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Leong M, Picton R, Wratten M, Mahe A, Zimmerman PA. Baseline evaluation of the World Health Organization (WHO) infection prevention and control (IPC) core components in Pacific Island Countries and Territories (PICTs). Antimicrob Resist Infect Control 2024; 13:108. [PMID: 39334478 PMCID: PMC11437787 DOI: 10.1186/s13756-024-01447-9] [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: 02/14/2024] [Accepted: 07/31/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Comprehensive infection prevention and control (IPC) programmes are proven to reduce the spread of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR). However, published assessments of IPC programmes against the World Health Organization (WHO) IPC Core Components in Pacific Island Countries and Territories (PICTs) at the national and acute healthcare facility level are currently unavailable. METHODS From January 2022 to April 2023, a multi-country, cross-sectional study was conducted in PICTs. The self reporting survey was based on the WHO Infection Prevention Assessment Framework (IPCAF) that supports implementing the minimum requirements of the WHO eight core components of IPC programmes at both the national and facility level. The results were presented as a 'traffic light' (present, in progress, not present) matrix. Each PICT's overall status in achieving IPC core components was summarised using descriptive statistics. RESULTS Fifteen PICTs participated in this study. Ten (67%) PICTs had national IPC programmes, supported mainly by IPC focal points (87%, n = 13), updated national IPC guidelines (80%, n = 12), IPC monitoring and feedback mechanisms (80%, n = 12), and waste management plans (87%, n = 13). Significant gaps were identified in education and training (20%, n = 3). Despite being a defined component in 67% (n = 10) of national IPC programmes, HAI surveillance and monitoring was the lowest scoring core component (13%, n = 2). National and facility level IPC guidelines had been adapted and implemented in 67% (n = 10) PICTs; however, only 40% (n = 6) of PICTs had a dedicated IPC budget, 40% (n = 6) had multimodal strategies for IPC, and 33% (n = 5) had daily environmental cleaning records. CONCLUSIONS Identifying IPC strengths, gaps, and challenges across PICTs will inform future IPC programme priorities and contribute to regional efforts in strengthening IPC capacity. This will promote global public health through the prevention of HAIs and AMR.
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Affiliation(s)
| | - Rochelle Picton
- Griffith University, Parklands Drive, Southport, Brisbane, QLD, Australia
| | | | - Ana Mahe
- Vaiola Hospital, P.O.Box 59, Nuku'alofa, Tonga
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Ssekamatte T, Mugambe RK, Isunju JB, Wanyenze RK, Nalugya A, Adyedo C, Wafula ST, Buregyeya E, Nuwematsiko R, Bateman J, Balen J, Lusenaka L, Yakubu H, Moe CL. Application of the behaviour-centred design to understand facilitators and deterrents of hand hygiene among healthcare providers: findings from a formative phase of a cluster randomised trial in the Kampala Metropolitan area. BMC Health Serv Res 2024; 24:1031. [PMID: 39237982 PMCID: PMC11378471 DOI: 10.1186/s12913-024-11512-z] [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: 05/31/2023] [Accepted: 08/29/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Hand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour-centered Design approach to explore the facilitators and deterrents to hand hygiene among healthcare providers in the Kampala Metropolitan area, Uganda. METHODS We conducted a formative qualitative study as part of a cluster randomised trial in 19 healthcare facilities (HCFs). The study used 19 semi-structured and 18 key informant interviews to collect data on hand hygiene status and facilitators and deterrents of hand hygiene. Research assistants transcribed verbatim and used a thematic framework aided by Nvivo 14.0. to undertake analysis. We used thick descriptions and illustrative quotes to enhance the credibility and trustworthiness of our findings. RESULTS About 47.4% of the HCFs had sufficient hand hygiene infrastructure, and 57.9% did not report total compliance with hand hygiene during patient care. The physical facilitator for hand hygiene was the presence of constant reminders such as nudges, while the biological included the frequency of patient contact and the nature of clinical work. The only biological deterrent was the heavy workload in HCFs. The executive brain facilitators included knowledge of workplace health risks, infection prevention and control (IPC) guidelines, and a positive attitude. A negative attitude was the executive brain deterrent to hand hygiene. Recognition, rewards, and fear of infections were the only motivated brain facilitators. Behavioural setting facilitators included proximity to functional hand hygiene infrastructure, the existence of active IPC committees, good leadership, and the availability of a budget for hand hygiene supplies. Behavioural setting deterrents included the non-functionality and non-proximity to hand hygiene infrastructure and inadequate supplies. CONCLUSIONS The study revealed low compliance with hand hygiene during the critical moments of patient care and inadequacy of hand hygiene infrastructure. The deterrents to hand hygiene included a heavy workload, negative attitude, inadequate supplies, non-functionality, and long distance to hand washing stations. Facilitators included constant reminders, fear of infections, frequency of patient contact and nature of clinical work, positive attitude, knowledge of IPC guidelines, recognition and reward, good leadership, availability of budgets for hand hygiene supplies, availability and proximity to hand hygiene supplies and infrastructure and active IPC committees. TRIAL REGISTRATION ISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda.
