scholarly journals Improvement of Infection Prevention and Control Practices Using Quality Improvement Approach in Two Model Hospitals in Kenya

2020 ◽  
Vol 41 (S1) ◽  
pp. s286-s287
Author(s):  
Loyce Kihungi ◽  
Mary Ndinda ◽  
Samantha Dolan ◽  
Evelyn Wesangula ◽  
Linus Ndegwa ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Hand Hygiene ◽  
Waste Management ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Technical Assistance ◽  
Infection Prevention And Control ◽  
Waste Segregation ◽  
And Control

Background: Little is known about how best to implement infection prevention and control programs in low-resource settings. The quality improvement approach using plan-do-study-act (PDSA) cycles provides a framework for data-driven infection prevention and control implementation. We used quality improvement techniques and training to improve infection prevention and control practices in 2 model hospitals in Kenya. Methods: The 2 hospitals were chosen by the Kenya Ministry of Health for capacity building on infection prevention and control. At each site, the project team (the University of Washington International Training for Education and Training in Health, Ministry of Health, and Centers for Disease Control) conducted infection prevention and control training to infection prevention and control committee members. Infection prevention and control quality improvement activities were introduced in a staggered manner, focusing on hand hygiene and waste management practices. For hand hygiene, the project team’s technical assistance focused on facility hand hygiene infrastructure, hand hygiene practice adherence, hand hygiene supply quantification, and monitoring and evaluation using WHO hand hygiene audit tools. Waste management technical assistance focused on availability of policy, guidelines, equipment and supplies, waste segregation, waste quantification, and monitoring and evaluation using a data collection tool customized based on previously published tools. Regular interactive video conference sessions between the project team and the sites that included didactic sessions and sharing of data provided ongoing mentorship and feedback on quality improvement implementation, data interpretation, and data use. Results: Hand hygiene data collection began in April 2018. In hospital A, hand hygiene compliance increased from a baseline of 3% to 51% over 9 months. In Hospital B, hand hygiene compliance rates increased from 23% at baseline to 44% after 9 months. Waste management data collection began in November 2018. At hospital A, waste segregation compliance scores increased from 73% at baseline to 80% over 6 months, whereas hospital B, waste segregation compliance went from 44% to 80% over 6 months. Conclusions: A quality improvement approach appears to be a feasible means of infection prevention and control program strengthening in low resource settings.Funding: NoneDisclosures: None

scholarly journals Enhancing Infection Prevention and Control Capacity in Health Facilities Following the 2019 Ebola Outbreak in Kasese, Uganda

2020 ◽  
Vol 41 (S1) ◽  
pp. s471-s471
Author(s):  
Maureen Kesande ◽  
Mohammed Lamorde ◽  
Elizabeth Bancroft ◽  
Carolyn Herzig ◽  
Judith Nanyondo ◽  
...  
Keyword(s):  
High Risk ◽  
Hand Hygiene ◽  
Waste Management ◽  
Personal Protective Equipment ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Water Source ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
And Control

Background: In June 2019, 3 people were diagnosed with Ebola virus disease (EVD) in Kasese district, Uganda, all of whom had come from the Democratic Republic of Congo (DRC). Although no secondary transmission of Ebola occurred, an assessment of infection prevention and control (IPC) using the WHO basic IPC facility assessment checklist revealed significant gaps. Robust IPC systems are critical for the prevention of healthcare-associated infections like EVD. A rapid intervention was developed and implemented in Kasese to strengthen IPC capacity in high-risk facilities. Methods: Of 117 healthcare facilities, 50 were considered at high risk of receiving suspected EVD cases from DRC based on population movement assessments. In August 2019, IPC mentors were selected from 25 high-risk facilities and assigned to support their facility and a second high-risk facility. Mentors ensured formation of IPC committees and implemented the national mentorship strategy for IPC preparedness in non-EVD treatment facilities. This effort focused on screening, isolation, and notification of suspect cases: 4 mentorship visits were conducted (1 per week for 1 month). Middle and terminal assessments were conducted using the WHO IPC checklist 2 and 4 weeks after the intervention commenced. Results were evaluated against baseline data. Results: Overall, 39 facilities had data from baseline, middle, and end assessments. Median scores in facility IPC standard precautions increased from baseline 50% (IQR, 39%–62%) to 73% (IQR, 67%–76%) at the terminal assessments. Scores increased for all measured parameters except for water source (access to running water). Greatest improvements were seen in formation of IPC committees (41% to 75%), hand hygiene compliance (47% to 86%), waste management (51% to 83%), and availability of dedicated isolation areas (16% to 42%) for suspect cases. Limited improvement was noted for training on management of suspect isolated cases and availability of personal protective equipment (PPE) (Fig. 1). No differences were noted in scores for facilities with nonresident mentors versus those with resident mentors at baseline (48% vs 50%) and end assessments (72% vs 74%). Conclusions: This intervention improved IPC capacity in health facilities while avoiding the cost and service disruption associated with large-scale classroom-based training of health workers. The greatest improvements were seen in activities relying on behavior change, such as hand hygiene, IPC committee, and waste management. Smaller changes were seen in areas requiring significant investments such as isolation areas, steady water source, and availability of personal protective equipment (PPE). Mentorship is ongoing in moderate- and lower-risk facilities in Kasese district.Funding: NoneDisclosures: Mohammed Lamorde reports contract research for Janssen Pharmaceutica, ViiV, Mylan.

