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Asgedom AA. Status of infection prevention and control (IPC) as per the WHO standardised Infection Prevention and Control Assessment Framework (IPCAF) tool: existing evidence and its implication. Infect Prev Pract 2024; 6:100351. [PMID: 38469414 PMCID: PMC10926125 DOI: 10.1016/j.infpip.2024.100351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
Healthcare settings have a high prevalence of infectious agents. This narrative review examines the existing evidence regarding infection prevention and control (IPC) using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool in healthcare facilities. A total of 13 full length papers from Africa, Asia and Europe were considered for this review. The findings showed that there are discrepancies in the IPCAF values from insufficient to advanced level. The current review shows an advanced IPCAF level in middle income and high income countries. Low income countries showed a lower IPCAF score. There is a need to enhance the IPC capacity building and to supply infection prevention resources to prevent healthcare associated infection (HAI) with a focus on low income countries.
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Affiliation(s)
- Akeza Awealom Asgedom
- Department of Environmental Health Science, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Parra LM, Cantero M, Ortí-Lucas RM, Salcedo-Leal I, Asensio Á. Evaluation of infection prevention and control programmes according to the European Centre for Disease Prevention and Control and the World Health Organization in Spain 2012-2022: indicators of core component 1. J Hosp Infect 2024; 147:17-24. [PMID: 38432588 DOI: 10.1016/j.jhin.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Key and core components of effective infection prevention and control programmes (IPCPs) issued by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) have been described. WHO core component 1 relates to the structure, organization and management of IPCPs. AIM The objective of this study was to assess the status and the time trends of some indicators of core component 1 of IPCPs in acute hospitals in Spain throughout the period 2012-2022. METHODS Hospital-level data from the Spanish point prevalence survey for years 2012-2022 were analysed. Core component 1 indicators were calculated and tested for association to healthcare-associated infections (HAIs). In addition, trends were also examined. RESULTS Overall, 67.0% and 57.2% of Spanish hospitals reported having an annual infection prevention and control (IPC) plan and an annual IPC report that was approved by the hospital managing director, respectively. The global median number of full-time equivalent (FTE) IPC nurses per 250 beds for the period was 0.87 and the global median number of FTE IPC doctors was 0.70. The rates of blood cultures and stool tests for Clostridioides difficile were 39.9 and 6.1 per 1000 patient-days, respectively. No significant correlation was found between core component 1 indicators and HAI prevalence. CONCLUSION Spain is currently at a basic level on the structure, organization and management of IPCPs. Profound differences were found between hospitals depending on size and type.
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Affiliation(s)
- L M Parra
- Preventive Medicine Department, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Spain; Spanish Society of Preventive Medicine, Public Health and Health Management, Madrid, Spain.
| | - M Cantero
- Preventive Medicine Department, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Spain; Spanish Society of Preventive Medicine, Public Health and Health Management, Madrid, Spain
| | - R M Ortí-Lucas
- Preventive Medicine Department, University Clinical Hospital of Valencia, Valencia, Spain; Spanish Society of Preventive Medicine, Public Health and Health Management, Madrid, Spain
| | - I Salcedo-Leal
- Preventive Medicine Department, Reina Sofia Hospital, Cordoba, Spain; Spanish Society of Preventive Medicine, Public Health and Health Management, Madrid, Spain
| | - Á Asensio
- Preventive Medicine Department, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Spain; Spanish Society of Preventive Medicine, Public Health and Health Management, Madrid, Spain
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Vicentini C, Bussolino R, Gastaldo C, Castagnotto M, D'Ancona FP, Zotti CM. Level of implementation of multimodal strategies for infection prevention and control interventions and prevalence of healthcare-associated infections in Northern Italy. Antimicrob Resist Infect Control 2024; 13:39. [PMID: 38605378 PMCID: PMC11010422 DOI: 10.1186/s13756-024-01398-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND In November 2022, Italy participated in the third edition of the European Centre for disease prevention and control (ECDC) point prevalence survey (PPS) of healthcare-associated infections (HAIs) in acute-care hospitals. A questionnaire based on the WHO infection prevention and control assessment framework (IPCAF) was included, which aims to investigate multimodal strategies for the implementation of IPC interventions. METHODS A PPS was conducted using the ECDC PPS protocol version 6.0. The Regional health authority of the region of Piedmont, in north-western Italy, chose to enlist all public acute-care hospitals. Data were collected within one day per each ward, within 3 weeks in each hospital, at hospital, ward and patient level. A score between 0-1 or 0-2 was assigned to each of the 9 items in the IPCAF questionnaire, with 14 points representing the best possible score. HAI prevalence was calculated at the hospital-level as the percentage of patients with at least one HAI over all included patients. Relations between HAI prevalence, IPCAF score, and other hospital-level variables were assessed using Spearman's Rho coefficient. RESULTS In total, 42 acute-care hospitals of the region of Piedmont were involved, with a total of 6865 included patients. All participant hospitals reported they employed multimodal strategies to implement IPC interventions. The median IPCAF overall score was 11/14 (interquartile range, IQR: 9.25-12). The multimodal strategy with the highest level of adherence was education and training, followed by communication and reminders. Strategies with the lowest level of adherence were safety climate and culture of change, and system change. Overall HAI prevalence was 8.06%. A weak to moderate inverse relation was found between IPCAF score and HAI prevalence (Spearman's Rho -0.340, p 0.034). No other significant correlation was found. CONCLUSIONS This study found a high self-reported overall level of implementation of multimodal strategies for IPC in the region. Results of this study suggest the relevance of the multimodal approach and the validity of the IPCAF score in measuring IPC programs, in terms of effectiveness of preventing HAI transmission.
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Affiliation(s)
- Costanza Vicentini
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy.
| | - Roberta Bussolino
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Claudia Gastaldo
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Marta Castagnotto
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Fortunato Paolo D'Ancona
- Epidemiology, Biostatistics and Mathematical Modeling Unit (EPI), Department of Infectious Diseases, Istituto Superiore Di Sanità (ISS), Viale Regina Elena 299, 00161, Rome, Italy
| | - Carla Maria Zotti
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
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Ahmed A, Hossain L, Banik G, Sayeed A, Sajib MRUZ, Hasan MM, Hoque DE, Hasan ASM, Raghuyamshi V, Zaman S, Akter E, Nusrat N, Rahman F, Raza S, Hasan MR, Uddin J, Sarkar S, Adnan SD, Rahman A, Ameen S, Jabeen S, El Arifeen S, Rahman AE. Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control: a multi-centre study in Bangladesh. J Hosp Infect 2024; 145:22-33. [PMID: 38157940 DOI: 10.1016/j.jhin.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh. AIM Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh. METHODS We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities. RESULTS The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level. CONCLUSION The integrated intervention package improved IPCAF score in all facilities.
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Affiliation(s)
- A Ahmed
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - L Hossain
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - G Banik
- Health and Nutrition Sector, Save the Children, Dhaka, Bangladesh
| | - A Sayeed
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R U-Z Sajib
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois Urbana-Champaign, USA
| | - M M Hasan
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | | | | | - E Akter
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - N Nusrat
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | - F Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Raza
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R Hasan
- Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh
| | - J Uddin
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - S Sarkar
- Hospital Service Management, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S D Adnan
- Hospital and Clinics, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - A Rahman
- Communicable Disease Control, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S Ameen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Jabeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S El Arifeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A E Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Aghdassi SJS, Saydan S, Behnke M, Clausmeyer J, Gastmeier P, Geffers C. Surveillance of infections of surgical sites and lower respiratory tracts should be combined: experiences from the German surveillance module for operated patients (OP-KISS), 2018 to 2022. Euro Surveill 2024; 29:2300416. [PMID: 38487888 PMCID: PMC10941308 DOI: 10.2807/1560-7917.es.2024.29.11.2300416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/16/2023] [Indexed: 03/17/2024] Open
Abstract
BackgroundSurveillance of lower respiratory tract infections (LRTI) of operated patients conventionally focuses on intubated patients in intensive care units (ICU). Post-operative immobilisation increases the risk of LRTI not associated with ventilators. Operated patients, however, have thus far not been a primary target for LRTI surveillance.AimWe aimed to describe the applied LRTI surveillance method in the German surveillance module for operated patients (OP-KISS) and to report data between 2018 and 2022.MethodsSurveillance of LRTI can be performed voluntarily in addition to surgical site infection (SSI) surveillance in OP-KISS. We calculated LRTI rates per 100 operations for all procedures combined, as well as for individual surgical groups and procedures. Additionally, a combined post-operative infection rate (SSI and LRTI) was calculated.ResultsSurveillance of LRTI was performed in 4% of all participating OP-KISS departments and for 2% (23,239 of 1,332,438) of all procedures in the OP-KISS database. The pooled LRTI rate was 0.9 per 100 operations, with marked differences between different types of surgery (3.6 for lobectomies, 0.1 for traumatology and orthopaedics). The share of LRTI among all post-operative infections was highly variable. For lobectomies, the LRTI rate was higher than the SSI rate (3.6 vs 1.5 per 100 operations).ConclusionSurveillance of post-operative LRTI is not yet widely adopted by German hospitals. Based on the data in this study, lobectomies represent a prime target for post-operative LRTI surveillance.
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Affiliation(s)
- Seven Johannes Sam Aghdassi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany
- National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Berlin, Germany
| | - Selin Saydan
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany
- National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - Michael Behnke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany
- National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - Jörg Clausmeyer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany
- National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - Petra Gastmeier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany
- National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - Christine Geffers
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany
- National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
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Gastaldi S, Festa MG, Nieddu A, Zavagno G, Cau E, Barbieri C, Beccaria E, D'Ancona F. Identification of essential contents and a standard framework for the development of an Infection Prevention and Control manual for healthcare facilities: A scoping review. Am J Infect Control 2024; 52:358-364. [PMID: 37689122 DOI: 10.1016/j.ajic.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Several international organizations have outlined the components of infection prevention and control (IPC) programs. To successfully implement an IPC program, hospital staff may adopt a manual that provides support for implementing the IPC measures, even requiring significant efforts. This study aims to identify essential aspects and develop a standardized structure for an IPC manual. The IPC manual framework can be customized and utilized by any health care facility, thereby facilitating adherence to international and national legislation. METHODS The study was conducted using the Joanna Briggs Institute methodology for scoping reviews. Reporting followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews standard. The search for evidence was performed on PubMed and Web of Science. Methodological quality was evaluated blindly by 2 reviewers using the Critical Appraisal Skills Program checklist. RESULTS Nineteen papers were included in the review. Data extraction considered the most recent guidelines and the categorization into the 8 Core Components established by the World Health Organization. Through the literature review, the essential elements and challenges of an IPC hospital manual were identified, and a framework was proposed. CONCLUSIONS By incorporating these essential elements into their IPC manual, health care facilities can establish a robust IPC framework. A potential future development stemming from this work could involve the creation of a standardized national IPC manual tailored for hospital settings.