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
| | | | - Solomon T Wafula
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
| | - Rebecca Nuwematsiko
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda
| | - Joann Bateman
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Julie Balen
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Lynnette Lusenaka
- National Academy of Sciences, Programs Office, Building 2101 Constitution Avenue, Washington, DC, USA
| | - Habib Yakubu
- The Centre for Global Safe Water, Sanitation and Hygiene, Hubert Department of Public Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Christine L Moe
- The Centre for Global Safe Water, Sanitation and Hygiene, Hubert Department of Public Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
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Gonzales A, Barbieri DF, Carbonell AM, Joseph A, Srinivasan D, Cha J. The compatibility of exoskeletons in perioperative environments and workflows: an analysis of surgical team members' perspectives and workflow simulation. ERGONOMICS 2024; 67:674-694. [PMID: 37478005 DOI: 10.1080/00140139.2023.2240045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/15/2023] [Indexed: 07/23/2023]
Abstract
Surgical team members in perioperative environments experience high physical demands. Interventions such as exoskeletons, external wearable devices that support users, have the potential to reduce these work-related physical demands. However, barriers such as workplace environment and task compatibility may limit exoskeleton implementation. This study gathered the perspectives of 33 surgical team members: 12 surgeons, four surgical residents, seven operating room (OR) nurses, seven surgical technicians (STs), two central processing technicians (CPTs), and one infection control nurse to understand their workplace compatibility. Team members were introduced to passive exoskeletons via demonstrations, after which surgical staff (OR nurses, STs, and CPTs) were led through a simulated workflow walkthrough where they completed tasks representative of their workday. Five themes emerged from the interviews (workflow, user needs, hindrances, motivation for intervention, and acceptance) with unique subthemes for each population. Overall, exoskeletons were largely compatible with the duties and workflow of surgical team members.
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Affiliation(s)
- Alec Gonzales
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | | | - Alfredo M Carbonell
- Department of Surgery, Prisma Health - Upstate, Greenville, South Carolina, USA
- University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, USA
| | - Anjali Joseph
- School of Architecture, Clemson University, Clemson, South Carolina, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | - Jackie Cha
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
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Falana ROA, Ogidan OC, Fajemilehin BR. Barriers to infection prevention and control implementation in selected healthcare facilities in Nigeria. Infect Dis Now 2024; 54:104877. [PMID: 38395258 DOI: 10.1016/j.idnow.2024.104877] [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: 06/21/2023] [Revised: 12/01/2023] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE While infection prevention and control are of paramount importance, up until recently an assessment of implementation challenges and performance gaps was lacking. This study explored the barriers to infection prevention and control implementation at selected healthcare facilities, the objective being to find ways to improve their programs. MATERIAL AND METHOD A qualitative approach was applied. Purposive sampling was used to select thirty-three healthcare facilities in Ekiti State, Nigeria. They were globally assessed, and an Infection Prevention and Control team, represented by the Infection Prevention and Control referent in each of the selected facilities trained the participants. Data were collected using the Key Informant Interview Guide and analyzed by means of content and thematic analyses using Atlas.ti software. RESULTS Inadequate infection prevention and control materials, poor waste management, non-compliance of patients with infection prevention and control protocols, and poor infrastructure were identified as major barriers to infection prevention and control implementation. CONCLUSION The study concluded that a number of identified factors hindering infection prevention and control implementation in healthcare facilities in Ekiti State needed to be addressed.