scholarly journals Infection Prevention and Control Policies and Staffing: A National Survey of Home Health Agencies in the United States

2020 ◽  
Vol 41 (S1) ◽  
pp. s301-s301
Author(s):  
Jingjing Shang ◽  
Ashley Chastain ◽  
U. Gayani Perera ◽  
Monika Pogorzelska-Maziarz ◽  
Patricia Stone
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Staff Member ◽  
Antibiotic Stewardship ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
For Profit ◽  
Healthcare Settings ◽  
And Control

Background: Infection prevention and control (IPC) is a national priority in all healthcare settings, and IPC staffing characteristics have been linked to patient safety outcomes. However, there is a lack of knowledge about IPC in home healthcare (HHC), the fastest growing healthcare sector. Our aim was to better understand the current state of IPC in HHC, as well as the HHC staff involved with IPC policy implementation. Methods: A national survey was conducted between October 2018 and November 2019. The participants included (1) agencies recruited from a national HHC conference and (2) a national random sample of 1,501 agencies stratified by census region, ownership status, and rural or urban location. Survey items included staff influenza vaccination policies, antibiotic stewardship, infection surveillance, and IPC staffing. Descriptive statistics were computed, and differences by ownership were calculated using 2 and Student t tests. Results: Of the 535 HHC agencies that responded to the survey (response rate, 33%), 64% were for-profit agencies. Overall, 30.8% of the agencies (17.9% for-profit, 57.6% nonprofit; P < .01) required staff influenza vaccination. Most nonprofit agencies (84.1%) and about half of the for-profit agencies (48.1%) offered free influenza vaccinations to staff (P < .01). During the past influenza season, 62.6% of agencies (81.5% nonprofit vs 51.6% for-profit; P < .01) had 75% of their employees vaccinated for influenza, and 9.3% (2% nonprofit vs 13.5% for-profit; P < .01) reported that they did not track this data. Only 17.9% of HHC agencies used antibiotic prescribing guidelines, and 33.3% reported that they reviewed cases to assess the appropriateness of antibiotic administration and/or indication. Most HHC agencies (86%) reported collecting and reviewing infection data to identify trends, which was often done quarterly or more frequently. Almost every responding agency reported that the staff member in charge of IPC had other responsibilities including administrative, education/training, or quality improvement, and 33.5% of those personnel had received no specific IPC training. Also, ~6% of agencies (12.5% of government-owned agencies) reported that they currently did not have a staff member in charge of IPC. Conclusions: This is the first national study of IPC in HHC, which can be used as a benchmark for quality improvement initiatives in the home care environment. Compared to other healthcare settings, HHC agencies have substantial challenges related to IPC. Most HHC agencies do not have a staff member exclusively dedicated to IPC, and staff training is inadequate. Furthermore, a significant number of agencies have no staff influenza vaccination or antibiotic stewardship policies in place. The situation is worse at for-profit agencies, which dominate the current US HHC industry.Funding: NoneDisclosures: None

scholarly journals Frequently Identified Infection Control Gaps Related to Hand Hygiene in Long-Term Care Facilities

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S407-S407
Author(s):  
Kate Tyner ◽  
Regina Nailon ◽  
Sue Beach ◽  
Margaret Drake ◽  
Teresa Fitzgerald ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Long Term Care ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Care Facilities ◽  
And Control