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Affiliation(s)
- Silvana Gastaldi
- National Association of Nurses for Prevention of Hospital Infections (ANIPIO), Bologna, Italy.
| | | | - Alma Nieddu
- HAI Group Contact, Hospital and Territory Clinical Government Operating Unit, USL Parma, Parma, Italy
| | - Giulia Zavagno
- Sant'Antonio Hospital, San Daniele del Friuli (ASUFC-Azienda Sanitaria Universitaria Friuli Centrale), Udine, Italy
| | - Ennio Cau
- Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco", Catania, Italy
| | - Corinna Barbieri
- AULSS 3 Serenissima, Medical Department Ospedale dell'Angelo - Mestre, Venice, Italy
| | | | - Fortunato D'Ancona
- Department of Communicable Diseases, Istituto Superiore di Sanità, Rome, Italy
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Keil V, Schaumburg T, Buchta F, Luz JK, Kolbe-Busch S, Chaberny IF, von Lengerke T. Improving leadership skills of infection prevention and control teams by psychological empowerment: study protocol for a cluster randomised controlled trial (IP-POWER). BMJ Open 2024; 14:e083806. [PMID: 38346888 PMCID: PMC10862334 DOI: 10.1136/bmjopen-2023-083806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION Infection prevention and control (IPC) teams are routinely confronted with intense emotions in their daily work, as they are involved in many change processes with front-line medical staff, for example, when promoting compliance with basic IPC measures. In addition, they are confronted with challenges due to their role as intermediaries. Based on former research, this study aims to empower IPC teams to promote clinicians' compliance through interventions focusing on the IPC teams' leadership skills. METHODS AND ANALYSIS The IP-POWER study (Infection Prevention with head and heart: Psychological empowerment of IPC teams), a multicentre, two-arm, non-blinded, cluster-randomised controlled trial with a parallel waiting control group, is planned to be conducted in Germany as of February to November 2024. A group of 10 voluntary hospitals is going to participate in a multistage intervention programme, including 2 days of intense psychological training; 5 hospitals will be randomly assigned to the waiting control group. After the workshops, there will be a 12-week follow-up period during which the contents learnt within the workshops can be applied and internalised into IPC practice. The proposed outcomes (both self-assessed and other-assessed leadership competencies of IPC team members and their task profiles, perceived workload, motivation to act in order to implement IP measures and goal attainment) are going to be collected with an online questionnaire, followed by an analysis with IBM SPSS (Statistics 29 (or later)) using descriptive analyses and multiple linear regressions. Additionally, as external data sources, hand hygiene compliance rates from the study hospitals' monitoring systems will be analysed using χ² tests. ETHICS AND DISSEMINATION This study was reviewed and approved by the ethics committee of the University of Leipzig (184/23-ek; vote from 4 July 2023). Findings will be disseminated via peer-review publications, and national and international conference presentations. TRIAL REGISTRATION NUMBER DRKS00031879.
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Affiliation(s)
- Valentine Keil
- Hannover Medical School, Department of Medical Psychology, Hannover, Germany
- University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany
| | - Tiffany Schaumburg
- University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany
| | - Frederike Buchta
- University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany
| | - J Katrin Luz
- University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany
| | - Susanne Kolbe-Busch
- University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany
| | - Iris Freya Chaberny
- University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany
- Christian-Albrecht University of Kiel, University Medical Center Schleswig-Holstein, Institute of Hospital Epidemiology and Environmental Hygiene, Kiel, Germany
| | - Thomas von Lengerke
- Hannover Medical School, Department of Medical Psychology, Hannover, Germany
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Cissé DM, Laure EEM, Blaise KA, Jean Paul NN, Gbonon MV, Mayaka CRA, Eugénie GD, Simplice DN, Philippe KL, Mamadou S. Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the autonomous district of Abidjan (Cote d'Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF). BMC Health Serv Res 2023; 23:870. [PMID: 37587467 PMCID: PMC10433570 DOI: 10.1186/s12913-023-09853-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION As part of the implementation of its mission "to integrate hygiene activities into healthcare", the general directorate of health conducted in 2018 with its technical structures, an evaluation of the implementation of Infection Prevention and Control (IPC) using the WHO IPCAF tool in 30 health-care facilities in the autonomous district of Abidjan. MATERIALS AND METHODS This were a cross-sectional survey with a conceptualized component considering the issue of injection safety and sanitary waste management, which was conducted in the named health-care facilities from March 20 to 28, 2018. The scores of the essential components of the IPC made it possible to assess the IPC level of each health-care facility evaluated and the overall IPCAF score of all facilities. RESULTS The overall median IPCAF score of the health-care facilities was 242.5/800 and corresponded to an inadequate level overall. No facility reached the "advanced" level of performance, 5 facilities (17%) reached the "intermediate" level, 10 (33%) fell into the "basic" level, and 15 (50%) were at the "inadequate" level. Baseline institutions had much higher scores than first contact institutions. CONCLUSION IPC component activities were inadequate and fragmented in the under-resourced health facilities at the time of the assessment. It would be appropriate to provide adequate resources and develop expertise in IPC through strong political will and leadership. This will contribute to the achievement of universal health insurance objectives with safe health services for patients.
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Affiliation(s)
- Doumbia Mariamou Cissé
- Minister of Health, Public Hygiene and Universal Health Coverage of Directorate General of Health, BP V 4 Abidjan, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
- Department of Public Health, Felix Houphouët Boigny University, UFR of Pharmaceutical and Biological Sciences, 22 BP 582 Abidjan 22, Abidjan, Côte d'Ivoire
| | - Essis Esme Marie Laure
- National Institute of Public Health, BPV 47 Abidjan, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire.
- Reproductive Health Research Unit of Cote d'Ivoire, BPV 47 Abidjan, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire.
| | - Koné Atioumounan Blaise
- Minister of Health, Public Hygiene and Universal Health Coverage of Directorate General of Health, BP V 4 Abidjan, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
- National Institute of Public Hygiene, BPV 14 Abidjan 01, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
| | - N'gbesso N'gbesso Jean Paul
- Biology and Health Laboratory, University of Félix Houphouët Boigny, 22 B.P. 582, Abidjan 22, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
| | - Mbengue Valérie Gbonon
- Pasteur Institute of Cote d'Ivoire, 01 BP 490 Abidjan 01, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
- Molecular Genetics Platform of the National Reference Center, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
| | - Cissé Raïssa Adja Mayaka
- Department of Public Health, Felix Houphouët Boigny University, UFR of Pharmaceutical and Biological Sciences, 22 BP 582 Abidjan 22, Abidjan, Côte d'Ivoire
| | - Gagne Doh Eugénie
- Directorate of Public Hygiene and Health-Environment, BP V 4 Abidjan, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
| | - Dagnan N'cho Simplice
- Department of Public Health and Biostatistics, Félix Houphouët Boigny University, UFR of Medical Sciences, 01 BP V34, Abidjan, Réf.ECI554. Abidjan, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
| | - Kouadio Luc Philippe
- Department of Public Health, Felix Houphouët Boigny University, UFR of Pharmaceutical and Biological Sciences, 22 BP 582 Abidjan 22, Abidjan, Côte d'Ivoire
- National Institute of Public Hygiene, BPV 14 Abidjan 01, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
| | - Samba Mamadou
- Minister of Health, Public Hygiene and Universal Health Coverage of Directorate General of Health, BP V 4 Abidjan, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
- Department of Public Health Department, UFR of Odonto- stomatology, Félix Houphouët Boigny University, 01 BPV 34 Abidjan 01, CI-AB. IV93. 14/ CI.AB. 110, Abidjan, Côte d'Ivoire
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Montella E, Iodice S, Bernardo C, Frangiosa A, Pascarella G, Santalucia I, Triassi M. Integrated System for the Proactive Analysis on Infection Risk at a University Health Care Establishment Servicing a Large Area in the South of Italy. J Patient Saf 2023; 19:313-322. [PMID: 37366611 PMCID: PMC10373839 DOI: 10.1097/pts.0000000000001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Our study proposes the use of a proactive system to manage risk combining the new Risk Identification Framework by the World Health Organization, the Lean method, and the hospital's Procedure Analysis.The system was tested for the prevention of surgical site infections in the University Hospital of Naples "Federico II" on the surgical paths, where they were usually applied individually. METHODS We conducted a retrospective observational study from March 18, 2019, to June 30, 2019, at the University Hospital "Federico II" of Naples, Italy (Europe).The study is structured in 3 phases: phase 1, application of each proactive risk management tool (March 18-April 15, 2019); phase 2, analysis and integration of the results, and elaboration of an overview of critical and control points (April 15-20, 2019); and phase 3, evaluation of the outcomes as variation of surgical site infection's incidence between the 3-month period of the 2019 and the same period of the 2018, when each tool was implemented separately (April 30-June 30, 2019). RESULTS (1) The application of the single tool has detected different criticalities; (2) the combined system allowed us to draw a risk map and identify "improving" macroareas; and (3) the infection rate, with the application of this system, was equal to 1.9%; in the same period of the previous year, it was equal to 4%. CONCLUSIONS Our study demonstrates that "integrated system" has been more effective to proactively identify surgical route risks compared with the application of each single instrument.
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Affiliation(s)
- Emma Montella
- From the Department of Public Health, University of Naples “Federico II”
| | - Sabrina Iodice
- From the Department of Public Health, University of Naples “Federico II”
| | - Carlo Bernardo
- From the Department of Public Health, University of Naples “Federico II”
| | | | | | - Ida Santalucia
- From the Department of Public Health, University of Naples “Federico II”
| | - Maria Triassi
- Department of Public Health and Interdepartmental Centre for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II,” Naples, Italy
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Listiowati E, Samsudin MA, Wulandari Y, Taritasari C, Mundakir M, Nurmansyah MI. Evaluating infection prevention and control structure of Indonesian COVID-19 referral hospitals. JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2023; 15:1466. [PMID: 37781445 PMCID: PMC10407457 DOI: 10.4102/jamba.v15i1.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/09/2023] [Indexed: 10/03/2023]
Abstract
Due to the emergence of COVID-19, hospitals are required to increase vigilance in providing care. However, their readiness for infection prevention and control (IPC) as a referral hospital in providing COVID-19 services has not been determined. This study aims to evaluate the IPC structure of 30 private non-profit Indonesian referral hospitals for COVID-19 based on the World Health Organization Infection Prevention and Control Assessment Framework (WHO IPCAF). A descriptive cross-sectional quantitative study was used, where 30 hospitals as the COVID-19 referral hospital were selected. The data collection was conducted by an online survey using the IPCAF questionnaire created by the WHO and was analysed with descriptive analysis. The majority of the hospitals' IPC level is at an advanced level (73.3%). All type B hospitals have an advanced IPC level, while only 64.7% of type C and 71.4% of type D have an advanced level. The highest average IPC score is on the IPC guidelines component (94.0), while the lowest value of 71.9 is on the Surveillance of HAIs component. In the minimum scores, there were hospitals with the lowest scores in HAI Surveillance and Multimodal strategies, namely 20.0 and 25.0, respectively. Preparing human resource capacities, establishing functional programmes, developing and implementing IPC guidelines, and providing adequate supplies are needed to improve hospital IPC structures. Contribution This study demonstrates the necessity to improve hospital IPC structures to increase the resilience of health services to natural hazards and public health emergencies.
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Affiliation(s)
- Ekorini Listiowati
- Department of Public Health, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Mohammad A. Samsudin
- Department of Management, Faculty of Economics, Social and Humanities, Universitas Aisyiyah Yogyakarta, Indonesia
| | - Yuanita Wulandari
- Department of Nursing, Faculty of Health Sciences, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | | | - Mundakir Mundakir
- Department of Nursing, Faculty of Health Sciences, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Mochamad I. Nurmansyah
- Department of Public Health, Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah, Jakarta, Indonesia
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11
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Deryabina A, Aiypkhanova A, Juvashev A, Alimbetov K, Tekebayev K, Kassa G, Howard AA. Core components of infection prevention and control programs at the facility level in Kazakhstan: key challenges and opportunities. Antimicrob Resist Infect Control 2023; 12:59. [PMID: 37349829 PMCID: PMC10286477 DOI: 10.1186/s13756-023-01264-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/07/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Kazakhstan is developing a National Roadmap to strengthen its Infection Prevention and Control (IPC), but until recently has lacked a country-wide facility-level assessment of IPC performance gaps. METHODS In 2021, the World Health Organization (WHO)'s IPC Core Components and Minimal Requirements were assessed at 78 randomly selected hospitals across 17 administrative regions using adapted WHO tools. The study included site assessments, followed by structured interviews with 320 hospital staff, validation observations of IPC practices, and document reviews. RESULTS All hospitals had at least one dedicated IPC staff member, 76% had IPC staff with any formal IPC training; 95% established an IPC committee and 54% had an annual IPC workplan; 92% had any IPC guidelines; 55% conducted any IPC monitoring in the past 12 months and shared the results with facility staff, but only 9% used monitoring data for improvements; 93% had access to a microbiological laboratory for HAI surveillance, but HAI surveillance with standardized definitions and systematic data collection was conducted in only one hospital. Adequate bed spacing of at least 1 m in all wards was maintained in 35% of hospitals; soap and paper towels were available at the hand hygiene stations in 62% and 38% of hospitals, respectively. CONCLUSIONS Existing IPC programs, infrastructure, IPC staffing, workload and supplies present within hospitals in Kazakhstan allow for implementation of effective IPC. Development and dissemination of IPC guidelines based on the recommended WHO IPC core components, improved IPC training system, and implementation of systematic monitoring of IPC practices will be important first steps towards implementing targeted IPC improvement plans in facilities.
