Exploring patient participation in reducing health-care-related safety risks

Patient participation in hand hygiene in Bulgarian health care
and promote a health-and-safety culture in the population, which will be an important
factor in epidemic or pandemic prevention and control.
Patients will be targeted with leaflets, posters and other measures to raise their awareness
and will be asked to complete questionnaire surveys to assess baseline and outcomes
(17). National goals will also include an audit of compliance with hand hygiene and use
of ABHR.
Formal infection control education
Nurses in Bulgaria can specialize in hospital hygiene/HAI prevention and control by
taking a basic training course. Currently, there are 165 graduates.
The national infection control training programme for doctors uses the IPSE core
curriculum. It was developed in response to Ordinance No. 34 of 29 December 2006
on the Acquisition of Specialty in a Healthcare System (SG No. 7 of 23 January 2007;
updated by SG No. 50 of 3 July 2012), which identifies “prevention and control of HAI”
as a new medical postgraduate qualification. Medical doctors with a therapeutic, surgical,
clinical diagnostic or prophylactic specialist background can take the programme.
HAI training for clinical medical and nursing staff is part of the CME system. Training
courses regularly held for clinical specialists and nurses include:
» seminars in health care facilities and national symposia with training modules;
» courses on diagnostic methods, risks for staff and patient safety in organ
transplantation (provided by the National Agency for Transplantation); and
» training in infection control based on the IPSE core curriculum for infection
control practitioners.
Patient safety and HCW protection are included in the curricula of these courses.
Existing infection control training programmes will be further developed by expanding
coverage and addressing additional target audiences such as medical students (medical/
dental, medicine/pharmacology) and primary health care (PHC) professionals.
Initiatives to raise public awareness of, and provide education about, patient safety and
prevention of HAIs are scheduled to be started in schools and within communities.
Survey using hand hygiene self-assessment framework in hospitals
NRC−HAI organized a national survey (18) based on the WHO self-assessment
framework on hand hygiene (19) as part of the 2011 national hand hygiene campaign.
Its aim was to evaluate existing resources and implementation of the WHO hand
hygiene standards at hospital level. Thirty-nine acute care hospitals participated. The
overall results indicate that work on hand hygiene is progressing at hospital level, with
59% of participating hospitals in the survey’s “intermediate or consolidation” category.
The hand hygiene self-assessment framework (19) looks at: system change (part 1);
training and education (part 2); evaluation and feedback (part 3); reminders in the
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