Determining the status quo of infection prevention and control standards in the hospitals of iran: a case study in 23 hospitals

Quality of the hospital infection control programs: an integrative review

OBJECTIVE

To analyze the quality of health in relation to the components of structure, process, and outcome in actions for the prevention and control of infections.

METHOD

An integrative literature review in the LILACS, Web of Science, Scopus, and SciELO databases. The time delimitation covered articles published between January 2009 and May 2019.

RESULTS

The final sample consisted of 10 articles published, mainly in Scopus (60%), and in Web of Science (30%). The structural elements varied among the study countries, suggesting opportunities for improvement of organizational characteristics and human resources. Regarding the process of the implemented routines, inconsistencies were found to comply with the guidelines. The result component was not emphasized among the studies included in the review.

CONCLUSION

The quality of hospital infection control programs has yet to be improved among the health services, highlighting the need for investment in the structure, process, and outcome components.

Repeat Auditing of Primary Health-care Facilities Against Standards for Occupational Health and Infection Control: A Study of Compliance and Reliability

Background

The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit.

Methods

The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011–2012 were compared with follow-up internal audits in 2014–2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability.

Results

At baseline, 25% of 60 facilities were “noncompliant” (audit score<50%), 48% “conditionally compliant” (score >50 < 80%), and only 27% “compliant” (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate).

Conclusion

Low baseline compliance with OHS–IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.