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Affiliation(s)
- Anna Deryabina
- Mailman School of Public Health, ICAP at Columbia University, 34/1 Samal-3, 050051, Almaty, Kazakhstan.
| | | | - Almat Juvashev
- Mailman School of Public Health, ICAP at Columbia University, 34/1 Samal-3, 050051, Almaty, Kazakhstan
| | - Kuanysh Alimbetov
- National Centre for Public Health of the Ministry, Astana, Kazakhstan
| | - Kanat Tekebayev
- National Centre for Public Health of the Ministry, Astana, Kazakhstan
| | - Getachew Kassa
- Mailman School of Public Health, ICAP at Columbia University, New York, USA
| | - Andrea A Howard
- Mailman School of Public Health, ICAP at Columbia University, New York, USA
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12
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Aghdassi SJS, Goodarzi H, Gropmann A, Clausmeyer J, Geffers C, Piening B, Gastmeier P, Behnke M. Surgical site infection surveillance in German hospitals: a national survey to determine the status quo of digitalization. Antimicrob Resist Infect Control 2023; 12:49. [PMID: 37208780 PMCID: PMC10197484 DOI: 10.1186/s13756-023-01253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Surveillance of surgical site infections (SSI) relies on access to data from various sources. Insights into the practices of German hospitals conducting SSI surveillance and their information technology (IT) infrastructures are scarce. The aim of this study was to evaluate current SSI surveillance practices in German hospitals with a focus on employed IT infrastructures. METHODS German surgical departments actively participating in the national SSI surveillance module "OP-KISS" were invited in August 2020 to participate in a questionnaire-based online survey. Depending on whether departments entered all data manually or used an existing feature to import denominator data into the national surveillance database, departments were separated into different groups. Selected survey questions differed between groups. RESULTS Of 1,346 invited departments, 821 participated in the survey (response rate: 61%). Local IT deficits (n = 236), incompatibility of import specifications and hospital information system (n = 153) and lack of technical expertise (n = 145) were cited as the most frequent reasons for not using the denominator data import feature. Conversely, reduction of workload (n = 160) was named as the main motivation to import data. Questions on data availability and accessibility in the electronic hospital information system (HIS) and options to export data from the HIS for the purpose of surveillance, yielded diverse results. Departments utilizing the import feature tended to be from larger hospitals with a higher level of care. CONCLUSIONS The degree to which digital solutions were employed for SSI surveillance differed considerably between surgical departments in Germany. Improving availability and accessibility of information in HIS and meeting interoperability standards will be prerequisites for increasing the amount of data exported directly from HIS to national databases and laying the foundation for automated SSI surveillance on a broad scale.
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Affiliation(s)
- Seven Johannes Sam Aghdassi
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
| | - Hengameh Goodarzi
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Alexander Gropmann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Jörg Clausmeyer
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Christine Geffers
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Brar Piening
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Petra Gastmeier
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Michael Behnke
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
- National Reference Center for Surveillance of Nosocomial Infections, Hindenburgdamm 27, 12203 Berlin, Germany
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13
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Marme G, Kuzma J, Zimmerman PA, Harris N, Rutherford S. Tuberculosis infection prevention and control in rural Papua New Guinea: an evaluation using the infection prevention and control assessment framework. Antimicrob Resist Infect Control 2023; 12:31. [PMID: 37046339 PMCID: PMC10092912 DOI: 10.1186/s13756-023-01237-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Papua New Guinea (PNG) is one of the 14 countries categorised as having a triple burden of tuberculosis (TB), multidrug-resistant TB (MDR TB), and TB-human immunodeficiency virus (HIV) co-infections. TB infection prevention and control (TB-IPC) guidelines were introduced in 2011 by the National Health Department of PNG. This study assesses the implementation of this policy in a sample of district hospitals in two regions of PNG. METHODS The implementation of TB-IPC policy was assessed using a survey method based on the World Health Organization (WHO) IPC assessment framework (IPCAF) to implement the WHO's IPC core components. The study included facility assessment at ten district hospitals and validation observations of TB-IPC practices. RESULTS Overall, implementation of IPC and TB-IPC guidelines was inadequate in participating facilities. Though 80% of facilities had an IPC program, many needed more clearly defined IPC objectives, budget allocation, and yearly work plans. In addition, they did not include senior facility managers in the IPC committee. 80% (n = 8 of 10) of hospitals had no IPC training and education; 90% had no IPC committee to support the IPC team; 70% had no surveillance protocols to monitor infections, and only 20% used multimodal strategies for IPC activities. Similarly, 70% of facilities had a TB-IPC program without a proper budget and did not include facility managers in the TB-IPC team; 80% indicated that patient flow poses a risk of TB transmission; 70% had poor ventilation systems; 90% had inadequate isolation rooms; and though 80% have personal protective equipment available, frequent shortages were reported. CONCLUSIONS The WHO-recommended TB-IPC policy is not effectively implemented in most of the participating district hospitals. Improvements in implementing and disseminating TB-IPC guidelines, monitoring TB-IPC practices, and systematic healthcare worker training are essential to improve TB-IPC guidelines' operationalisation in health settings to reduce TB prevalence in PNG.
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Affiliation(s)
- Gigil Marme
- Faculty of Medicine and Health Sciences, Department of Public Health and Leadership, Divine Word University, P O Box 483, Madang Province, Papua New Guinea.
| | - Jerzy Kuzma
- Faculty of Medicine and Health Sciences, Department of Medicine, Divine Word University, P O Box 483, Madang Province, Papua New Guinea
| | - Peta-Anne Zimmerman
- School of Nursing and Midwifery, Graduate Infection Prevention and Control Program, Griffith University, Parklands Drive, Southport, QLD, 4215, Australia
| | - Neil Harris
- School of Medicine & Dentistry (Public Health), Griffith University, Gold Coast, QLD, 4215, Australia
| | - Shannon Rutherford
- School of Medicine & Dentistry (Public Health), Griffith University, Gold Coast, QLD, 4215, Australia
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14
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Azak E, Sertcelik A, Ersoz G, Celebi G, Eser F, Batirel A, Cag Y, Ture Z, Ozturk Engin D, Yetkin MA, Kaygusuz S, Candevir A, Tartari E, Rello J, Alp E. Evaluation of the implementation of WHO infection prevention and control core components in Turkish health care facilities: results from a WHO infection prevention and control assessment framework (IPCAF)-based survey. Antimicrob Resist Infect Control 2023; 12:11. [PMID: 36782267 PMCID: PMC9923650 DOI: 10.1186/s13756-023-01208-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/21/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The core components (CCs) of infection prevention and control (IPC) from World Health Organization (WHO) are crucial for the safety and quality of health care. Our objective was to examine the level of implementation of WHO infection prevention and control core components (IPC CC) in a developing country. We also aimed to evaluate health care-associated infections (HAIs) and antimicrobial resistance (AMR) in intensive care units (ICUs) in association with implemented IPC CCs. METHODS Members of the Turkish Infectious Diseases and Clinical Microbiology Specialization Association (EKMUD) were invited to the study via e-mail. Volunteer members of any healt care facilities (HCFs) participated in the study. The investigating doctor of each HCF filled out a questionnaire to collect data on IPC implementations, including the Infection Prevention and Control Assessment Framework (IPCAF) and HAIs/AMR in ICUs in 2021. RESULTS A total of 68 HCFs from seven regions in Türkiye and the Turkish Republic of Northern Cyprus participated while 85% of these were tertiary care hospitals. Fifty (73.5%) HCFs had advanced IPC level, whereas 16 (23.5%) of the 68 hospitals had intermediate IPC levels. The hospitals' median (IQR) IPCAF score was 668.8 (125.0) points. Workload, staffing and occupancy (CC7; median 70 points) and multimodal strategies (CC5; median 75 points) had the lowest scores. The limited number of nurses were the most important problems. Hospitals with a bed capacity of > 1000 beds had higher rates of HAIs. Certified IPC specialists, frequent feedback, and enough nurses reduced HAIs. The most common HAIs were central line-associated blood stream infections. Most HAIs were caused by gram negative bacteria, which have a high AMR. CONCLUSIONS Most HCFs had an advanced level of IPC implementation, for which staffing was an important driver. To further improve care quality and ensure everyone has access to safe care, it is a key element to have enough staff, the availability of certified IPC specialists, and frequent feedback. Although there is a significant decrease in HAI rates compared to previous years, HAI rates are still high and AMR is an important problem. Increasing nurses and reducing workload can prevent HAIs and AMR. Nationwide "Antibiotic Stewardship Programme" should be initiated.
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Affiliation(s)
- Emel Azak
- grid.411105.00000 0001 0691 9040Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Ahmet Sertcelik
- grid.14442.370000 0001 2342 7339Division of Epidemiology, Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Gulden Ersoz
- grid.411691.a0000 0001 0694 8546Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Guven Celebi
- grid.411822.c0000 0001 2033 6079Department of Infectious Diseases and Clinical Microbiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Fatma Eser
- grid.449874.20000 0004 0454 9762Department of Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Türkiye
| | - Ayse Batirel
- grid.488643.50000 0004 5894 3909Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Türkiye
| | - Yasemin Cag
- grid.411776.20000 0004 0454 921XDepartment of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Türkiye
| | - Zeynep Ture
- grid.411739.90000 0001 2331 2603Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
| | - Derya Ozturk Engin
- grid.414850.c0000 0004 0642 8921Department of Infectious Diseases and Clinical Microbiology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Türkiye
| | - Meltem Arzu Yetkin
- grid.411709.a0000 0004 0399 3319Department of Infectious Diseases and Clinical Microbiology, Giresun University Faculty of Medicine, Giresun, Türkiye
| | - Sedat Kaygusuz
- grid.411047.70000 0004 0595 9528Department of Infectious Diseases and Clinical Microbiology, Kirikkale University Faculty of Medicine, Kirikkale, Türkiye
| | - Aslıhan Candevir
- grid.98622.370000 0001 2271 3229Department of Infectious Diseases and Clinical Microbiology, Cukurova University Faculty of Medicine, Adana, Türkiye
| | - Ermira Tartari
- grid.4462.40000 0001 2176 9482Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Jordi Rello
- grid.410675.10000 0001 2325 3084Catedràtic de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Emine Alp
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Türkiye.
