The draft of National Health Policy 2015 is under discussion and process of finalization. Issues of healthcare quality, maternal and neonatal health, communicable diseases, infor- mation technology, affordable and accessible healthcare, health as a fundamental right and justiciable healthcare are some of the key focus areas in the draft. Most of the focus areas of the draft will have a direct bearing on the patient safety. Numerous discussions on the National Health Policy Draft 2015 are available but none relate to the issue of patient safety specifically. This paper analyses the Policy Draft with a focus on patient safety regulatory needs in India.

HealthCare Associated Infections (HCAIs) are increasingly considered to be preventable adverse events, which require prioritized global attention. In the face of increasing antimi- crobial resistance, prevention remains the best method to curb these infections. Surveil- lance of HCAIs and antimicrobial resistance using standard methods is becoming a model for prevention. Surveillance identifies the rates of HCAIs, the areas for intervention and improvement, as well as the impact of those preventive interventions. Objectivized defini- tions, algorithmic diagnosis and electronic databases have made surveillance systems more user-friendly and effective over time. The scope of surveillance is ever-widening with increasing need for post-discharge surveillance, day-care and home-based treatment and the technology revolution. This review provides an overview of the global health care associated infection surveillance systems and recent innovations therein.

Background: Methicillin resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. A strong correlation between the invasive and the nasal carriage strains in the patients has been well established indicating the need to eliminate the carriage of MRSA to prevent the transmission. The objectives of this study are to assess the prevalence of MRSA colonisation in patients from ICUs and high risk wards for a period of 33 months, (2011-2013) by routine active surveillance culture, and also to evaluate the role of extra-nasal sites in the screening. Methods: The nasal and extra-nasal specimens were obtained from patients using sterile cotton swab. Staphylococci were identified based on colony morphology on blood agar, Gram's staining and coagulase test. The Staphylococcus aureus (S. aureus) isolates were screened for methicillin resistance by Kirby-Bauer disc diffusion method using oxacillin (1 mg) and cefoxitin (30 mg) discs and reported according to CLSI guidelines. Results: Out of the 5372 nasal samples tested, S. aureus was identified in 14.1% patients. The rate of methicillin resistance was 31.7% of the total S. aureus isolates. The overall prevalence of MRSA was 4.5%. Out of 219 extra-nasal samples tested, 4.1% of the patients carried MRSA in sites like axilla and groin without nasal carriage. Conclusion: Our results encourage us to continue with the screening program so as to prevent the high risk patients contracting endogenous infections thus controlling the transmission and spread and also the addition of extra-nasal site; either axilla or groin might increase the screening efficiency in non nasal colonisers.

Background: Hand hygiene is the most cost effective method to control the health care associated infections. Despite knowing the fact the compliance of health care professionals with hand hygiene is not up to the mark. Methods: An observational, prospective study was designed to assess knowledge, and attitude of health care professionals towards hand hygiene practices. The impact of hand hygiene awareness programme (HHAP) on the compliance of 106 health care professionals working in paediatric medical and surgical wards of a tertiary care hospital was also evaluated. Clinical audit comprised of 200 observations each before and after the HHAP was done. Results: Of total 106 health care professionals 73 (68.8%) were nurses, 33 (31.13%) doctors with mean age (years) of 32.14 ± 7.4. Mean knowledge and attitude scores of HCP were 19.28 ± 2.4and 39.26 ± 3.9 respectively. Majority HCP had good knowledge (91/106, 85.8%) and favourable attitude (89/106, 83.9%) related to hand hygiene practices. Significant improve- ment in hand hygiene compliance was observed among the health care professionals following the hand hygiene awareness programme ( p < 0.001). Conclusion: Hand hygiene awareness programme should be continued on ongoing basis to improve the compliance of HCP with hand hygiene practices.

Aims: The aims of this study were to assess errors that occurred during the prescribing and administration of intravenous (IV) anti-infective therapy with standard infusion devices and to retrospectively determine preventability with smart pump technology. Methods: Data was collected at the Peninsula Health Frankston Hospital, Melbourne, Australia. Errors in terms of non-adherence to the hospital's IV prescribing and administra- tion protocols as well as administration and formal prescribing errors were defined. Pre- ventability using the smart pump technology was determined based on a retrospective evaluation. Results: IV medication errors occurred frequently: almost half (42/100) anti-infectives used with standard infusion pump technology were associated with errors. Non-adherence to protocols in prescribing or administration was identified as the most common source for errors (n = 35) followed by administration (n = 12) and prescribing (n = 3) errors. Thirty-two out of 50 (64%) errors including those rated to be most severe were considered to be preventable if smart pump technology had been implemented. Conclusions: Errors happened frequently with the use of standard infusion devices. Errors in terms of non-adherence to protocols/guidelines were the most common and administration was identified as the stage in the medication-use process that is most susceptible to errors. The most severe errors were those likely to be reduced by the implementation of smart pump technology. Factors other than technology have to be emphasized as well, e.g. standardization of doctors' and nurses' practices on the wards in order to reduce errors in the future.