Abstract Background Little is known about hand hygiene (HH) policies and practices in long-term care facilities (LTCF). Hence, we decided to study the frequency of HH-related infection control (IC) gaps and the factors associated with it. Methods The Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) in collaboration with NE Department of Health and Human Services conducted in-person surveys and on-site observations to assess infection prevention and control programs (IPCP) in 30 LTCF from 11/2015 to 3/2017. The Centers for Disease Control and Prevention (CDC) Infection Prevention and Control Assessment tool for LTCF was used for on-site interviews and the Centers for Medicare and Medicaid (CMS) Hospital IC Worksheet was used for observations. Gap frequencies were calculated for questions (6 on CDC survey and 8 on CMS worksheet) representing best practice recommendations (BPR). The factors studied for the association with the gaps included LTCF bed size (BS), hospital affiliation (HA), having trained infection preventionists (IP), and weekly hours (WH)/ 100 bed spent by IP on IPCP. Fisher’s exact test and Mann Whitney test were used for statistical analyses. Results HH-related IC gap frequencies from on-site interviews are displayed in Figure 1. Only 6 (20%) LTCF reported having all 6 BPR in place and 10 (33%) having 5 BPR. LTCF with fewer gaps (5 to 6 BPR in place) appear more likely to have HA as compared with the LTCF with more gaps but the difference didn’t reach statistical significance (37.5% vs. 7.1%, P = 0.09). When analyzed separately for each gap, it was found that LTCF with HA are more likely to have a policy on preferential use of alcohol based hand rubs than the ones without HA. (85.7%, vs. 26.1% P = 0.008). Several IC gaps were also identified during observations (Figure 2) with one of them being overall HH compliance of &lt;80%. LTCF that have over 90% HH compliance are more likely to have higher median IP WH/100 beds dedicated towards IPCP as compared with the LTCFs with less than 90% compliance (16.4 vs. 4.4, P &lt; 0.05). Conclusion Many HH-related IC gaps still exist in LTCF and require mitigation. Mitigation strategies may include encouraging LTCF to collaborate with IP at local acute care hospitals for guidance on IC activities and to increase dedicated IP times towards IPCP in LTCF. Disclosures All authors: No reported disclosures.

scholarly journals Train-the-Trainers in hand hygiene: a standardized approach to guide education in infection prevention and control

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Ermira Tartari ◽  
Carolina Fankhauser ◽  
Sarah Masson-Roy ◽  
Hilda Márquez-Villarreal ◽  
Inmaculada Fernández Moreno ◽  
...  
Keyword(s):  
South Africa ◽  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
World Health ◽  
Infection Prevention And Control ◽  
Rank Test ◽  
Hand Hygiene Improvement ◽  
And Control

Abstract Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.

scholarly journals Experience and Challenges in Establishing Quarantine Facility for Suspected COVID-19 Cases: Field Briefing

2021 ◽  
Vol 06 (03) ◽  
pp. 1-8
Author(s):  
Shubha Garg ◽  
Keyword(s):  
Waste Management ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Medical Waste ◽  
Infection Prevention And Control ◽  
Successful Operation ◽  
Environmental Cleaning ◽  
The World ◽  
Medical Waste Management ◽  
And Control

Introduction: Due to the unprecedented SARS-CoV-2 pandemic, in late January 2020, many countries in the world imposed a travel ban. Governments across the world initiated repatriation operations for stranded nationals. It was important to instantly develop quarantine facilities for evacuees. As the disease was fairly new, data on it was sparse to fulfil the requirement. Objectives: We are sharing our experience of establishing and managing India’s first quarantine facility for repatriate nationals focusing on key parameters including infection prevention and control, environmental cleaning, and bio-medical waste management along with basic living requirements. Results: The facility housed a total of 617 evacuees from China and Italy. Among them, 17 were found to be positive on initial testing and one tested positive on the 14th day of testing. 25 contacts were traced and prescribed an additional quarantine period of fourteen days in the facility, and were discharged accordingly. All evacuees were put on community surveillance. Supply of logistics, manpower management, and ensuring compliance to protocols were some of the major challenges faced, for which appropriate actions were taken. Conclusion: Impeccable collaboration and coordination among different stakeholders is the most essential ingredient for the successful operation of any quarantine facility in the context of the current pandemic.

scholarly journals Improvement in Infection Prevention and Control Measures at The Children Hospital, Lahore. A My Child Matters Collaborative Project

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 223s-223s
Author(s):  
M. Faizan ◽  
S. Anwar ◽  
R.U.A. Kashif ◽  
R. Saleem ◽  
H. Javed ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Pediatric Cancer ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Improvement Strategy ◽  
Targeted Interventions ◽  
Healthcare Associated ◽  
And Control