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15
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Supriadi IR, Haanappel CP, Saptawati L, Widodo NH, Sitohang G, Usman Y, Anom IB, Saraswati RD, Heger M, Doevendans PA, Satari HI, Voor in ‘t holt AF, Severin JA. Infection prevention and control in Indonesian hospitals: identification of strengths, gaps, and challenges. Antimicrob Resist Infect Control 2023; 12:6. [PMID: 36732802 PMCID: PMC9894741 DOI: 10.1186/s13756-023-01211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/22/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Infection prevention and control (IPC) in hospitals is key to safe patient care. There is currently no data regarding the implementation of IPC in hospitals in Indonesia. The aim of this study was to assess the existing IPC level in a nationwide survey, using the World Health Organization (WHO) IPC assessment framework tool (IPCAF), and to identify strengths, gaps, and challenges. METHODS A cross-sectional study was conducted from July to November 2021. Of all general hospitals in Indonesia, 20% (N = 475) were selected using stratified random sampling based on class (A, B, C and D; class D with a maximum of 50 beds and class A with ≥ 250 beds) and region. The IPCAF was translated into Indonesian and tested in four hospitals. Questions were added regarding challenges in the implementation of IPC. Quantitative IPCAF scores are reported as median (minimum-maximum). IPC levels were calculated according to WHO tools. RESULTS In total, 355 hospitals (74.7%) participated in this study. The overall median IPCAF score was 620.0 (535.0-687.5). The level of IPC was mostly assessed as advanced (56.9% of hospitals), followed by intermediate (35.8%), basic (7.0%) and inadequate (0.3%). In the eastern region of the country, the majority of hospitals scored intermediate level. Of the eight core components, the one with the highest score was IPC guidelines. Almost all hospitals had guidelines on the most important topics, including hand hygiene. Core components with the lowest score were surveillance of healthcare-associated infections (HAIs), education and training, and multimodal strategies. Although > 90% of hospitals indicated that surveillance of HAIs was performed, 57.2% reported no availability of adequate microbiology laboratory capacity to support HAIs surveillance. The most frequently reported challenges in the implementation of IPC were communication with the management of the hospitals, followed by the unavailability of antimicrobial susceptibility testing results and insufficient staffing of full-time IPC nurses. CONCLUSION The IPC level in the majority of Indonesian hospitals was assessed as advanced, but there was no even distribution over the country. The IPCAF in combination with interviews identified several priority areas for interventions to improve IPC in Indonesian hospitals.
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Affiliation(s)
- Indri Rooslamiati Supriadi
- Center for Health Policy on Resilience System and Resource, Health Policy Agency, Ministry of Health of Indonesia, Percetakan Negara 23, Jakarta, Indonesia. .,Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands. .,Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
| | - Cynthia P. Haanappel
- grid.5645.2000000040459992XDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Leli Saptawati
- grid.444517.70000 0004 1763 5731Department of Microbiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia ,Department of Microbiology, Moewardi Teaching Hospital, Surakarta, Indonesia
| | - Nani H. Widodo
- grid.415709.e0000 0004 0470 8161Directorate of Referral Health Care, Ministry of Health of Indonesia, Jakarta, Indonesia
| | - Gortap Sitohang
- grid.487294.40000 0000 9485 3821Infection Prevention and Control Committee, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Yuslely Usman
- grid.415709.e0000 0004 0470 8161Center for Health Financing and Decentralization Policy, Health Policy Agency, Ministry of Health of Indonesia, Jakarta, Indonesia
| | - Ida Bagus Anom
- grid.415709.e0000 0004 0470 8161Directorate of Referral Health Care, Ministry of Health of Indonesia, Jakarta, Indonesia
| | - Ratih Dian Saraswati
- grid.415709.e0000 0004 0470 8161Center for Health Policy on Resilience System and Resource, Health Policy Agency, Ministry of Health of Indonesia, Percetakan Negara 23, Jakarta, Indonesia
| | - Michal Heger
- grid.5477.10000000120346234Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands ,grid.5477.10000000120346234Membrane Biochemistry and Biophysics, Department of Chemistry, Faculty of Science, Utrecht University, Utrecht, The Netherlands ,grid.5645.2000000040459992XLaboratory for Experimental Oncology, Department of Pathology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands ,grid.411870.b0000 0001 0063 8301Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang China
| | - Pieter A. Doevendans
- grid.7692.a0000000090126352Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hindra Irawan Satari
- grid.487294.40000 0000 9485 3821Infection Prevention and Control Committee, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia ,grid.9581.50000000120191471Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Anne F. Voor in ‘t holt
- grid.5645.2000000040459992XDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Juliëtte A. Severin
- grid.5645.2000000040459992XDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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Aiken AM, Nyamwaya B, Madrid L, Edessa D, Labi AK, Obeng-Nkrumah N, Mwabaya W, Chimenya M, Cocker D, Iregbu KC, Princewill-Nwajiobi PIP, Dramowski A, Sonda T, Mmbaga BT, Ojok D, Fwoloshi S, Scott JAG, Whitelaw A. Circumstances for treatment and control of invasive Enterobacterales infections in eight hospitals across sub-Saharan Africa: a cross-sectional study. Gates Open Res 2023; 7:21. [PMID: 38532981 PMCID: PMC10963387 DOI: 10.12688/gatesopenres.14267.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 03/28/2024] Open
Abstract
Background: Bloodstream infections caused by Enterobacterales show high frequency of antimicrobial resistance (AMR) in many Low- and Middle-Income Countries. We aimed to describe the variation in circumstances for management of such resistant infections in a group of African public-sector hospitals participating in a major research study. Methods: We gathered data from eight hospitals across sub-Saharan Africa to describe hospital services, infection prevention and antibiotic stewardship activities, using two WHO-generated tools. We collected monthly cross-sectional data on availability of antibiotics in the hospital pharmacies for bloodstream infections caused by Enterobacterales. We compared the availability of these antibiotics to actual patient-level use of antibiotics in confirmed Enterobacterales bloodstream infections (BSI). Results: Hospital circumstances for institutional management of resistant BSI varied markedly. This included self-evaluated infection prevention level (WHO-IPCAF score: median 428, range 155 to 687.5) and antibiotic stewardship activities (WHO stewardship toolkit questions: median 14.5, range 2 to 23). These results did not correlate with national income levels. Across all sites, ceftriaxone and ciprofloxacin were the most consistently available antibiotic agents, followed by amoxicillin, co-amoxiclav, gentamicin and co-trimoxazole. There was substantial variation in the availability of some antibiotics, especially carbapenems, amikacin and piperacillin-tazobactam with degree of access linked to national income level. Investigators described out-of-pocket payments for access to additional antibiotics at 7/8 sites. The in-pharmacy availability of antibiotics correlated well with actual use of antibiotics for treating BSI patients. Conclusions: There was wide variation between these African hospitals for a range of important circumstances relating to treatment and control of severe bacterial infections, though these did not all correspond to national income level. For most antibiotics, patient-level use reflected in-hospital drug availability, suggesting external antibiotics supply was infrequent. Antimicrobial resistant bacterial infections could plausibly show different clinical impacts across sub-Saharan Africa due to this contextual variation.
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Affiliation(s)
- Alexander M. Aiken
- Infectious Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Brian Nyamwaya
- KEMRI Centre for Geographic Medicine Research, Kilifi, Kenya
| | - Lola Madrid
- Infectious Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Dumessa Edessa
- School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Appiah-Korang Labi
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, University of Ghana, Accra, Ghana
| | - William Mwabaya
- KEMRI Centre for Geographic Medicine Research, Kilifi, Kenya
| | - Mabvuto Chimenya
- Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Derek Cocker
- Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kenneth C. Iregbu
- Department of Medical Microbiology, National Hospital Abuja, Abuja, Nigeria
| | | | - Angela Dramowski
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Tolbert Sonda
- Kilimanjaro Clinical Research Institute-Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Blandina Theophil Mmbaga
- Kilimanjaro Clinical Research Institute-Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Department of Paediatric and Child Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - David Ojok
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Sombo Fwoloshi
- Department of Medicine, University Teaching Hospital, Ministry of Health, Lusaka, Zambia
| | - J Anthony G Scott
- Infectious Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Whitelaw
- National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
- Division of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - MBIRA study collaborators
- Infectious Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
- KEMRI Centre for Geographic Medicine Research, Kilifi, Kenya
- School of Pharmacy, Haramaya University, Harar, Ethiopia
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
- Department of Medical Laboratory Sciences, University of Ghana, Accra, Ghana
- Malawi-Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Department of Medical Microbiology, National Hospital Abuja, Abuja, Nigeria
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Kilimanjaro Clinical Research Institute-Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Department of Paediatric and Child Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Medicine, University Teaching Hospital, Ministry of Health, Lusaka, Zambia
- National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
- Division of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Arns B, Agani CAJO, Sesin GP, Horvath JDC, Fogazzi DV, Romeiro Silva FK, Costa LS, Pereira AJ, Nassar Junior AP, Cavalcanti BT, Dietrich C, Veiga VC, Catarino DG, Cheno MY, Biasi A, Ferronatto BR, Bassetti BR, Fernandes CCF, Deutschendorf C, Grion CMC, Vidal CFDL, de Oliveira CD, Caser EB, Boschi E, Silva EM, Pizzol FD, Urbano HCDA, Silva I, Maia IS, Rego LRDM, Oliveira LP, Tavares MB, Dracoulakis MDA, Bainy MP, Golin NA, Tomba PO, Kurtz PMP, Foernges RB, Prestes RM, de Melo RMV, Da Silva RR, Toledo TGP, Lima VP, Fernandes VDF, Lovato WJ, Zavascki AP. Evaluation of the characteristics of infection prevention and control programs and infection control committees in Brazilian hospitals: A countrywide cross-sectional study. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e79. [PMID: 37179767 PMCID: PMC10173283 DOI: 10.1017/ash.2023.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/11/2023] [Indexed: 05/15/2023]
Abstract
Objective Data are scarce regarding hospital infection control committees and compliance with infection prevention and control (IPC) recommendations in Brazil, a country of continental dimensions. We assessed the main characteristics of infection control committees (ICCs) on healthcare-associated infections (HAIs) in Brazilian hospitals. Methods This cross-sectional study was conducted in ICCs of public and private hospitals distributed across all Brazilian regions. Data were collected directly from the ICC staff by completing an online questionnaire and during on-site visits through face-to-face interviews. Results In total, 53 Brazilian hospitals were evaluated from October 2019 to December 2020. All hospitals had implemented the IPC core components in their programs. All centers had protocols for the prevention and control of ventilator-associated pneumonia as well as bloodstream, surgical site, and catheter-associated urinary tract infections. Most hospitals (80%) had no budget specifically allocated to the IPC program; 34% of the laundry staff had received specific IPC training; and only 7.5% of hospitals reported occupational infections in healthcare workers. Conclusions In this sample, most ICCs complied with the minimum requirements for IPC programs. The main limitation regarding ICCs was the lack of financial support. The findings of this survey support the development of strategic plans to improve IPCs in Brazilian hospitals.
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Affiliation(s)
- Beatriz Arns
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Infectious Diseases Service, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Author for correspondence: Beatriz Arns, MD, Rua Ramiro Barcelos, 630, sala 815. Bairro Moinhos de Vento, Porto Alegre - RS, Brazil. E-mail:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emerson Boschi
- Hospital Geral de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
| | | | | | | | - Iany Silva
- Santa Casa de Misericórdia de São João Del Rei, São João del Rei, Minas Gerais, Brazil
| | - Israel Silva Maia
- HCor Research Institute, São Paulo, Brazil
- Hospital Nereu Ramos, Florianópolis, Santa Catarina, Brazil
| | | | | | | | | | - Marina Peres Bainy
- Hospital Escola Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Pablo Oscar Tomba
- Hospital do Cancer Barretos, Unidade Jales, Jales, São Paulo, Brazil
| | | | | | | | | | | | | | - Valéria Paes Lima
- Hospital Universitário de Brasília, Brasília, Federal District, Brazil
| | | | - Wilson José Lovato
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Prehn Zavascki
- Infectious Diseases Service, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Alvim ALS, Couto BRMG, Gazzinelli A. Qualidade das práticas de profissionais dos programas de controle de infecção no Brasil: estudo transversal. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0229pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
RESUMO Objetivo Analisar a qualidade das práticas de profissionais dos programas de controle de infecção em relação aos componentes de estrutura, processo e resultado. Método Trata-se de um estudo de abordagem quantitativa, do tipo descritivo e transversal realizado em 114 serviços de controle de infecção hospitalar das cinco regiões oficiais do Brasil. Coletaram-se os dados por meio de um instrumento estruturado, cujas propriedades psicométricas foram validadas previamente. O tratamento dos dados foi realizado pela análise de componentes principais e o teste não paramétrico Kruskal-Wallis. Resultados O melhor índice de qualidade dos programas de controle de infecção foi atribuído à região Sul, aos hospitais que continham 300 leitos ou mais, aos que utilizavam o critério National Healthcare Safety Network para vigilância das infecções e aos locais que realizavam busca ativa prospectiva como método de vigilância. Conclusão e implicações para a prática O índice de qualidade dos programas de controle de infecção está relacionado à localização, ao tamanho do hospital e ao método adotado para vigilância de infecções. A criação de um índice de qualidade, até então inédito em estudos nacionais, chama atenção para o desempenho precário dos serviços de saúde.