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Affiliation(s)
- Rachael O A Falana
- Department of Nursing Science, Obafemi Awolowo University, Osun State, Nigeria.
| | - Oluwakemi C Ogidan
- Department of Nursing Science, Ekiti State University, Ado Ekiti, Ekiti State, Nigeria
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Kubde D, Badge AK, Ugemuge S, Shahu S. Importance of Hospital Infection Control. Cureus 2023; 15:e50931. [PMID: 38259418 PMCID: PMC10801286 DOI: 10.7759/cureus.50931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
The increasing demand for healthcare-acquired infection (HAI) control practices and services has intensified the need to evaluate care quality. The World Health Organization (WHO) introduced an infection prevention and control (IPC) framework to mitigate the impact of HAIs, crucial for ensuring patient safety in hospitals. HAIs acquired after hospitalization pose significant challenges due to factors such as compromised immunity, invasive medical procedures, and antibiotic-resistant pathogens, which have dire consequences, including higher mortality rates and increased healthcare costs. Healthcare workers (HCWs) are critical in implementing IPC measures. Infection control programs that include strategies such as hand hygiene, personal protective equipment (PPE), environmental cleaning, and surveillance have become standard. However, challenges such as resistance to change, resource limitations, patient turnover, and variability in patient conditions persist. Strategies to maintain hospital infection control involve rigorous compliance monitoring, staff education, advanced technologies such as artificial intelligence (AI), machine learning (ML), telemedicine, and innovative sanitation methods. The future of hospital infection control may involve increased integration of environmental monitoring, antimicrobial stewardship, and patient participation while leveraging collaboration among healthcare facilities. The review highlights the criticality of hospital infection control and suggests trends and opportunities to strengthen prevention efforts and patient safety.
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Affiliation(s)
- Dimple Kubde
- School of Allied Health Sciences, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Ankit K Badge
- Department of Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Sarita Ugemuge
- Department of Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Shivani Shahu
- School of Allied Health Sciences, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
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Mudenda S, Chizimu J, Chabalenge B, Kasanga M, Matafwali SK, Daka V, Yamba K, Mulomba M, Mufwambi W, Katowa-Mukwato P, Godman B. Knowledge, attitude, and practices toward infection prevention and control among undergraduate pharmacy students in Zambia: findings and implications. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e154. [PMID: 37771733 PMCID: PMC10523556 DOI: 10.1017/ash.2023.428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 09/30/2023]
Abstract
Background Infection prevention and control (IPC) measures are critical in preventing the risk of acquiring and transmitting nosocomial infections. In Zambia, there is little information concerning IPC practices among pharmacy students who are exposed to potentially infectious areas both in public and private healthcare settings. Therefore, this study assessed the knowledge, attitude, and practices of undergraduate pharmacy students toward infection prevention and control at the University of Zambia. Materials and methods This cross-sectional study was conducted among 290 undergraduate pharmacy students at the University of Zambia using a structured questionnaire from August 2022 to October 2022. Data analysis was performed using SPSS version 25.0, and statistical significance was set at a 95% confidence level. Results Of the 290 participants, 166(57.2%) were female and the majority were aged between 18 and 23 years. Overall, 252(86.9%) had good knowledge, 167(57.6%) had positive attitudes, and 248(85.5%) had good practices toward IPC measures. These results indicate lower attitude scores compared to knowledge and practices. Having good knowledge of IPC was associated with being a Christian by religion compared to other religions (OR = 5.314, 95% CI: 1.141-24.745). There was no association between sociodemographics and attitude and practice concerning IPC. Conclusion This study found that pharmacy students had good knowledge, positive attitudes, and good practices toward IPC measures. Consequently, more emphasis is needed to improve the student's knowledge, attitudes, and practices toward IPC, especially in areas where gaps were identified. Additionally, there is a need to improve curricula on IPC measures in the training of pharmacy programs.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
- Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute, Lusaka, Zambia
| | - Joseph Chizimu
- Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute, Lusaka, Zambia
| | - Billy Chabalenge
- Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka, Zambia
| | - Maisa Kasanga
- Zhengzhou University, College of Public Health, Zhengzhou, Henan, China
| | - Scott Kaba Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Kaunda Yamba
- Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute, Lusaka, Zambia
| | - Margret Mulomba
