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PLACE YOUR
LOGO HERE
ANNUAL
2019
REVIEW
Introduction
About Us
Mona
Mona, IC Manager
Previous experience
AICpd(Arab Institute for Continuing Professional Development), CBIC cerified, 2 JCI accreditation experience through 10 years included 4 years as leader of IC
Hard worker, accountable,Dedicated
2 years Work experience In KNH added to my CV 3rd JCI experience And CBAHI, added to communication skills,knowledge
IC Targeted Customers
Target 2
Target 3
Target 1
Target 4
Patient
Staff
MOH
Visitors
Profile 1 (targeted Customers)
Mission
Infection Prevention and Control Mission
To promote safe, quality, excellent care to our patients, staff, and visitors through prevention and control of infections, using sound epidemiological.
Profile
6- Linen Management
IC & Nursing
Feedback of Compliance
1- Patient safety
Polices
Implementation thru Training & Audit
5- Staff health program
Profile 2 (Collaboration with other Departments)
Monitoring them & vaccination
2- Reporting
IC Link
4- CSSD
3- Member of IC committee & Outbreak
MOH laws & IC
Standards
- Nursing Director & supervisor
Accreditation Achievement
For 2018
Achievement
Goal 1
CBAHI Re-accreditation
My IPC Score target was 80%, the result is exceptional
Goal 2
JCI - Accreditation with Score 97.3 %
PCI score target As per JCI standard was 94% , result i expectational
GLD, ACC, SQE, ASC score target As per JCI standard was 95% , result i expectational
FMS , MMU, score target As per JCI standard was 92% , result i expectational
Goal 3
Communicable disease online reporting system
PROJECT
DEEP DIVE
2018 Project 1
Hand Hygiene
Improvement project - 6.3.1.3-5 strategic
Plan 2018
Project 2
2- SSI improvement project
Item 2
2
Item 1
Item 4
4
Item 3
3
Project 3
3-HK improvement project - 6.3.1.3-5
in Strategic plan for 2018
Financial - We don't buy anew Cleaning cart for each Dept.
Project 4
3-linen management - 2.2.1.9-6
in Strategic plan for 2018
Financial - We don't buy anew linen car t for each Dept.
PROJECT
DEEP DIVE
Project 1
Project 1
Project 2
Project 2
Item 2
2
Item 1
1
Item 4
4
Item 3
3
Project 3
Project 3
SUCCESS
STORIES
Timeline
Timeline
2018
First to make - Drill Sudden influx of infectious patient
Improve CSSD Workflow
Endoscopy Storage
Vaccination Day Celebration with promotion Offer
Infection control Program and HAI prevention strategies
Antibiogram
Hepatitis Day Celebration with promotion Offer Day Celebration with promotion Offer
Q3
Q1
Q3
Q2
Q4
Q43
Q2
Numbers
Numbers
Key Partners
Key Partners
Leadership
IC links in Each Dept.
FMS
Nursing
IC links in Each Dept.
Medical
Supply chain
Laboraotory
IT
IC
People to thank
People to thank
Timeline
Timeline
2019
6.3.1.3-5
in Strategic plan for 2018
Improve CSSD Workflow
Maintain MOH audit score
Antibiotic
Hand Hygiene Celebration & Workshop
Infection control Program and HAI prevention strategies
Q1
Q2
Q4
Q3
Q2
SUCCESS
STORIES
Timeline
Timeline
2018
First to make - Drill Sudden influx of infectious patient
Improve CSSD Workflow
Endoscopy Storage
Vaccination Day Celebration with promotion Offer
Infection control Program and HAI prevention strategies
Antibiogram
Hepatitis Day Celebration with promotion Offer Day Celebration with promotion Offer
Q3
Q1
Q3
Q2
Q4
Q43
Q2
Numbers
Numbers
Key Partners
Key Partners
Leadership
IC links in Each Dept.
Nursing
IC links in Each Dept.
Medical
Supply chain
Laboraotory
IT
IC
People to thank
People to thank
People to thank
Timeline
Timeline
2019
6.3.1.3-5
in Strategic plan for 2018