Background: Overcrowding, lack of operational funds, and healthcare associated infections are major challenges at the Children Hospital Lahore, a public healthcare facility in Pakistan with 900 new pediatric cancer admissions annually. In 2014, a collaboration between My Child Matters (MCM), St. Jude Global Infectious Diseases Program (SJ-GID), and our institution was established to address these issues. Aim: To describe the effect of a collaborative improvement strategy on the infection prevention and control (IPC) standards in a pediatric oncology unit in a resource-limited setting. Methods: Our study was a prospective before-and-after study. We compare the WHO Hand Hygiene Self-Assessment Framework (HHSAF) and 4 modules of the St. Jude modified Infection Control Assessment Tool (ICAT) scores. Our strategy included: (1) creating a multidisciplinary team of pediatric hematology-oncology, infectious disease physicians, nurses, microbiologist, and a data manager, (2) engaging on monthly online IPC mentoring sessions with the SJ-GID and MCM mentors, (3) performing daily inpatient healthcare associated (HAI) surveillance rounds, and (4) providing regular hand hygiene training and compliance audits. Results: Our hand hygiene facility level per WHO scores increased from “Inadequate” during the baseline assessment to “Intermediate/Consolidation” by the end of 3-year implementation (122 vs 352 HHSAF scores). The sink: bed and hand sanitizer: bed ratios improved to 1:6 and 1:1 respectively. Six washrooms were added to our unit. ICAT general infection control module increased by 40% (45 vs 78 ICAT score) and hygiene compliance improved by 20% from baseline. Identification of HAI increased from baseline (4.07 vs 8.7 infections per 1000 patient days). A 25% of the isolates were multidrug-resistant microorganisms. Conclusion: Implementing a collaborative improvement strategy improved the IPC standards in our pediatric cancer center. The increase of HAI might be a result of a better surveillance and laboratory identification. Further targeted interventions should be develop to decrease HAI rates and infection-related morbidity and mortality in our population.

scholarly journals Pengembangan Program Pencegahan dan Pengendalian Infeksi COVID-19 dalam Mempertahankan Status Kesehatan pada Tenaga Kesehatan di Rumah Sakit Kota Medan

2021 ◽  
Vol 6 (2) ◽  
pp. 99
Author(s):  
Muhammad Taufik Daniel Hasibuan ◽  
Harsudianto Silaen
Keyword(s):  
Health Status ◽  
Focus Group ◽  
Data Collection ◽  
Vital Sign ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Control Program ◽  
Infection Prevention And Control ◽  
And Control

The COVID-19 infection prevention and control program in hospitals is an effort to provide guidance for health workers to stay healthy, safe, productive, and the community gets services that meet standards. Health workers who work in hospitals are very vulnerable to being exposed to  COVID -19, so it is very important that health workers and policy makers understand the basic concepts of infectious diseases. The purpose of this study was to develop a program to prevent and control covid-19 infection in maintaining the health status of health workers at the Medan City Hospital. The type of research used is action research. The participants in this study were 14 people consisting of 2 parts, namely 1) Participants for qualitative data were taken from managerial such as medical services, nursing, medical records, infection prevention and control units, and the head of the room. 2) Participants for quantitative data are taken from health workers, namely nurses. Data collection in this study used various methods, namely individual interviews, observation, self-report, focus group discussions and several data collection tools, namely interview guides, focus group discussion guides, questionnaires, observation sheets, and supporting tools, namely voice recorders. The results of this study obtained outputs, namely standard operating procedures for the prevention and control of covid-19 infection, and from the results of health status checks on health workers from before and after the implementation of the  COVID -19 infection prevention and control program, the results were before (PCR/Antigen: Negative). 71.43%, Positive: 28.57%; Vital sign normal: 85.71%, Abnormal 14.29%), and after (PCR/Antigen: Negative 85.71%, Positive: 14.29%; Vital sign normal: 100%). This proves that there is an influence of the Covid-19 infection prevention and control program in maintaining the health status of health workers in hospitals. Suggestions to hospital leaders to continue to evaluate prevention and control programs for COVID-19 infection in accordance with developments and the situation at hand.

Hospital and community infection prevention and control (IPC)

2016 ◽  
Author(s):  
Paul Shears ◽  
Andrea Ledgerton ◽  
Rita Huyton
Keyword(s):  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Local Health ◽  
Community Settings ◽  
Infection Surveillance ◽  
And Control ◽  
Community Infection

This chapter outlines the key principles of infection prevention and control (IPC) in both hospital and community settings. This includes understanding the structures surrounding infection prevention and control in these two different environments. It outlines some of the practical components including hand hygiene, infection surveillance, personal protective equipment, decontamination, and policies and guidelines. The chapter also covers the investigation and management of clusters/outbreak, and provides an outline of situations that require local health protection team input. Finally, the interface between community and hospital IPC is discussed, along with the importance of providing a seamless IPC service in all geographical areas.

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