scholarly journals Challenges to Infection Control Team during COVID-19 Pandemic in a Quaternary Medical Center in Saudi Arabia

Author(s):  
Hala A Amer ◽  
Ibrahim A Alowidah ◽  
Chasteffi Bugtai ◽  
Barbara M. Soule ◽  
Ziad A Memish

Abstract Background: King Saud Medical City (KSMC) is a quaternary care center based in the center of the capital city, Riyadh, Kingdom of Saudi Arabia (KSA) and is one of the key Ministry of Health (MoH) facilities dedicated to the care of COVID-19 patients in the central region. Methods: A comprehensive surge plan was promptly launched in mid-March 2020 to address the pandemic and then expanded in a phase-wise approach. Supporting the capacity of the infection prevention and control department (IPCD) was one of the main pillars of KSMC surge plan. Task force Infection Control teams have been formulated to tackle the different aspects of pandemic containment processes. The challenges and measures undertaken by the IPC team have been described. Conclusion: Realizing the more prominent role of infection prevention and control staff as frontline responders to public health emergencies like COVID-19, a solid infection prevention and control system at the healthcare setting supported by qualified and sufficient manpower, a well-developed multidisciplinary team approach, electronic infrastructure and efficient supply utilization is required for effective crisis management.

Author(s):  
Ahmad M. Albarrag ◽  
Abdulmajeed A. Aloraini ◽  
Abdulaziz I. Alhussain ◽  
Faris I. Alwarhi ◽  
Abdullah I. Altashlan ◽  
...  

Background: Patients and healthcare workers are susceptible to health care associated infections if they are not compliant with infection prevention and control standards. There are no previous studies regarding the assessment of knowledge and practice of intern doctors toward infection prevention and control precautions in Saudi Arabia.Methods: A cross-sectional study that was carried-out on 259 intern doctors at the main hospitals of Riyadh city in Saudi Arabia. A self-administered questionnaire was distributed to the participants after validation during their clinical rounds and their morning meetings of their departments. Data were analysed using SPSS version 21.0.  Results: Out of 259 participants, the overall mean score for knowledge assessment was 79.4±7.52. For hand hygiene mean score was 23.53±2.66 out of 30, personal protective equipment mean score was 20.63±2.49 out of 25. A significant low level of knowledge regarding needle stick injury with a score of 19.18±2.50 out of 30. Regarding, knowledge towards isolation precautions, around 50% reported adequate knowledge regarding isolation precautions. Meanwhile, 78 (30.1%) denied receiving any form of training or orientation in infection control.  Conclusions: There is a moderate level of knowledge and satisfactory level of practice among intern doctors in Riyadh. However, there was some misconceptions regarding needle stick injury and isolation precaution. Implementing infection control education and training programs is recommended before starting clinical practice.


2020 ◽  
Vol 41 (S1) ◽  
pp. s299-s300
Author(s):  
Hala Amer ◽  
Ahmed Alenizi

Background: In 2018, the Ministry of Health (MOH) in Saudi Arabia launched the Infection Control Excellence Center (ICEC) program among healthcare governmental institutions to create an exceptionally high concentration of expertise and resources within the infection prevention and control discipline to afford the best patient outcomes possible. King Saud Medical City (KSMC), one of the main healthcare institutions in Riyadh, was selected to be among the 10 facilities participating in ICEC 2019 competition. It is expected to qualify the facility to lead the Kingdom infection prevention and control as well as sharing expertise at regional and international levels. Methods: The infection control team at KSMCA used a business model canvas to present the project vision, resources, partners, values, and revenue streams (Fig. 1). All project stakeholders were engaged, including core infection control team, various hospital departments as internal partners, along with the MOH team as external partners. The ICEC program was presented at the KSMC executive council to earn leadership support. The following assessment areas were included in the presentation: (1) quality assurance and patient care through sustain basic infection control standards and improve key performance indicators (KPIs); (2) enhance the development and structure of the infection control team; (3) pursue innovative ideas in infection control practices. Overall, 17 projects arranged into 4 programs have been proposed (Fig. 2). Results: The institution successfully passed the eligibility criteria assessment in the first quarter of 2019. Infection control KPIs have been corporatized with KSMC strategic KPIs that support infection control improvement initiatives. The infection control team continues to grow in function and capacity. Also, 4 additional were awarded CIC certification in 2019 to reach total of 11 CICs, which represent 30% of the team (including 1 recertification). A dashboard designed by the project management office facilitates follow-up with the proposed projects in progress. Completion levels ranging between 30% and 100% have been achieved among these projects. A final evaluation was conducted in December 2019, including a field visit by the MOH ICEC team as well as a written MCQs exams and interviews with the core infection control team. Communication among the stakeholders and leadership involvement were considered among the assessment criteria. Conclusions: The ICEC supports and motivates investment in human capital and encourages innovative, cost-effective solutions in infection control field in Saudi Arabia. It is also aligned with Saudi Arabia healthcare transformation and the 2030 vision through integrated programs in healthcare facilities.Funding: NoneDisclosures: None


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S407-S407
Author(s):  
Kate Tyner ◽  
Regina Nailon ◽  
Sue Beach ◽  
Margaret Drake ◽  
Teresa Fitzgerald ◽  
...  

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 <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 < 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.