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Alvim ALS, Couto BRMG, Gazzinelli A. The quality of professional practices in infection control programs in Brazil: a cross-sectional study. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0229en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
ABSTRACT Objective To analyze the quality of professional practices in infection control programs regarding structure, process, and outcome. Method This is a quantitative, descriptive, and cross-sectional study carried out in 114 hospital infection control services in the five official regions of Brazil. The data were collected using a structured instrument whose psychometric properties were previously validated. Data treatment was performed by principal component analysis and non-parametric Kruskal-Wallis test. Results The best quality index of infection control programs was attributed to the South region, to hospitals that had 300 beds or more, to those that used the National Healthcare Safety Network criterion for infection surveillance and to places that carried out an active prospective search as their surveillance method. Conclusion and implications for practice: The quality of infection control programs is related to hospital location, size, and infection surveillance method. The creation of a quality index, hitherto unheard of in Brazilian studies, draws attention to the precarious performance of health services.
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Ni K, Jin D, Wu Z, Sun L, Lu Q. The status of infection prevention and control structures in Eastern China based on the IPCAF tool of the World Health Organization. Antimicrob Resist Infect Control 2022; 11:46. [PMID: 35264208 PMCID: PMC8905555 DOI: 10.1186/s13756-022-01087-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background The burden of healthcare-associated infections (HAIs) and the spread of antimicrobial resistance can be potentially preventable through comprehensive infection prevention and control (IPC) programs. However, information on the current state of IPC implementation is rare in China. Methods A cross-sectional study was conducted in Zhejiang province, China, from April to June 2021. The Zhejiang nosocomial infection control and quality improvement center (NICQI) cooperated with 11 municipal NICQI centers to introduce the purpose of this study and invite all licensed secondary and tertiary hospitals in Zhejiang province through WeChat group. The questionnaire had three sections, including information about participating hospitals, demographic information about IPs, and the Chinese version of the Infection Prevention and Control Assessment Framework that covered eight core components (CC).
Results Of the 382 hospitals invited, 222 (58.1% response rate) accepted and completed the online questionnaire. The overall median score of the participating hospitals was 682 (630–723), which corresponded to an advanced level of IPC. There was a significant difference in scores between hospitals types (P < 0.001). Profound differences were revealed regarding the scores of the individual components, with CC2 (IPC guidelines) and CC6 (Monitoring/audit of IPC practices and feedback) having the highest (100) and lowest (65) median scores, respectively. Only 23 (10.4%) hospitals reported assessing facility safety culture. Conclusions IPC structures are at a relatively high level in acute care hospitals in Eastern China. The identified potential areas for improvement were similar to those identified in developed countries, particularly regarding multimodal strategies for implementation and safety culture construction. Meanwhile, the Chinese government should pay more attention to IPC resources and practices among secondary care hospitals. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01087-x.
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Kimani D, Ndegwa L, Njeru M, Wesangula E, Mboya F, Macharia C, Oliech J, Weyenga H, Owiso G, Irungu K, Luvsansharav UO, Herman-Roloff A. Adopting World Health Organization Multimodal Infection Prevention and Control Strategies to Respond to COVID-19, Kenya. Emerg Infect Dis 2022; 28:S247-S254. [PMID: 36502468 DOI: 10.3201/eid2813.212617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The World Health Organization advocates a multimodal approach to improving infection prevention and control (IPC) measures, which Kenya adopted in response to the COVID-19 pandemic. The Kenya Ministry of Health formed a national IPC committee for policy and technical leadership, coordination, communication, and training. During March-November 2020, a total of 69,892 of 121,500 (57.5%) healthcare workers were trained on IPC. Facility readiness assessments were conducted in 777 health facilities using a standard tool assessing 16 domains. A mean score was calculated for each domain across all facilities. Only 3 domains met the minimum threshold of 80%. The Ministry of Health maintained a national list of all laboratory-confirmed SARS-CoV-2 infections. By December 2020, a total of 3,039 healthcare workers were confirmed to be SARS-CoV-2-positive, an infection rate (56/100,000 workers) 12 times higher than in the general population. Facility assessments and healthcare workers' infection data provided information to guide IPC improvements.
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22
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Jeong Y, Joo H, Bahk H, Koo H, Lee H, Kim K. A nationwide survey on the implementation of infection prevention and control components in 1442 hospitals in the Republic of Korea: comparison to the WHO Infection Prevention and Control Assessment Framework (IPCAF). Antimicrob Resist Infect Control 2022; 11:71. [PMID: 35562838 PMCID: PMC9101985 DOI: 10.1186/s13756-022-01107-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The current SARS-CoV-2 pandemic continues to underscore the inadequacy of infection prevention and control (IPC) and the importance of its sound establishment in healthcare facilities. The Infection Prevention and Control Assessment Framework (IPCAF) by the World Health Organization allows systematic assessment of IPC capacity in healthcare facilities and has been applied in many national-level surveys. This study aims to assess the IPC capacity of Korean hospitals as well as their strengths and pitfalls by analyzing the results of the first government-led nationwide IPC survey in comparison to the IPCAF frame.
Methods
The Korean National Infection Prevention and Control Survey (KNIPCS) was conducted from February to March 2018. The survey questionnaire for KNIPCS was developed through a series of expert consultations and a round of pre-testing in two randomly selected hospitals. The survey questionnaire was distributed to a total of 2108 hospitals. Although the survey preceded the release of IPCAF, its contents complied with IPCAF to a large extent, allowing exploration of its results with regards to IPCAF.
Results
All tertiary hospitals and 96.5% of general hospitals had implemented IPC teams, whereas the percentage was lower for long-term care hospitals (6.3%). A similar trend was observed for IPC surveillance and monitoring activities across hospital types. The percentage of interactive IPC training was lower than 30% in all hospital groups. Disinfection was frequently monitored in all hospital types (e.g. 97.3% in general hospitals and 85.3% in long-term care hospitals). However, activities regarding antimicrobial resistance, such as multi-drug resistant pathogen screening, were weak in hospitals (25%) and long-term care hospitals (25%), compared to tertiary hospitals (83.3%) and general hospitals (57.7%).
Conclusions
In general, essential IPC structures, such as IPC teams and programs, were well in place in most tertiary and general hospitals in Korea. These hospital groups also actively conducted various IPC activities. As most previous legislative and multimodal policy measures have targeted these hospital groups, we speculate that future policy efforts should encompass long-term care hospitals and smaller-sized hospitals to strengthen the IPC capacity of these hospital groups. Efforts should also be put forth to promote IPC training and antimicrobial activities.
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Puro V, Coppola N, Frasca A, Gentile I, Luzzaro F, Peghetti A, Sganga G. Pillars for prevention and control of healthcare-associated infections: an Italian expert opinion statement. Antimicrob Resist Infect Control 2022; 11:87. [PMID: 35725502 PMCID: PMC9207866 DOI: 10.1186/s13756-022-01125-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 06/07/2022] [Indexed: 01/04/2023] Open
Abstract
Healthcare-associated infections (HAIs) represent a relevant problem for all healthcare facilities, because they involve both the care aspect and the economic management of the hospital. Most HAIs are preventable through effective Infection Prevention and Control (IPC) measures. Implementation and improvement of IPC programs are critical to reducing the impact of these infections and the spread of multi-resistant microorganisms. The purpose of this Expert Opinion statement was to provide a practical guide for healthcare organizations, physicians, and nursing staff on the optimal implementation of the core components of Infection Prevention and Control, as recommended by a board of specialists after in-depth discussion of the available evidence in this field. According to their independent suggestions and clinical experiences, as well as evidence-based practices and literature review, this document provides a practical bundle of organizational, structural, and professional requirements necessary to promote, through multimodal strategies, the improvement of the quality and safety of care with respect to infectious risk in order to protect the patient, facilities, and healthcare providers.
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Palozyan G, Avetisyan S, Abovyan R, Melik-Andreasyan G, Vanyan A. EVALUATION OF THE IMPLEMENTATION OF PREVENTION AND INFECTION CONTROL PROGRAMS IN ARMENIAN HOSPITALS DURING THE COVID-19 PANDEMIC. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2022. [DOI: 10.15789/2220-7619-aio-2044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT: Aim of the study: To determine the current state of implementation of key aspects of infection prevention and control (IPC) in Armenian hospitals, defined by the main components of WHO, using the survey tool IPCAF (Infection Prevention and Control Assessment Framework). Materials and methods. 113 hospitals were involved in the study. All participants filled in IPCAF questionnaire, Все они заполнили вопросник IPCAF, consisting of 8 sections (each rated up to 100 points) devoted to various aspects IPC. Depending on the total final score, IPC programs were divided into the following categories: advanced (601-800 points), intermediate (401-600 points), basic (201-400 points) and inadequate (0-200 points). The study conducted a descriptive analysis of the overall IPCAF score as well as the evaluation of scores of the relevant core components and some selected questions of particular interest. Results: The total average score for all IPCAF components for all hospitals in Armenia in 2021 is 578.07.9 points, which is currently regarded as an intermediate level. At the same time, 47 (41.6%) hospitals were assigned to the advanced category, 63 (55.7%) - to the average category and 3 (2.7%) - to the basic category. Analysis of the main IPC components (CC, Core component) revealed that the maximum average scores were obtained for the components CC2 (IPC Guidelines) - 80.8 points, CC8 (Creating a safe environment in medical premises, as well as materials and equipment for IPC) - 75.5 points and CC7 (Workload, staffing and number of beds) - 75.2 points. The lowest average scores were obtained for the key components: CC4 (Surveillance for healthcare-associated infections) with 54.7 points and CC3 (IPC education and training) with 59.5 points. Conclusion. Legislative and practical changes implemented in the real world during the novel coronavirus infection (COVID-19) pandemic have significantly contributed to improved scores for many key components of IPC programs. The study found that the IPCAF is a useful tool for assessing IPC standards and identifying gaps, regardless of a country economic development level. In our opinion, the re-use of IPCAF in all medical institutions should be encouraged, which is important for monitoring changes and trends in IPC, as well as developing individual strategies in the development and improvement of IPC.