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Webrod Mufwambi
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Patricia Katowa-Mukwato
- Department of Basic and Clinical Nursing, School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow, UK
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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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Khetsuriani N, Gamkrelidze A, Shadaker S, Tsereteli M, Alkhazashvili M, Chitadze N, Tskhomelidze I, Gvinjilia L, Averhoff F, Cloherty G, An Q, Chakhunashvili G, Drobeniuc J, Imnadze P, Zakhashvili K, Armstrong PA. Toward reaching hepatitis B goals: hepatitis B epidemiology and the impact of two decades of vaccination, Georgia, 2021. Euro Surveill 2023; 28:2200837. [PMID: 37498531 PMCID: PMC10375835 DOI: 10.2807/1560-7917.es.2023.28.30.2200837] [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: 10/22/2022] [Accepted: 03/10/2023] [Indexed: 07/28/2023] Open
Abstract
BackgroundGeorgia has adopted the World Health Organization European Region's and global goals to eliminate viral hepatitis. A nationwide serosurvey among adults in 2015 showed 2.9% prevalence for hepatitis B virus (HBV) surface antigen (HBsAg) and 25.9% for antibodies against HBV core antigen (anti-HBc). HBV infection prevalence among children had previously not been assessed.AimWe aimed to assess HBV infection prevalence among children and update estimates for adults in Georgia.MethodsThis nationwide cross-sectional serosurvey conducted in 2021 among persons aged ≥ 5 years used multi-stage stratified cluster design. Participants aged 5-20 years were eligible for hepatitis B vaccination as infants. Blood samples were tested for anti-HBc and, if positive, for HBsAg. Weighted proportions and 95% confidence intervals (CI) were calculated for both markers.ResultsAmong 5-17 year-olds (n = 1,473), 0.03% (95% CI: 0-0.19) were HBsAg-positive and 0.7% (95% CI: 0.3-1.6) were anti-HBc-positive. Among adults (n = 7,237), 2.7% (95% CI: 2.3-3.4) were HBsAg-positive and 21.7% (95% CI: 20.4-23.2) anti-HBc-positive; HBsAg prevalence was lowest (0.2%; 95% CI: 0.0-1.5) among 18-23-year-olds and highest (8.6%; 95% CI: 6.1-12.1) among 35-39-year-olds.ConclusionsHepatitis B vaccination in Georgia had remarkable impact. In 2021, HBsAg prevalence among children was well below the 0.5% hepatitis B control target of the European Region and met the ≤ 0.1% HBsAg seroprevalence target for elimination of mother-to-child transmission of HBV. Chronic HBV infection remains a problem among adults born before vaccine introduction. Screening, treatment and preventive interventions among adults, and sustained high immunisation coverage among children, can help eliminate hepatitis B in Georgia by 2030.
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Affiliation(s)
- Nino Khetsuriani
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Amiran Gamkrelidze
- National Center for Disease Control and Public Health of Georgia (NCDC), Tbilisi, Georgia
| | - Shaun Shadaker
- Division of Viral Hepatitis, Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Maia Tsereteli
- National Center for Disease Control and Public Health of Georgia (NCDC), Tbilisi, Georgia
| | - Maia Alkhazashvili
- National Center for Disease Control and Public Health of Georgia (NCDC), Tbilisi, Georgia
| | - Nazibrola Chitadze
- National Center for Disease Control and Public Health of Georgia (NCDC), Tbilisi, Georgia
| | | | - Lia Gvinjilia
- Eastern Europe and Central Asia Regional Office, Centers for Disease Control and Prevention (CDC), Tbilisi, Georgia
| | | | - Gavin Cloherty
- Abbott Pandemic Defense Coalition, Abbott Park, IL, United States
| | - Qian An
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Giorgi Chakhunashvili
- National Center for Disease Control and Public Health of Georgia (NCDC), Tbilisi, Georgia
| | - Jan Drobeniuc
- Division of Viral Hepatitis, Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Paata Imnadze
- National Center for Disease Control and Public Health of Georgia (NCDC), Tbilisi, Georgia
| | - Khatuna Zakhashvili
- National Center for Disease Control and Public Health of Georgia (NCDC), Tbilisi, Georgia
| | - Paige A Armstrong
- Division of Viral Hepatitis, Centers for Disease Control and Prevention (CDC), Atlanta, United States
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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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10
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Zheng F, Wang K, Wang Q, Yu T, Wang L, Zhang X, Wu X, Zhou Q, Tan L. Factors Influencing Clinicians' Use of Hospital Information Systems for Infection Prevention and Control: Cross-Sectional Study Based on the Extended DeLone and McLean Model. J Med Internet Res 2023; 25:e44900. [PMID: 37347523 PMCID: PMC10337337 DOI: 10.2196/44900] [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: 12/08/2022] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Healthcare-associated infections have become a serious public health problem. Various types of information systems have begun to be applied in hospital infection prevention and control (IPC) practice. Clinicians are the key users of these systems, but few studies have assessed the use of infection prevention and control information systems (IPCISs) from their perspective. OBJECTIVE This study aimed to (1) apply the extended DeLone