2021 ◽  
Vol 15 (1) ◽  
pp. 64-70
Author(s):  
Ali AlAhdal ◽  
Haila Al-Huraishi ◽  
Ahmad Almalag ◽  
Adel Alrusayes ◽  
Saud M Orfali

Objective: Novel newly discovered coronavirus, also known as severe acute respiratory syndrome coronavirus-2, is a recently emerging virus that has been rapidly spreading globally since December 2019. Due to the vicinity inoro-dental treatment and aerosol production, people inside the dental office are at high risk of being infected with severe acute respiratory syndrome coronavirus-2. This guideline aims to protect the dental health-care workers during their plans to re-open and increasingly continue their routine services until further notice from their governing body. Methods: A panel of experts in dentistry and infection prevention and control reviewed the local and global research and guidelines related to infection prevention and control during coronavirus disease-2019, along with the re-opening guidance provided by different entities. Results: Such a document might either be adopted or adapted to any regional and international organization that wishes to use a revised professional guideline in infection prevention and control dental services. Conclusion: A careful re-opening plan should be developed and implemented, including strict infection control measures before resuming the dental practice.


Author(s):  
Marwa Ahmed Abdelwahab ◽  
Eman Abdel Raheem Labah ◽  
Laila Mahmoud Sayed ◽  
Mohamed Mokhtar Elbedwey ◽  
Heba Mohamed Gabr

Objective: Infection is a leading cause of hospitalization and the second most common cause of mortality among hemodialysis (HD) patients. The aim of this study is to assess the impact of infection prevention and control education program on improving healthcare workers knowledge, attitude and practices and reducing incidence of infection in the hemodialysis unit. Methodology: All patients and healthcare workers in the unit within the study period were included. This study was conducted through 3 phases; Phase I: base line survey for assessment of infection prevention and control knowledge, attitude and practices among healthcare workers, Phase II: Intervention that included infection control standardized education program followed by post education survey. Phase III: Implementation of infection control program was done associated with assessment of blood born viruses (HCV, HBV & HIV) and monitoring patients for fever and/or local signs of inflammation at catheter exit or at skin around shunt to be subjected to blood culture. Results: Health care workers knowledge, attitude and practices of infection prevention and control before intervention were unsatisfactory followed by significant improvement reflecting the effectiveness of such interventions. Regarding incidence of infection there were three cases of blood stream infections; two of them were multidrug resistant organisms (MDROs) and no reported cases of seroconverion for HIV, HCV or HBV during study period.  Conclusion: Lack of knowledge about infection prevention and control practices in hemodialysis unit could be significantly improved by standardized education program which results in reducing incidence of infections in such units.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 223s-223s
Author(s):  
M. Faizan ◽  
S. Anwar ◽  
R.U.A. Kashif ◽  
R. Saleem ◽  
H. Javed ◽  
...  

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.


2020 ◽  
Author(s):  
Yingzi Ye ◽  
Peng Shi ◽  
Yonghao Gui ◽  
Albert M. Li ◽  
Guoying Huang ◽  
...  

Abstract Background: To evaluate the effectiveness of training on knowledge and practices of infection prevention and control (IPC) among pediatric health care workers (HCW) in Shanghai, China, in the context of COVID-19 pandemic. Methods: An online training program was designed by the Shanghai Pediatric Clinical Quality Control Center (SPQCC) during the early phase of COVID-19 pandemic on disease knowledge and practice of IPC. Training took place in the 81 partner hospitals affiliated with SPQCC. A 25-item self-administered questionnaire was used to evaluate knowledge gained from the training. Stratified-random sampling was used to select HCW according to three professionals (i.e., pediatricians, nurses and administrators) within each partner hospital. Awareness and knowledge of COVID-19 and its related infection control and practice was assessed by comparing survey results between different types of hospitals, professionals and professional ranks. A higher survey score meant that the respondent was more prepared and knowledgeable about COVID-19 and its infection control measures. Results: Completed questionnaires were returned from 1,062 subjects (385 pediatricians, 410 nurses, and 267 administrators), giving a response rate of 96.5%. Overall, awareness of clinical information related to COVID-19, importance of personal hygiene and isolation policy was high among the respondents. No statistical difference of scores on knowledge of COVID-19, IPC and relevant practice between the tertiary and peripheral hospitals. Among all respondents, middle-ranked health care personnel were most knowledgeable and achieved the highest score. Conclusions: Majority of pediatric HCW showed good recognition and practice in infection protection and control measures. The online training was able to achieve its aim to enhance knowledge and awareness and could have contributed to the zero infection rate among HCW caring for confirmed COVID-19 cases in Shanghai.


2021 ◽  
pp. JNM-D-20-00044
Author(s):  
Elena Gurková ◽  
Ian Blackman ◽  
Daniela Bartoníčková ◽  
Darja Jarošová ◽  
Lenka Machálková ◽  
...  

Background and PurposeOnly a limited number of items involved in missed nursing care inventories specifically focused on infection control practices. The study aimed to adapt and evaluate psychometric properties of the Czech and Slovak version of the Infection Control Missed Care survey; and to assess and compare the amount, type, and reasons for missed nursing care in infection prevention and control among Czech and Slovak nurses.MethodsThe convenience sample of 1459 nurses from the Czech and Slovak republic was recruited. Analysis of the nurses' responses to both subscales of the surveys and validation of their data was undertaken using the item response theory (Rasch scaling).ResultsThe now-modified Czech version consists only of 20 items measuring the type and frequency of missed care and 11 items focusing on the reasons for missed care. The now modified Slovak version consists of 34 items measuring the type and frequency of missed care and 17 items measuring the reasons for missed care. Reliability estimates with the removal of unreliable items showed acceptable reliability estimates for both sub-scales of the instrument.ConclusionsWith modification to the two subscales used in the survey (removal of poorly fitting items) it should be reliable, and the resulting data could be used for further investigation such as factor analysis or modelling. The modified Infection Control Missed Care survey could be useful in further research investigating a relationship between nurse staffing, skill mix, and infection control outcomes in acute care hospitals.


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