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Nomoto H, Saito H, Ishikane M, Gu Y, Ohmagari N, Pittet D, Kunishima H, Allegranzi B, Yoshida M. First nationwide survey of infection prevention and control among healthcare facilities in Japan: impact of the national regulatory system. Antimicrob Resist Infect Control 2022; 11:135. [PMID: 36352429 PMCID: PMC9647990 DOI: 10.1186/s13756-022-01175-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Infection prevention and control (IPC) measures in Japan are facilitated by a financial incentive process at the national level, where facilities are categorized into three groups (Tier 1, Tier 2, or no financial incentive). However, its impact on IPC at the facility level using a validated tool has not been measured. METHODS A nationwide cross-sectional study was conducted from August 2019 to January 2020 to evaluate the situation of IPC programs in Japan, using the global IPC Assessment Framework (IPCAF) developed by the World Health Organization. Combined with the information on the national financial incentive system, the demographics of facilities and each IPCAF item were descriptively analyzed. IPCAF scores were analyzed according to the facility level of care and the national financial incentive system for IPC facility status, using Dunn-Bonferroni and Mann-Whitney U tests. RESULTS Fifty-nine facilities in Japan responded to the IPCAF survey: 34 private facilities (57.6%) and 25 public facilities (42.4%). Of these, 11 (18.6%), 29 (49.2%), and 19 (32.3%) were primary, secondary, and tertiary care facilities, respectively. According to the national financial incentive system for IPC, 45 (76.3%), 11 (18.6%), and three (5.1%) facilities were categorized as Tier 1, Tier 2, and no financial incentive system, respectively. Based on the IPCAF total score, more than half of the facilities were categorized as "Advanced" (n = 31, 55.3%), followed by "Intermediate" (n = 21, 37.5%). The IPCAF total score increased as the facility level of care increased, while no statistically significant difference was identified between the secondary and tertiary care facilities (p = 0.79). There was a significant difference between Tier 1 and Tier 2 for all core components and total scores. Core components 5 (multimodal strategies for implementation of IPC interventions) and 6 (monitoring/audit of IPC and feedback) were characteristically low in Japan with a median score of 65.0 (interquartile range 40.0-85.0) and 67.5 (interquartile range 52.5-87.5), respectively. CONCLUSIONS The national financial incentive system was associated with IPC programs at facility level in Japan. The current financial incentive system does not emphasize the multimodal strategy or cover monitoring/audit, and an additional systematic approach may be required to further promote IPC for more practical healthcare-associated infection prevention.
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Affiliation(s)
- Hidetoshi Nomoto
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.69566.3a0000 0001 2248 6943Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Hiroki Saito
- grid.8591.50000 0001 2322 4988Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland ,grid.412764.20000 0004 0372 3116Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine Yokohama Seibu Hospital, Kanagawa, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Gu
- grid.265073.50000 0001 1014 9130Department of Infectious Diseases, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norio Ohmagari
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.69566.3a0000 0001 2248 6943Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Didier Pittet
- grid.150338.c0000 0001 0721 9812Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Hiroyuki Kunishima
- grid.412764.20000 0004 0372 3116Department of Infectious Diseases, St Marianna University School of Medicine, Kanagawa, Japan
| | - Benedetta Allegranzi
- grid.3575.40000000121633745Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Masaki Yoshida
- grid.411898.d0000 0001 0661 2073Department of Infectious Diseases and Infection Control, The Jikei University School of Medicine, Tokyo, Japan
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Harun MGD, Anwar MMU, Sumon SA, Hassan MZ, Mohona TM, Rahman A, Abdullah SAHM, Islam MS, Kaydos-Daniels SC, Styczynski AR. Rationale and guidance for strengthening infection prevention and control measures and antimicrobial stewardship programs in Bangladesh: a study protocol. BMC Health Serv Res 2022; 22:1239. [PMID: 36207710 PMCID: PMC9540083 DOI: 10.1186/s12913-022-08603-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/26/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hospital-acquired infections (HAIs) and antimicrobial resistance (AMR) are major global health challenges. Drug-resistant infectious diseases continue to rise in developing countries, driven by shortfalls in infection control measures, antibiotic misuse, and scarcity of reliable diagnostics. These escalating global challenges have highlighted the importance of strengthening fundamental infection prevention and control (IPC) measures and implementing effective antimicrobial stewardship programs (ASP). This study aims to present a framework for enhancing IPC measures and ASP efforts to reduce the HAI and AMR burden in Bangladesh. METHODS This implementation approach will employ a mixed-methods strategy, combining both quantitative and qualitative data from 12 tertiary hospitals in Bangladesh. A baseline assessment will be conducted using the Infection Prevention and Control Assessment Framework (IPCAF) developed by the WHO. We will record IPC practices through direct observations of hand hygiene, personal protective equipment (PPE) utilization, and hospital ward IPC infrastructure. Additionally, data on healthcare providers' knowledge, attitudes, and practices regarding IPC and antibiotic prescribing will be collected using both structured questionnaires and qualitative interviews. We will also assist the hospital leadership with establishing and/or strengthening IPC and ASP committees. Based on baseline assessments of each healthcare facility, tailored interventions and quality improvement projects will be designed and implemented. An end-line assessment will also be conducted after 12 months of intervention using the same assessment tools. The findings will be compared with the baseline to determine changes in IPC and antibiotic stewardship practices. DISCUSSION Comprehensive assessments of healthcare facilities in low-resource settings are crucial for strengthening IPC measures and ASP activities,. This approach to assessing existing IPC and ASP activities will provide policy-relevant data for addressing current shortfalls. Moreover, this framework proposes identifying institutionally-tailored solutions, which will ensure that response activities are appropriately contextualized, aligned with stakeholder priorities, and offer sustainable solutions. CONCLUSION Findings from this study can guide the design and implementation of feasible and sustainable interventions in resource-constrained healthcare settings to address gaps in existing IPC and ASP activities. Therefore, this protocol will be applicable across a broad range of settings to improve IPC and ASP and reduce the burden of hospital-acquired infections and AMR.
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Affiliation(s)
- Md Golam Dostogir Harun
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
| | - Md Mahabub Ul Anwar
- Centers for Disease Control and Prevention (CDC), Bangladesh Country Office, Dhaka, Bangladesh
| | - Shariful Amin Sumon
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Md Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Tahrima Mohsin Mohona
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Aninda Rahman
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
| | | | | | | | - Ashley R Styczynski
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, USA
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Harun MGD, Anwar MMU, Sumon SA, Hassan MZ, Haque T, Mah-E-Muneer S, Rahman A, Abdullah SAHM, Islam MS, Styczynski AR, Kaydos-Daniels SC. Infection prevention and control in tertiary care hospitals of Bangladesh: results from WHO infection prevention and control assessment framework (IPCAF). Antimicrob Resist Infect Control 2022; 11:125. [PMID: 36203207 PMCID: PMC9535892 DOI: 10.1186/s13756-022-01161-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Infection prevention and control (IPC) in healthcare settings is imperative for the safety of patients as well as healthcare providers. To measure current IPC activities, resources, and gaps at the facility level, WHO has developed the Infection Prevention and Control Assessment Framework (IPCAF). This study aimed to assess the existing IPC level of selected tertiary care hospitals in Bangladesh during the COVID-19 pandemic using IPCAF to explore their strengths and deficits. METHODS Between September and December 2020, we assessed 11 tertiary-care hospitals across Bangladesh. We collected the information from IPC focal person and/or hospital administrator from each hospital using the IPCAF assessment tool.. The score was calculated based on eight core components and was used to categorize the hospitals into four distinct IPC levels- Inadequate, Basic, Intermediate, and Advanced. Key performance metrics were summarized within and between hospitals. RESULTS The overall median IPCAF score was 355.0 (IQR: 252.5-397.5) out of 800. The majority (73%) of hospitals scored as 'Basic' IPC level, while only 18% of hospitals were categorized as 'Intermediate'. Most hospitals had IPC guidelines as well as environments, materials and equipments. Although 64% of hospitals had IPC orientation and training program for new employees, only 30% of hospitals had regular IPC training program for the staff. None of the hospitals had an IPC surveillance system with standard surveillance case definitions to track HAIs. Around 90% of hospitals did not have an active IPC monitoring and audit system. Half of the hospitals had inadequate staffing considering the workload. Bed occupancy of one patient per bed in all units was found in 55% of hospitals. About 73% of hospitals had functional hand hygiene stations, but sufficient toilets were available in only 37% of hospitals. CONCLUSION The majority of sampled tertiary care hospitals demonstrate inadequate IPC level to ensure the safety of healthcare workers, patients, and visitors. Quality improvement programs and feedback mechanisms should be implemented to strengthen all IPC core components, particularly IPC surveillance, monitoring, education, and training, to improve healthcare safety and resilience.
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Affiliation(s)
- Md Golam Dostogir Harun
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
| | - Md Mahabub Ul Anwar
- Centers for Disease Control and Prevention (CDC), Bangladesh Country Office, Dhaka, Bangladesh
| | - Shariful Amin Sumon
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Md Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Tahmidul Haque
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Syeda Mah-E-Muneer
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Aninda Rahman
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
| | | | - Md Saiful Islam
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
- University of New South Wales, Sydney, Australia
| | - Ashley R Styczynski
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, 94305, USA
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Tomczyk S, Twyman A, de Kraker MEA, Coutinho Rehse AP, Tartari E, Toledo JP, Cassini A, Pittet D, Allegranzi B. The first WHO global survey on infection prevention and control in health-care facilities. THE LANCET. INFECTIOUS DISEASES 2022; 22:845-856. [PMID: 35202599 PMCID: PMC9132775 DOI: 10.1016/s1473-3099(21)00809-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/19/2021] [Accepted: 12/10/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND WHO core components for infection prevention and control (IPC) are important building blocks for effective IPC programmes. To our knowledge, we did the first WHO global survey to assess implementation of these programmes in health-care facilities. METHODS In this cross-sectional survey, IPC professionals were invited through global outreach and national coordinated efforts to complete the online WHO IPC assessment framework (IPCAF). The survey was created in English and was then translated into ten languages: Arabic, Chinese, English, French, German, Italian, Japanese, Russian, Spanish, and Thai. Post-stratification weighting was applied and countries with low response rates were excluded to improve representativeness. Weighted median scores and IQRs as well as weighted proportions (Nw) meeting defined IPCAF minimum requirements were reported. Indicators associated with the IPCAF score were assessed using a generalised estimating equation. FINDINGS From Jan 16 to Dec 31, 2019, 4440 responses were received from 81 countries. The overall weighted IPCAF median score indicated an advanced level of implementation (605, IQR 450·4-705·0), but significantly lower scores were found in low-income (385, 279·7-442·9) and lower-middle-income countries (500·4, 345·0-657·5), and public facilities (515, 385-637·8). Core component 8 (built environment; 90·0, IQR 75·0-100·0) and core component 2 (guidelines; 87·5, 70·0-97·5) scored the highest, and core component 7 (workload, staffing, and bed occupancy; 70·0, 50-90) and core component 3 (education and training; 70 ·0, 50·0-85·0) scored the lowest. Overall, only 15·2% (Nw: 588 of 3873) of facilities met all IPCAF minimum requirements, ranging from 0% (0 of 417) in low-income countries to 25·6% (278 of 1087) in primary facilities, 9% (24 of 268) in secondary facilities, and 19% (18 of 95) in tertiary facilities in high-income countries. INTERPRETATION Despite an overall high IPCAF score globally, important gaps in IPC facility implementation and core components across income levels hinder IPC progress. Increased support for more effective and sustainable IPC programmes is crucial to reduce risks posed by outbreaks to global health security and to ensure patient and health worker safety. FUNDING WHO and the Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine. TRANSLATIONS For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sara Tomczyk
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland; Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
| | - Anthony Twyman
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Marlieke E A de Kraker
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ana Paula Coutinho Rehse
- Infectious Hazard Management Programme, Health Emergencies Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland; Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Msida, Malta
| | - João Paulo Toledo
- Clinical Management of Infectious Diseases, Health Emergencies Department, Pan American Health Organization, Washington, DC, USA
| | - Alessandro Cassini
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
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Kamara IF, Tengbe SM, Fofanah BD, Bunn JE, Njuguna CK, Kallon C, Kumar AMV. Infection Prevention and Control in Three Tertiary Healthcare Facilities in Freetown, Sierra Leone during the COVID-19 Pandemic: More Needs to Be Done! INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095275. [PMID: 35564669 PMCID: PMC9105082 DOI: 10.3390/ijerph19095275] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/04/2022] [Accepted: 04/20/2022] [Indexed: 02/06/2023]
Abstract
Infection Prevention and Control (IPC) measures are critical to the reduction in healthcare-associated infections, especially during pandemics, such as that of COVID-19. We conducted a hospital-based cross-sectional study in August 2021 at Connaught Hospital, Princess Christian Maternity Hospital and Ola During Children's Hospital located in Freetown, Sierra Leone. We used the World Health Organization's Infection Prevention and Control Assessment Framework Tool to assess the level of IPC compliance at these healthcare facilities. The overall IPC compliance score at Connaught Hospital was 323.5 of 800 points, 313.5 of 800 at Ola During Children's Hospital, 281 of 800 at Princess Christian Maternity Hospital, implying a 'Basic' IPC compliance grade. These facilities had an IPC program, IPC committees and dedicated IPC focal persons. However, there were several challenges, including access to safe and clean water and insufficient quantities of face masks, examination gloves and aprons. Furthermore, there was no dedicated budget or no healthcare-associated infection (HAI) surveillance, and monitoring/audit of IPC practices were weak. These findings are of concern during the COVID-19 era, and there is an urgent need for both financial and technical support to address the gaps and challenges identified.
