A brief history of 70-years’ hospital IPC in Australia
Lyn Gilbert1
1Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney
Modern hospital infection prevention and control (IPC) in Australia, had its roots in the 1940s/50s, when outbreaks of hospital-acquired ‘Staphylococcus pyogenes’ surgical and neonatal infections were first described and investigated. In the 1960s, increasing surgical site infection (SSI) rates and antibiotic resistance prompted bacteriologists and surgeons, collaboratively, to appoint the first ‘infection control nurses’ (ICNs), in Brisbane, 1962 and Sydney, 1965 (when MRSA was first identified) and, gradually, in other states and more hospitals.
ICNs’ main task, initially, was SSI surveillance, which they combined with daily ward visits and on-the-spot staff coaching, but they rapidly became involved and influential in all aspects of hospital practice – cleaning, sterilisation, ventilation, and aseptic technique – often with technical and moral support from hospital microbiologists. However, in the 1970s, when ICNs were required for hospital accreditation, many were appointed without role definition or training. Local support and education groups formed; they amalgamated, in 1985, into AICA, and ACIPC in 2011. Opportunities for training, ICP appointments and recognition of IPC as a critical subspeciality increased, gradually but haphazardly.
Meanwhile emerging viral infections – HBV, HIV, HCV, SARS-CoV-1, H1N1pdm09, MERS-CoV, Ebola – have raised awareness and improved IPC practice, intermittently, but complacency has returned between crises. Although hand hygiene compliance has increased and MRSA prevalence and SABSI rates have fallen, AMR and preventable HAIs persist, and national HAI surveillance is elusive.
Will the aftermath of COVID-19 be different? How can we consolidate the lessons, maintain IPC awareness and embed best practice and resilience into the future?
Biography:
Lyn Gilbert is an infectious disease physician, clinical microbiologist, and University of Sydney professor and senior researcher at Marie Bashir Institute for Infectious Diseases and Biosecurity. She has nearly 50 years’ experience in diagnosis, surveillance, prevention and control of infectious diseases of public health importance. For 25 years, she was director of Clinical Microbiology at ICPMR, Westmead and clinical lead in infection prevention and control (IPC).
After a long career in clinical medicine and microbiological research, she has concentrated on applied ethics research, over the past 5-10 years, focusing on aspects of IPC, and gained experience in qualitative research methods including video-reflexive ethnography.
From February 2020 to March 2021, she was chair of the national Infection Control Expert Group (ICEG) that advises the Australian Health Protection Principal Committee (AHPPC) on COVID-19 and, since March 2020, has conducted four independent reviews of COVID-19 outbreaks in residential aged care facilities in Australia.