and McLean Information Systems Success model (D&M model) that incorporates IPC culture to examine how technical factors like information quality, system quality, and service quality, as well as organizational culture factors affect clinicians' use intention, satisfaction, and perceived net benefits, and (2) identify which factors are the most important for clinicians' use intention. METHODS A total of 12,317 clinicians from secondary and tertiary hospitals were surveyed online. Data were analyzed using partial least squares-structural equation modeling and the importance-performance matrix analysis. RESULTS Among the technical factors, system quality (β=.089-.252; P<.001), information quality (β=.294-.102; P<.001), and service quality (β=.126-.411; P<.001) were significantly related to user satisfaction (R2=0.833), use intention (R2=0.821), and perceived net benefits (communication benefits [R2=0.676], decision-making benefits [R2=0.624], and organizational benefits [R2=0.656]). IPC culture had an effect on use intention (β=.059; P<.001), and it also indirectly affected perceived net benefits (β=.461-.474; P<.001). In the importance-performance matrix analysis, the attributes of service quality (providing user training) and information quality (readability) were present in the fourth quadrant, indicating their high importance and low performance. CONCLUSIONS This study provides valuable insights into IPCIS usage among clinicians from the perspectives of technology and organization culture factors. It found that technical factors (system quality, information quality, and service quality) and hospital IPC culture have an impact on the successful use of IPCISs after evaluating the application of IPCISs based on the extended D&M model. Furthermore, service quality and information quality showed higher importance and lower performance for use intention. These findings provide empirical evidence and specific practical directions for further improving the construction of IPCISs.
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Affiliation(s)
- Feiyang Zheng
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Kang Wang
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Qianning Wang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Tiantian Yu
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Lu Wang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Wu
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Qian Zhou
- Department of Hospital Infection Management, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Tan
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
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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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12
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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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Burnett E, Cooper T, Wares K, Wigglesworth N, Chiwera L, Settle C, Robinson J. Designing an optimal infection prevention service: Part 1. J Infect Prev 2023; 24:3-10. [PMID: 36644524 PMCID: PMC9834424 DOI: 10.1177/17571774221127695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/04/2022] [Indexed: 01/18/2023] Open
Abstract
Background Healthcare-associated infections (HCAIs) pose a significant threat to the health and safety of patients, staff, and visitors. Infection prevention and control (IPC) teams play a crucial role in ensuring that systems and processes are in place to keep everyone safe within the healthcare environment. Aim The aim of this study was to identify components of infection prevention services, priorities, indicators of successes and how they are measured, and facilitators and barriers to success. Methods A survey questionnaire was developed and circulated to infection prevention leaders and managers. Findings/results Seventy IPC leaders/managers completed the survey. Participants were responsible for a range of IPC services within and across healthcare organisations, with significant variations to IPC delivery components. Additionally, a range of budget availability was reported. Several IPC service requirements were considered core work of IPC teams, including providing IPC advice and support, surveillance and audit and education and training. Discussion An optimal IPC service needs to be in place to ensure HCAIs are minimised or prevented. In a post pandemic era, this is more important than ever before. This is also as crucial for the health and wellbeing of those working in IPC, who have endured unprecedented demand for their services during the pandemic.
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Affiliation(s)
- Emma Burnett
- Health Sciences, Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Tracey Cooper
- Infection Prevention, Worcestershire Acute Hospitals NHS Trust, Worcester, UK
| | | | | | | | - Chris Settle
- South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK
| | - Jude Robinson
- Infection prevention and Control, NHS England-Midlands, Nottinghamshire, UK
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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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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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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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