Best Practices in Infection Prevention and Control: An International Perspective

Abstract Quality challenge The Sierra Leone (SL) Ministry of Health and Sanitation’s National Infection Prevention and Control Unit (NIPCU) launched National Infection and Prevention Control (IPC) Policy and Guidelines in 2015, but a 2017 assessment found suboptimal compliance with standards on environmental cleanliness (EC), waste disposal (WD) and personal protective equipment (PPE) use. Methods ICAP at Columbia University (ICAP), NIPCU and the Centers for Disease Control and Prevention (CDC) designed and implemented a Rapid Improvement Model (RIM) quality improvement (QI) initiative with a compressed timeframe of 6 months to improve EC, WD and PPE at eight purposively selected health facilities (HFs). Targets were collaboratively developed, and a 37-item checklist was designed to monitor performance. HF teams received QI training and weekly coaching and convened monthly to review progress and exchange best practices. At the final learning session, a “harvest package” of the most effective ideas and tools was developed for use at additional HFs. Results The RIM resulted in marked improvement in WD and EC performance and modest improvement in PPE. Aggregate compliance for the 37 indicators increased from 67 to 96% over the course of 4 months, with all HFs showing improvement. Average PPE compliance improved from 85 to 89%, WD from 63 to 99% and EC from 51 to 99%. Lessons learned The RIM QIC approach is feasible and effective in SL’s austere health system and led to marked improvement in IPC performance. The best practices are being scaled up and the RIM QIC methodology is being applied to other domains.

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A pre-pandemic COVID-19 assessment of the costs of prevention and control interventions for healthcare associated infections in medical and surgical units in Québec

10.21203/rs.3.rs-608797/v1 ◽

2021 ◽

Author(s):

Eric Tchouaket ◽

Stephanie Robins ◽

Sandra Boivin ◽

Drissa Sia ◽

Kelley Kilpatrick ◽

...

Keyword(s):

Best Practices ◽

Prevention And Control ◽

Healthcare Workers ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Healthcare Associated Infections ◽

Median Cost ◽

Healthcare Associated ◽

The Cost ◽

And Control

Abstract Background Healthcare-associated infections (HCAIs) present a major public health problem that significantly affects patients, health care providers and the entire healthcare system. Infection prevention and control programs limit HCAIs and are an indispensable component of patient and healthcare worker safety. The clinical best practices (CBPs) of handwashing, screening, hygiene and sanitation of surfaces and equipment, and basic and additional precautions are keystones of infection prevention and control (IPC). Systematic reviews of IPC economic evaluations report the lack of rigorous empirical evidence demonstrating the cost-benefit of IPC program in general, and point to the lack of assessment of the value of investing in CBPs more specifically. Objective This study aims to assess overall costs associated with each of the four CBPs. Methods Across two Quebec hospitals, 48 healthcare workers were observed for two hours each shift, for two consecutive weeks. A modified time-driven activity-based costing framework method was used to capture all human resources (time) and materials required (e.g. masks, cloths, disinfectants) for each clinical best practice. Using a hospital perspective with a time horizon of one year, median costs per CBP per hour, as well as the cost per action, were calculated and reported in 2018 Canadian dollars. Sensitivity analyses were performed. Results A total of 1831 actions were recorded. The median cost of hand hygiene (N = 867) was 19.6 cents per action. For cleaning and disinfection of surfaces (N = 102), the cost was 21.4 cents per action, while cleaning of small equipment (N = 85) was 25.3 cents per action. Additional precautions median cost was $4.13 per action. The donning or removing or personal protective equipment (N = 720) cost was 75.9 cents per action. Finally, the total median costs for the five categories of clinical best practiced assessed were 27.2 cents per action. Conclusion The costs of clinical best practices were low, from 20 cents to $4.13 per action. This study provides evidence based arguments with which to support the allocation of resources to infection prevention and control practices that directly affect the safety of patients, healthcare workers and the public. Further research of costing clinical best care practices is warranted.

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Assessment of the infection prevention and control learning needs of Ottawa community-based healthcare providers

Canadian Journal of Infection Control ◽

10.36584/cjic.2019.014 ◽

2019 ◽

pp. 135-140

Author(s):

Geneviève Cadieux ◽

Abha Bhatnagar ◽

Tamara Schindeler ◽

Chatura Prematunge ◽

Donna Perron ◽

...

