scholarly journals An innovative quality improvement approach for rapid improvement of infection prevention and control at health facilities in Sierra Leone

2020 ◽  
Vol 32 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Ilka Rondinelli ◽  
Gillian Dougherty ◽  
Caitlin A Madevu-Matson ◽  
Mame Toure ◽  
Adewale Akinjeji ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Best Practices ◽  
Sierra Leone ◽  
Marked Improvement ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Rapid Improvement ◽  
And Control

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.

scholarly journals A health worker knowledge, attitudes and practices survey of SARS-CoV-2 infection prevention and control in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saiendhra Vasudevan Moodley ◽  
Muzimkhulu Zungu ◽  
Molebogeng Malotle ◽  
Kuku Voyi ◽  
Nico Claassen ◽  
...  
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Health Facilities ◽  
World Health ◽  
Infection Prevention And Control ◽  
Successful Implementation ◽  
And Control

Abstract Background Health workers are crucial to the successful implementation of infection prevention and control strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces of South Africa as well as explore some elements of health worker and health facility infection prevention and control practices. Methods A cross-sectional study design was utilised. The study population comprised both clinical and non-clinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A structured self-administered questionnaire was developed using the World Health Organization guidance as the basis for the knowledge questions. COVID-19 protocols were observed during data collection. Results A total of 286 health workers from 47 health facilities at different levels of care participated in the survey. The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%) answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants (50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had received infection prevention and control training. Some participants indicated they did not have access to medical masks (11.8%) and gloves (9.9%) in their departments. Conclusions The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring adequate infection prevention and control training for all staff and universal access to appropriate PPE were identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings that needed to be addressed were provided to the relevant provincial departments of health.

scholarly journals Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation

2019 ◽  
Author(s):  
Govha Emmanuel ◽  
Zizhou Simukai Tirivanhu ◽  
Shambira Gerald ◽  
Gombe Tafara Notion ◽  
Tsitsi Juru ◽  
...  
Keyword(s):  
Health Facility ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Outcome Evaluation ◽  
Hazard Identification ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Hiv Test ◽  
And Control

Abstract Background A healthcare-associated infection (HAI) is defined as an infection originating in the environment of a health facility that was not present or incubating at the time of patient admission. HAIs can be prevented through infection, prevention and control (IPC) measures. No hazard identification and risk assessment IPC rounds and monthly meetings were conducted in Goromonzi district since 1st of January to 30th of June 2018. No trainings nor orientation for the new employees was conducted. We therefore evaluated Goromonzi District IPC program. Methods A process-outcome evaluation using the logic model was conducted in Goromonzi district’s 15 health facilities. Checklists, interviewer administered questionnaires and key informant guides were used to collect data on availability of inputs, knowledge of health workers, processes performed, outputs and outcomes achieved. Data were entered into Epi Info 7TM, which was used to generate frequencies and proportions. Qualitative data from checklists and key informants interviews was sorted manually into themes and analysed. Results All 15 health facilities had adequate stocks of HIV test kits and PEP kits. Adequate bins and detergents were found in only 3/15 (20%) of health facilities. All facilities failed to hold a single IPC meeting and none had specific budget for IPC in 2018. No IPC mentorship activities were carried out in the district. Only 7/13 (54%) health workers who had needle pricks received PEP with 2/7 (29%) of them finishing the course. No health facility had a functional HAI surveillance system. The overall knowledge rating was fair. Conclusion The IPC program inputs in Goromonzi district were inadequate hence its failure to achieve the intended outputs and outcomes. Inadequate knowledge, unavailability of health worker training plans, specific budgets and absence of IPC committees reflected non prioritisation of the program.

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

The impact of supportive supervision of infection prevention and control practices on Ebola outbreak in Liberia

2018 ◽  
Vol 19 (6) ◽  
pp. 287-293
Author(s):  
Ogbaini-Emovon Ephraim ◽  
Sneh Cyrus ◽  
Pajibo Myer ◽  
Abah Steve
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Virus Disease ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Small Scale ◽  
Supportive Supervision ◽  
And Control ◽  
Isolation Facilities ◽  
The Impact

Background: Supportive supervision of infection prevention and control (IPC) practices was one of a range of interventions employed at the county level in the control of the world’s most deadly Ebola virus disease outbreak that affected Liberia during 2013–2016. Methods: Datasets generated from four consecutive assessment visits to 25 health facilities in Maryland County, in Liberia, were analysed. Information on IPC practices was obtained by interview, direct observation and completion of a standardised assessment tool. For each of the IPC fields assessed, a score < 50% was graded poor, 50–75% as fair, while > 75% was rated as good. Results: Before the intervention, the first assessment (baseline) indicated that the majority of the health facilities scored low in terms of isolation facilities, IPC administration, supply and equipment, personnel and staffing, triage and waste management. Following the application of supportive supervision and monitoring, all the facilities recorded moderate to good performance in all the fields during the fourth round of assessment, except for isolation facilities, which scored low. Conclusion: Supportive supervision and monitoring of healthcare facilities appeared to have contributed to the improvement in IPC standards and compliance during the Ebola outbreak as demonstrated in this small-scale study and should be sustained as a core component of IPC programs, particularly in prolonged outbreak situations.

scholarly journals Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

2017 ◽  
Vol 7 (1) ◽  
pp. 94-99 ◽  
Author(s):  
N. Tremblay ◽  
E. Musa ◽  
C. Cooper ◽  
R. Van den Bergh ◽  
P. Owiti ◽  
...  
Keyword(s):  
Private Sector ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
And Control

scholarly journals Creation of a national infection prevention and control programme in Sierra Leone, 2015

2019 ◽  
Vol 4 (3) ◽  
pp. e001504 ◽  
Author(s):  
Hossinatu Kanu ◽  
Kathryn Wilson ◽  
Nanah Sesay-Kamara ◽  
Sarah Bennett ◽  
Shaheen Mehtar ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Rapid Development ◽  
Control Programme ◽  
Public Hospitals ◽  
Infection Prevention And Control ◽  
Ministry Of Health ◽  
Healthcare Facilities ◽  
And Control

Prior to the 2014–2016 Ebola epidemic, Sierra Leone’s Ministry of Health and Sanitation had no infection prevention and control programme. High rates of Ebola virus disease transmission in healthcare facilities underscored the need for infection prevention and control in the healthcare system. The Ministry of Health and Sanitation led an effort among international partners to rapidly stand up a national infection prevention and control programme to decrease Ebola transmission in healthcare facilities and strengthen healthcare safety and quality. Leadership and ownership by the Ministry of Health and Sanitation was the catalyst for development of the programme, including the presence of an infection prevention and control champion within the ministry. A national policy and guidelines were drafted and approved to outline organisation and standards for the programme. Infection prevention and control focal persons were identified and embedded at public hospitals to manage implementation. The Ministry of Health and Sanitation and international partners initiated training for new infection prevention and control focal persons and committees. Monitoring systems to track infection prevention and control implementation were also established. This is a novel example of rapid development of a national infection prevention and control programme under challenging conditions. The approach to rapidly develop a national infection prevention and control programme in Sierra Leone may provide useful lessons for other programmes in countries or contexts starting from a low baseline for infection prevention and control.

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

Sign in / Sign up

Export Citation Format

Share Document