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Affiliation(s)
- Ibrahim Franklyn Kamara
- World Health Organization, 21A-B Riverside, Off King Harman Road Freetown, Freetown 00232, Sierra Leone; (B.D.F.); (J.E.B.); (C.K.N.)
- Correspondence: or ; Tel.: +232-7634-5757
| | - Sia Morenike Tengbe
- Ministry of Health and Sanitation, 4th Floor, Youyi Building, Brookfields, Freetown 00232, Sierra Leone; (S.M.T.); (C.K.)
| | - Bobson Derrick Fofanah
- World Health Organization, 21A-B Riverside, Off King Harman Road Freetown, Freetown 00232, Sierra Leone; (B.D.F.); (J.E.B.); (C.K.N.)
| | - James Edward Bunn
- World Health Organization, 21A-B Riverside, Off King Harman Road Freetown, Freetown 00232, Sierra Leone; (B.D.F.); (J.E.B.); (C.K.N.)
| | - Charles Kuria Njuguna
- World Health Organization, 21A-B Riverside, Off King Harman Road Freetown, Freetown 00232, Sierra Leone; (B.D.F.); (J.E.B.); (C.K.N.)
| | - Christiana Kallon
- Ministry of Health and Sanitation, 4th Floor, Youyi Building, Brookfields, Freetown 00232, Sierra Leone; (S.M.T.); (C.K.)
| | - Ajay M. V. Kumar
- International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France;
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, C-6 Qutub Institutional Area, New Delhi 110016, India
- Yenepoya Medical College, Yenepoya (Deemed to Be University), University Road, Deralakatte 575018, India
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Saadeh R, Khader Y, Alyahya M, Al-Samawi M, Allouh MZ. Water, Sanitation, and Hygiene and Infection Prevention and Control in Jordanian Hospitals in the Context of COVID-19: A National Assessment. Risk Manag Healthc Policy 2022; 15:571-582. [PMID: 35411197 PMCID: PMC8994649 DOI: 10.2147/rmhp.s358600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/26/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose To identify areas that need improvement in Jordanian health centers regarding infection prevention and control (IPC) programs; water, sanitation, and hygiene (WASH) services; and other protective measures, especially in the context of coronavirus disease (COVID-19). Methods This is a national assessment study that comprised hospitals of different sectors in Jordan, including, Ministry of Health (MoH), private, and military hospitals. The study included 23 Jordanian hospitals. Assessment tools were developed and adapted mainly from the WASH Facility Improvement Tool (WASH FIT) and other tools. Hospitals were assessed to meet targets based on whether indicators were fully met, partially met, or not met. Results The mean percentage of the 150 indicators that met the standards was 83.2% (72.6% for MoH, 84.5% for private, and 90.4% for military hospitals). The percentage of indicators, both WASH/IPC and training and education indicators, that met the targets were higher in military hospitals than in MoH and private hospitals. However, in context of COVID-19, only 64.7% of indicators related to precautionary measures were met by all hospitals. Conclusion The data available on WASH/IPC in Jordan are scarce, and the study findings will help in preventing severe consequences of the COVID-19 pandemic. There is scope for improvement in many WASH/IPC aspects, and urgent actions should be taken, especially to fill the gaps in COVID-19 precautionary measures.
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Affiliation(s)
- Rami Saadeh
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Majid Al-Samawi
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammed Z Allouh
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Correspondence: Mohammed Z Allouh, Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, P. O. Box: 15551, Al Ain, United Arab Emirates, Tel +97 137 137 551, Email
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Katoch O, Katyal S, Srivastav S, Rodrigues C, Rupali P, Chakrabarti A, Ray P, Tak V, Biswal M, Nath R, Mukhopadhyay C, Bhattacharya S, Padmaja K, Deotale V, Venkatesh V, Wattal C, Ma T, Nag VL, Ray R, Behera B, Baveja S, Karuna T, Singh SK, Fomda B, Devi SK, Das P, Khandelwal N, Verma P, Gaind R, Bhattacharyya P, Kumar P, Srivastava A, Iravane J, Majumdar T, Sharma R, Sankara D, Kalwaje Eshwara V, Varma M, Nazir S, Tripathy S, Mishra S, Dey A, Thangavelu P, Kapoor L, Malhotra R, Walia K, Guleria R, Mathur P. Self-reported survey on infection prevention and control structures in healthcare facilities part of a national level healthcare associated infection surveillance network in India, 2019. Am J Infect Control 2022; 50:390-395. [PMID: 34600081 DOI: 10.1016/j.ajic.2021.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Healthcare associated infections (HAIs) are prevalent and difficult to treat worldwide. Most HAIs can be prevented by effective implementation of Infection Prevention and Control (IPC) measures. A survey was conducted to assess the existing IPC practices across a network of Indian Hospitals using the World Health Organization designed self-assessment IPC Assessment Framework (IPCAF) tool. METHODS This was a cross sectional observation study. Thirty-two tertiary care public and private facilities, part of the existing Indian HAI surveillance network was included. Data collected was analyzed by a central team at All India Institute of Medical Sciences, New Delhi, a tertiary care hospital of India. The WHO questionnaire tool was used to understand the capacity and efforts to implement IPC practices across the network. RESULTS The overall median score of IPCAF across the network was 620. Based on the final IPCAF score of the facilities; 13% hospitals had basic IPC practices, 28% hospitals had intermediate and 59% hospitals had advanced IPC practices. The component multimodal strategies had the broadest range of score while the component IPC guidelines had the narrowest one. CONCLUSIONS Quality improvement training for IPC nurses and healthcare professionals are needed to be provided to health facilities.
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Affiliation(s)
- Omika Katoch
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Sonal Katyal
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Sharad Srivastav
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Camilla Rodrigues
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Center, Mumbai, Maharashtra, India
| | - Priscilla Rupali
- Department of Infectious Diseases, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Arunaloke Chakrabarti
- Department of Microbiology, Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Pallab Ray
- Department of Microbiology, Assam Medical College, Assam, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Manisha Biswal
- Department of Microbiology, Assam Medical College, Assam, India
| | - Reema Nath
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Sanjay Bhattacharya
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Kanne Padmaja
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Vijayshri Deotale
- Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Vimala Venkatesh
- Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Chand Wattal
- Department of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, New Delhi, India
| | - Thirunarayan Ma
- Department of Microbiology, Apollo Hospital, Chennai, Tamil Nadu, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Raja Ray
- Department of Microbiology, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sujata Baveja
- Department of Microbiology, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Tadepalli Karuna
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh
| | - Sanjeev K Singh
- Department of Infection Control, Amrita Institute of Medicine Sciences, Amrita University, Kochi, Kerala, India
| | - Bashir Fomda
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | | | - Padma Das
- Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Neeta Khandelwal
- Department of Microbiology, Government Medical College, Surat, Gujarat, India
| | - Prachi Verma
- Department of Critical Care Medicine, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur
| | - Rajni Gaind
- Department of Microbiology, Safdarjung Hospital and VMMC, Delhi, India
| | - Prithwis Bhattacharyya
- Department of Anaesthesiology and ICU, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Puneet Kumar
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashutosh Srivastava
- Department of Microbiology MGM Medical College, Bhopal, Madhya Pradesh, India
| | - Jyoti Iravane
- Department of Microbiology, Govt. Medical College, Aurangabad, Maharashtra, India
| | - Tapan Majumdar
- Department of Microbiology, AGMC & GBP Hospital, Agartala,, Tripura, India
| | - Rajni Sharma
- Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India
| | - Dhanapaul Sankara
- Department of Microbiology, K.A,V.P. Govt. Medical College, Trichy, Tamil Nadu, India
| | | | - Muralidhar Varma
- Department of Infectious Diseases, Kasturba Medical College, Manipal, Karnataka, India
| | - Shaista Nazir
- Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Swagata Tripathy
- Department of Anesthesia and Critical Care Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Satyajeet Mishra
- Department of Anesthesia, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anupam Dey
- Department of General Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Premkumar Thangavelu
- Department of Infectious Disease, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Lata Kapoor
- Department of Microbiology, National Institute of Disease Control, New Delhi, India
| | - Rajesh Malhotra
- Department of Orthopedics, JPNATC, All India Institute of Medical Sciences, New Delhi, India
| | - Kamini Walia
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Purva Mathur
- Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India.
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Amponsah OKO, Owusu-Ofori A, Ayisi-Boateng NK, Attakorah J, Opare-Addo MNA, Buabeng KO. OUP accepted manuscript. JAC Antimicrob Resist 2022; 4:dlac034. [PMID: 35415611 PMCID: PMC8994196 DOI: 10.1093/jacamr/dlac034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background Addressing antimicrobial resistance (AMR) requires the rational use and optimization of available resources for prevention and management of infections. Structures in health facilities to support optimal antimicrobial therapy and AMR containment therefore need assessment and strengthening. Objectives To assess antimicrobial stewardship (AMS) capacity and conformance to National and WHO Infection Prevention and Control (IPC) guidelines in three hospitals in Ashanti region of Ghana. Methods A cross-sectional study using WHO’s hospital questionnaire for AMS capacity assessment, and Infection Prevention and Control Framework (IPCAF) to assess IPC practices in the three hospitals. Results All the facilities had Drug and Therapeutics and IPC Committees with microbiology laboratory services. H3 and H1 did not have a formal AMS programme or an organizational structure for AMS. However, both institutions had a formal procedure to review antibiotics on prescriptions for quality assessment and relevance. H2 and H1 did not participate in any surveillance of antibiotic resistance patterns or consumption. H1 had basic, while H2 and H3 had intermediate-level IPC systems scoring 385, 487.5 and 435.8 out of 800 respectively. Conclusions All the facilities assessed had AMS capacity and IPC conformity gaps that require strengthening to optimize antimicrobial use (AMU) and successful implementation of IPC protocols. Regular surveillance of antimicrobial consumption and microbial resistance patterns should be an integral part of activities in health institutions to generate evidence for impactful actions to contain AMR and improve AMU.