Keyword(s):

Public Health ◽

Professional Development ◽

Best Practices ◽

Prevention And Control ◽

Infection Prevention ◽

Healthcare Providers ◽

Infection Prevention And Control ◽

Learning Needs ◽

Community Based ◽

And Control

Background: Under the Health Protection and Promotion Act and Infection Prevention and Control (IPAC) Complaint Protocol, Ontario public health units are mandated to respond to IPAC complaints about community-based clinical offices. From 2015 to 2018, Ottawa Public Health noted a seven-fold increase in IPAC complaints involving medical and dental settings. In response, we sought to assess the IPAC learning needs of our community-based healthcare providers. Specifically, our objectives were to assess: 1) clinical practice characteristics, 2) current IPAC practices, 3) IPAC knowledge, 4) barriers/facilitators to adherence to IPAC best practices, and 5) preferred IPAC professional development activities. Methods: An anonymous online survey targeting Ottawa community-based healthcare providers was disseminated through multiple methods including through Ottawa Public Health’s (OPH) subscription-based e-bulletin to physicians. The short survey questionnaire included Likert-scale, multiple choice, and open-ended questions. Data collection began in August 2018; a descriptive analysis was conducted using data extracted on January 19, 2019. Results: Our findings suggest that medical respondents may not be as aware of IPAC practices in their clinic as dental respondents were. Familiarity with IPAC best practice documents was also higher among dental respondents, as compared to medical respondents. IPAC knowledge-testing questions revealed that more medical than dental respondents knew the appropriate use of multi-dose vials, and that few medical respondents knew the IPAC best practices for point-of-care glucose monitoring equipment. Respondents recognized the importance of adhering to IPAC best practices to prevent healthcare-associated infections; however, lack of evidence and cost were selfreported barriers to adherence to IPAC best practices. Over half of all medical and dental respondents surveyed were interested in a voluntary audit of their IPAC practices to help meet their IPAC professional development needs. Conclusions: Findings from this needs assessment helped describe current IPAC practices and knowledge, identify barriers and facilitators to adherence to IPAC best practices, and understand the learning preferences of Ottawa community-based healthcare providers. This information will be instrumental in planning future IPAC capacity-building activities and tailoring these activities to specific professional groups in Ottawa and potentially beyond.

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A pre-pandemic COVID-19 assessment of the costs of prevention and control interventions for healthcare associated infections in medical and surgical wards in Québec

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-021-01000-y ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Eric Tchouaket Nguemeleu ◽

Stephanie Robins ◽

Sandra Boivin ◽

Drissa Sia ◽

Kelley Kilpatrick ◽

...

Keyword(s):

Best Practices ◽

Prevention And Control ◽

Healthcare Workers ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Protective Equipment ◽

Healthcare Associated Infections ◽

Healthcare Associated ◽

The Cost ◽

And Control

Abstract Background Healthcare-associated infections (HCAIs) present a major public health problem that significantly affects patients, health care providers and the entire healthcare system. Infection prevention and control programs limit HCAIs and are an indispensable component of patient and healthcare worker safety. The clinical best practices (CBPs) of handwashing, screening, hygiene and sanitation of surfaces and equipment, and basic and additional precautions (e.g., isolation, and donning and removing personal protective equipment) are keystones of infection prevention and control (IPC). There is a lack of rigorous IPC economic evaluations demonstrating the cost–benefit of IPC programs in general, and a lack of assessment of the value of investing in CBPs more specifically. Objective This study aims to assess overall costs associated with each of the four CBPs. Methods Across two Quebec hospitals, 48 healthcare workers were observed for two hours each shift, for two consecutive weeks. A modified time-driven activity-based costing framework method was used to capture all human resources (time) and materials (e.g. masks, cloths, disinfectants) required for each clinical best practice. Using a hospital perspective with a time horizon of one year, median costs per CBP per hour, as well as the cost per action, were calculated and reported in 2018 Canadian dollars ($). Sensitivity analyses were performed. Results A total of 1831 actions were recorded. The median cost of hand hygiene (N = 867) was 20 cents per action. For cleaning and disinfection of surfaces (N = 102), the cost was 21 cents per action, while cleaning of small equipment (N = 85) was 25 cents per action. Additional precautions median cost was $4.1 per action. The donning or removing or personal protective equipment (N = 720) cost was 76 cents per action. Finally, the total median costs for the five categories of clinical best practiced assessed were 27 cents per action. Conclusions The costs of clinical best practices were low, from 20 cents to $4.1 per action. This study provides evidence based arguments with which to support the allocation of resources to infection prevention and control practices that directly affect the safety of patients, healthcare workers and the public. Further research of costing clinical best care practices is warranted.

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Pathology Laboratories and Infection Prevention and Control

Journal of Pathology of Nepal ◽

10.3126/jpn.v4i8.11603 ◽

2014 ◽

Vol 4 (8) ◽

pp. I

Author(s):

R Baral

Keyword(s):

