following appropriately and that fail-safes are in place to prevent contaminated instruments from reaching the field or patient.
• Assess competency on an ongoing basis, and provide refresher training at regular intervals to help staff sustain competency. The U.S. Centres for Disease Control and Prevention (CDC) recommends that training be provided at least once a year (CDC 2015).
• Prevent productivity pressures from forcing staff to deviate from the cleaning instructions for the instruments at hand.
• Seek input from reprocessing staff when assessing new instruments for purchase.
• Foster regular communication between reprocessing staff and the clinical departments they support.