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Affiliation(s)
- Obed Kwabena Offe Amponsah
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Corresponding author. E-mail:
| | - Alex Owusu-Ofori
- Department of Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nana Kwame Ayisi-Boateng
- School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Attakorah
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mercy Naa Aduele Opare-Addo
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwame Ohene Buabeng
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Rittmeier S, Waeschle RM, Artelt T, Fehling P, Suckow A, Siess M, Scheithauer S. Surveillance of surgical site infections: methodical comparison of the IQTIG and KISS strategies. GMS HYGIENE AND INFECTION CONTROL 2021; 16:Doc18. [PMID: 34123706 PMCID: PMC8165488 DOI: 10.3205/dgkh000389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aim: In 2017, the Institute for Quality Assurance and Transparency in Healthcare (IQTIG) introduced a quality assurance system for the surveillance of surgical site infections (SSI) on behalf the Federal Joint Committee. The establishment of the new system was made in parallel to existing methods, such as the “Krankenhaus-Infektions-Surveillance-System” (KISS). The aim of this work was to perform a comparative analysis. Methods: All 2,233 cases at the University Medical Center Goettingen requiring an assessment of the presence of SSI as part of the IQTIG procedure in 2018 and 2019 were evaluated retrospectively according to the KISS protocol. Results: In total, 2,050 patients were included in the comparative evaluation. Overall, 1,779 (79.7%) had a surgical anamnesis (surgery during the stay or in the past), and 1,716 (83.7%) showed identical results for both surveillance strategies. Different results were found for 334 patients (16.3%), with 160 of these (7.8%) positive for SSI according to IQTIG and 174 (8.5%) positive for KISS. Risk factors were identified for a discordant assessment between the methods. Conclusion: The congruence of the two strategies was consistently high over the study period. There is evidence that the efficiency of the documentation algorithm can be increased without the loss of documentation of SSI, while preserving the precision of the documentation through training.
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Affiliation(s)
- Sascha Rittmeier
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Reiner M Waeschle
- Department of Anesthesiology, University Medical Center Goettingen, Goettingen, Germany
| | - Tanja Artelt
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Patrick Fehling
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Arnt Suckow
- Quality and Risk Management Department, University Medical Center Goettingen, Goettingen, Germany
| | - Martin Siess
- Board of Health Care, University Medical Center Goettingen, Goettingen, Germany
| | - Simone Scheithauer
- Institute for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
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Opollo MS, Otim TC, Kizito W, Thekkur P, Kumar AMV, Kitutu FE, Kisame R, Zolfo M. Infection Prevention and Control at Lira University Hospital, Uganda: More Needs to Be Done. Trop Med Infect Dis 2021; 6:tropicalmed6020069. [PMID: 34062871 PMCID: PMC8167580 DOI: 10.3390/tropicalmed6020069] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/17/2022] Open
Abstract
Globally, 5–15% of hospitalized patients acquire infections (often caused by antimicrobial-resistant microbes) due to inadequate infection prevention and control (IPC) measures. We used the World Health Organization’s (WHO) ‘Infection Prevention and Control Assessment Framework’ (IPCAF) tool to assess the IPC compliance at Lira University hospital (LUH), a teaching hospital in Uganda. We also characterized challenges in completing the tool. This was a hospital-based, cross-sectional study conducted in November 2020. The IPC focal person at LUH completed the WHO IPCAF tool. Responses were validated, scored, and interpreted per WHO guidelines. The overall IPC compliance score at LUH was 225/800 (28.5%), implying a basic IPC compliance level. There was no IPC committee, no IPC team, and no budgets. Training was rarely or never conducted. There was no surveillance system and no monitoring/audit of IPC activities. Bed capacity, water, electricity, and disposal of hospital waste were adequate. Disposables and personal protective equipment were not available in appropriate quantities. Major challenges in completing the IPCAF tool were related to the detailed questions requiring repeated consultation with other hospital stakeholders and the long time it took to complete the tool. IPC compliance at LUH was not optimal. The gaps identified need to be addressed urgently.
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Affiliation(s)
- Marc Sam Opollo
- Department of Public Health, Faculty of Health Sciences, Lira University, 1035 Lira, Uganda;
- Correspondence: ; Tel.: +256-772-900-834
| | - Tom Charles Otim
- Department of Public Health, Faculty of Health Sciences, Lira University, 1035 Lira, Uganda;
| | - Walter Kizito
- Médecins Sans Frontières, MSF-B, 1050 Brussels, Belgium;
| | - Pruthu Thekkur
- International Union against Tuberculosis and Lung Disease (The Union), 75006 Paris, France; (P.T.); (A.M.V.K.)
| | - Ajay M. V. Kumar
- International Union against Tuberculosis and Lung Disease (The Union), 75006 Paris, France; (P.T.); (A.M.V.K.)
- The Union South-East Asia Office, New Delhi 110016, India
- Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru 575018, India
| | - Freddy Eric Kitutu
- Sustainable Pharmaceutical Systems (SPS) Unit, Pharmacy Department, Makerere University School of Health Sciences, 10217 Kampala, Uganda;
| | - Rogers Kisame
- Infectious Diseases Institute, Makerere University, 10217 Kampala, Uganda;
| | - Maria Zolfo
- Institute of Tropical Medicine, 2000 Antwerp, Belgium;
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Deryabina A, Lyman M, Yee D, Gelieshvilli M, Sanodze L, Madzgarashvili L, Weiss J, Kilpatrick C, Rabkin M, Skaggs B, Kolwaite A. Core components of infection prevention and control programs at the facility level in Georgia: key challenges and opportunities. Antimicrob Resist Infect Control 2021; 10:39. [PMID: 33627194 PMCID: PMC7903395 DOI: 10.1186/s13756-020-00879-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/26/2020] [Indexed: 01/21/2023] Open
Abstract
Background The Georgia Ministry of Labor, Health, and Social Affairs is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff. Methods In 2018, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews. Results IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system. Conclusions Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.
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Affiliation(s)
| | - Meghan Lyman
- International Infection Control Program, Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Atlanta, USA
| | - Daiva Yee
- International Infection Control Program, Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Atlanta, USA
| | - Marika Gelieshvilli
- South Caucasus Office, U.S. Centers for Disease Control and Prevention, Atlanta, USA
| | | | | | - Jamine Weiss
- International Infection Control Program, Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Atlanta, USA
| | | | | | - Beth Skaggs
- South Caucasus Office, U.S. Centers for Disease Control and Prevention, Atlanta, USA
| | - Amy Kolwaite
- International Infection Control Program, Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Atlanta, USA
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Tartari E, Tomczyk S, Pires D, Zayed B, Coutinho Rehse AP, Kariyo P, Stempliuk V, Zingg W, Pittet D, Allegranzi B. Implementation of the infection prevention and control core components at the national level: a global situational analysis. J Hosp Infect 2020; 108:94-103. [PMID: 33271215 PMCID: PMC7884929 DOI: 10.1016/j.jhin.2020.11.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/11/2022]
Abstract
Background Strengthening infection prevention and control (IPC) is essential to combat healthcare-associated infections, antimicrobial resistance, and to prevent and respond to outbreaks. Aim To assess national IPC programmes worldwide according to the World Health Organization (WHO) IPC core components. Methods Between June 1st, 2017 and November 30th, 2018, a multi-country, cross-sectional study was conducted, based on semi-structured interviews with national IPC focal points of countries that pledged to the WHO ‘Clean Care is Safer Care’ challenge. Results and differences between regions and national income levels were summarized using descriptive statistics. Findings Eighty-eight of 103 (85.4%) eligible countries participated; 22.7% were low-income, 19.3% lower-middle-income, 23.9% upper-middle-income, and 34.1% high-income economies. A national IPC programme existed in 62.5%, but only 26.1% had a dedicated budget. National guidelines were available in 67.0%, but only 36.4% and 21.6% of countries had an implementation strategy and evaluated compliance with guidelines, respectively. Undergraduate IPC curriculum and in-service and postgraduate IPC training were reported by 35.2%, 54.5%, and 42% of countries, respectively. Healthcare-associated infection surveillance was reported by 46.6% of countries, with significant differences ranging from 83.3% (high-income) to zero (low-income) (P < 0.001); monitoring and feedback of IPC indicators was reported by 65.9%. Only 12.5% of countries had all core components in place. Conclusion Most countries have IPC programme and guidelines, but many less have invested adequate resources and translated them in implementation and monitoring, particularly in low-income countries. Leadership support at the national and global level is needed to achieve implementation of the core components in all countries.
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Affiliation(s)
- E Tartari
- Infection Prevention and Control Programme, Geneva University Hospitals, and Faculty of Medicine, Geneva, Switzerland; Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - S Tomczyk
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - D Pires
- Infection Prevention and Control Programme, Geneva University Hospitals, and Faculty of Medicine, Geneva, Switzerland
| | - B Zayed
- WHO Antimicrobial Resistance and Infection Prevention and Control Unit, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - A P Coutinho Rehse
- Health Emergencies Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - P Kariyo
- Equipe d'Appui Interpays pour l'Afrique Centrale, WHO Country Office, Libreville, Gabon
| | - V Stempliuk
- Pan American Health Organization Office for Jamaica, Bermuda and the Cayman Islands, Kingston, Jamaica
| | - W Zingg
- Infection Prevention and Control Programme, Geneva University Hospitals, and Faculty of Medicine, Geneva, Switzerland
| | - D Pittet
- Infection Prevention and Control Programme, Geneva University Hospitals, and Faculty of Medicine, Geneva, Switzerland
| | - B Allegranzi
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland.
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Aghdassi SJS, Grisold A, Wechsler-Fördös A, Hansen S, Bischoff P, Behnke M, Gastmeier P. Evaluating infection prevention and control programs in Austrian acute care hospitals using the WHO Infection Prevention and Control Assessment Framework. Antimicrob Resist Infect Control 2020; 9:92. [PMID: 32571434 PMCID: PMC7309981 DOI: 10.1186/s13756-020-00761-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/14/2020] [Indexed: 01/19/2023] Open
Abstract
Background Infection prevention and control (IPC) is crucial for patient safety. The World Health Organization (WHO) has released various tools to promote IPC. In 2018, the WHO released the Infection Prevention and Control Assessment Framework (IPCAF) that enables acute care healthcare facilities to evaluate IPC structures and practices. Data regarding IPC implementation in Austria are scarce. To deliver insights into this topic and promote the IPCAF within the Austrian IPC community, we decided to invite all Austrian hospitals participating in the German nosocomial infection surveillance system to conduct a self-assessment using the WHO IPCAF. Methods The IPCAF follows the eight WHO core components of IPC. A German translation of the IPCAF was sent to 127 Austrian acute care hospitals. The survey period was from October to December 2018. Participation in the survey, data entry and transfer to the German national reference center for surveillance of healthcare-associated infections was on a voluntary basis. Results Altogether, 65 Austrian hospitals provided a complete dataset. The overall median IPCAF score of all hospitals was 620 (of a possible maximum score of 800), which corresponded to an advanced level of IPC. Of the 65 hospitals, 38 achieved an advanced IPC level. Deeper analysis of the different core components yielded diverse results. Scores were lowest for core components on multimodal strategies for implementation of IPC interventions, and IPC education and training. Around 26% (n = 17) of hospitals reported that the local IPC team was not steadily supported by an IPC committee. Senior clinical staff was not present in the IPC committee in 23% (n = 15) of hospitals. Only 26% (n = 17) of hospitals reported employing at least one IPC professional per ≤250 beds. Surveillance for multidrug-resistant pathogens was not conducted in 26% (n = 17) of hospitals. Conclusions Implementation of IPC key aspects is generally at a high level in Austria. However, potentials for improvement were demonstrated, most prominently with regard to staffing, IPC education and training, effective implementation of multimodal strategies, and involvement of professional groups. Our survey demonstrated that the IPCAF is a useful tool for IPC self-assessment and can uncover deficits even in a high-income setting like Austria.
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Affiliation(s)
- Seven Johannes Sam Aghdassi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany. .,National Reference Center for Surveillance of Nosocomial Infections, Berlin, Germany.
| | - Andrea Grisold
- D&R Institute of Hygiene, Microbiology and Environmental Medicine, Medical University, Graz, Austria.,Austrian Society of Hygiene, Microbiology and Preventive Medicine, Vienna, Austria
| | | | - Sonja Hansen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for Surveillance of Nosocomial Infections, Berlin, Germany
| | - Peter Bischoff
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for Surveillance of Nosocomial Infections, Berlin, Germany
| | - Michael Behnke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for Surveillance of Nosocomial Infections, Berlin, Germany
| | - Petra Gastmeier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for Surveillance of Nosocomial Infections, Berlin, Germany
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