Health Care ◽

Best Practices ◽

Hand Hygiene ◽

Prevention And Control ◽

Infection Prevention ◽

World Health ◽

Asia Pacific ◽

Infection Prevention And Control ◽

Effective Manner ◽

And Control

Laboratory health care workers are vulnerable to infection with the Hospital Acquired Infections (HAIs) while receiving, handling and disposing biological samples. Ideally the infrastructure of the lab should be according to the best practices like good ventilation, room pressure differential, lighting, space adequacy, hand hygiene facilities, personal protective equipments, biological safety cabinets etc. Disinfection of the environment, and specific precautions with sharps and microbial cultures should follow the protocols and policies of the Infection Prevention and Control Practices (IPAC). If Mycobacterium tuberculosis or Legionella pneumophila are expected, diagnostic tests should be performed in a bio-safety level 3 facilities (for agents which may cause serious or potentially lethal disease in healthy adults after inhalation). Laboratory access should be limited only to people working in it.Along with the advent of new technologies and advanced treatment we are now facing problems with the dreadful HAIs with Antimicrobial Resistant Organisms (AROs) which is taking a pandemic form. According to WHO, hundreds of millions of patients develop HAI every year worldwide and as many as 1.4 million occur each day in hospitals alone. The principal goals for hospital IPAC programs are to protect the patient, protect the health care worker (HCW), visitors, and other persons in the health environment, and to accomplish the previous goals in a cost-effective manner like hand hygiene, surveillance, training of the HCWs, initiating awareness programs and making Best Practices and Guidelines to be followed by everyone in the hospital.The initiation for the best practices in the Pathology Laboratories can be either Sporadic or Organizational. Sporadic initiation is when the laboratories make their own IPAC policies. It has been seen that in few centres these policies have been conceptualized but not materialized. Organizational initiation is much more effective since the best practices are the same for all hospitals and this helps in standardizing the policies. There are organizations which work in promoting IPAC through education, standards, and advocacy and consumer awareness. Examples of organizations working in this field are IPAC Canada, Centers for Disease Control and Prevention (CDC) USA, Infection Prevention Society UK, Asia Pacific Society of Infection Control (APSIC), World Health Organization (WHO). In Nepal organizational initiation to address the issues of IPAC has been recently taken by Healthy Life Foundation Nepal (HELF Nepal) which is an organization with the mission to inform, promote and implement best practices of IPAC to prevent HAIs in the patients as well as the healthcare workers in all healthcare settings in Nepal.In Nepal awareness on IPAC in Pathology Laboratories can be brought about by initiating trainings, surveillance, regular CMEs and demonstration of techniques to the Lab personnel. Administration will have to be involved in initiating the program and maintaining it with administrative resources and financial support. Before it is too late we have to address the issues of HAIs, AROs and safety in our laboratories.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11603

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The Perception of Healthcare Workers Toward Infection Prevention and Control Practices in Two Hospitals in Bo City

International Journal of Scientific and Research Publications (IJSRP) ◽

10.29322/ijsrp.9.11.2019.p9568 ◽

2019 ◽

Vol 9 (11) ◽

pp. p9568

Author(s):

Prince T. Lamin-Boima

Keyword(s):

Prevention And Control ◽

Healthcare Workers ◽

Infection Prevention ◽

Infection Prevention And Control ◽

And Control

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Effective infection prevention and control strategies in a large accredited psychiatric facility in Singapore

10.31234/osf.io/89uc5 ◽

2020 ◽

Author(s):

Daniel Poremski ◽

Sandra Henrietta Subner ◽

Grace Lam Fong Kin ◽

Raveen Dev Ram Dev ◽

Mok Yee Ming ◽

...

Keyword(s):

Mental Health ◽

Prevention And Control ◽

Infection Prevention ◽

Control Strategies ◽

Infection Prevention And Control ◽

Psychiatric Facility ◽

Essential Services ◽

Community Transmission ◽

And Control

The Institute of Mental Health in Singapore continues to attempt to prevent the introduction of COVID-19, despite community transmission. Essential services are maintained and quarantine measures are currently unnecessary. To help similar organizations, strategies are listed along three themes: sustaining essential services, preventing infection, and managing human and consumable resources.

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Barriers to infection prevention and control practice among Amhara region teaching hospitals in Ethiopia: Qualitative study

International Journal of Infection Control ◽

10.3396/ijic.v15i2.007.19 ◽

2019 ◽

Vol 15 (2) ◽

Author(s):

Walelegn Worku Yallew ◽

Abera Kumie ◽

Feleke Moges Yehuala

Keyword(s):

Healthcare Worker ◽

Prevention And Control ◽

Healthcare Workers ◽

Infection Prevention ◽

Teaching Hospitals ◽

Infection Prevention And Control ◽

Amhara Region ◽

Implementation Barriers ◽

Control Practice ◽

And Control

Healthcare workers have good perception towards infection prevention, but there has been a poor practice towards it. Therefore, the aim of this study was to explore barriers to practice of infection prevention and control practice in teaching hospitals in Amhara region. A phenomenological approach used to explore the lived experience of healthcare workers and management staffs towards infection prevention practice and control. The data was collected from ten in-depth interviews and 23 focus group discussion participants, by face to face interview using open ended interview performed in safe and quiet places. Data was managed using OpenCode software version 4.03 and contents were analyzed thematically. Totally ten different barriers were identified, such as availability of facilities, shortage of material supply, lack of maintenance of facilities and equipment, high patient flow, experience, emergency situation, healthcare worker behaviour and healthcare worker’s information about infection prevention, low awareness of patients and visitors and overflow of families and visitors to the hospital. For effective infection prevention practice implementation, barriers should be considered via identifying specific organizational, healthcare worker, patients and visitors as targets.

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