scholarly journals Perceived Challenges of COVID-19 Infection Prevention and Control Preparedness: A Multinational Survey

Author(s):  
Ermira Tartari ◽  
Joost Hopman ◽  
Benedetta Allegranzi ◽  
Bin Gao ◽  
Andreas Widmer ◽  
...  

AbstractObjectivesImplementation of effective infection prevention and control (IPC) measures is needed to support global capacity building to limit transmission of coronavirus disease 2019 (COVID-19) and mitigate its impact on health systems. We assessed the perceptions of healthcare workers on the current global IPC preparedness measures for COVID-19.MethodsA cross-sectional survey using an electronic survey was circulated between February 26, 2020, and March 20, 2020, to IPC professionals during COVID-19 pandemic. The survey addressed the presence of COVID-19 guidelines as well as specific IPC preparedness activities in response to the outbreak.FindingsIn total, 339 IPC professionals spanning 63 countries in all 6 World Health Organization (WHO) regions, mostly from tertiary care centres participated. Of all participants, 66·6% were aware of the existence of national guidelines to prevent COVID-19. A shortage of PPE supplies was reported by 48% (ranging from 64·2% in low-income countries to 27·4% in high-income countries); 41·5% of respondents considered that the media had an impact on guideline development and 63·6% believed that guidelines were based on maximum security rather than on evidence-based analyses. 58·5% and 72·7% of participants believed that healthcare facilities and community settings respectively were not sufficiently prepared.ConclusionResults revealed lack of guidelines and concerns over insufficient PPE supply in both high- and low-income countries. Our findings should alert national health authorities to ramp up the implementation of IPC measures and focus on long-term preparedness and readiness for future pandemics, likely requiring government funds rather than reliance on healthcare institutions.

2019 ◽  
Vol 32 (6) ◽  
pp. 927-940 ◽  
Author(s):  
Gertrude Sika Avortri ◽  
Juliet Nabyonga-Orem

Purpose Healthcare-associated infections (HAIs) constitute a major threat to patient safety and affect hundreds of millions of people worldwide. The World Health Organization in 2016 published guidelines on the core components for infection prevention and control (IPC) programme. This was in response to a global call for focused action. The purpose of this paper is to examine and promote understanding of the tenets of the IPC guidelines and highlight their implications for implementation in low-income countries. Design/methodology/approach Drawing from personal experiences in leading the implementation of health programmes as well as a review of published and grey literature on IPC, authors discussed and proposed practical approaches to implement IPC priorities in low-income setting. Findings Availability of locally generated evidence is paramount to guide strengthening leadership and institutionalisation of IPC programmes. Preventing infections is everybody’s responsibility and should be viewed as such and accorded the required attention. Originality/value Drawing from recent experiences from disease outbreaks and given the heavy burden of HAIs especially in low-income settings, this paper highlights practical approaches to guide implementation of the major components of IPC.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saiendhra Vasudevan Moodley ◽  
Muzimkhulu Zungu ◽  
Molebogeng Malotle ◽  
Kuku Voyi ◽  
Nico Claassen ◽  
...  

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.


2021 ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Iman Heweidy ◽  
Samiha Abdu ◽  
Abouelata Omar ◽  
Caroline Ackley ◽  
...  

Abstract Background: Antimicrobial resistance (AMR) is increasingly pervasive due to multiple, complex prescribing and consuming behaviours. Accordingly, behaviour change is an important component of response to AMR. Little is known about the best approaches to change antibiotic use practices and behaviours. This project aims to develop a context-specific behaviour change strategy focusing on promoting appropriate prescription practices following the World Health Organization recommendations for surgical prophylaxis in an orthopaedic surgery unit in Egypt.Methods: The project included a formative qualitative research study was based on the Theoretical Domains Framework (TDF) to explore the determinants for inappropriate prescription of surgical antibiotic prophylaxis at an orthopaedic unit. The intervention was developed to following the Behaviour Change Wheel (BCW) in a knowledge co-production workshop with infection prevention and control experts that ensured that the theory based intervention was a culturally acceptable, practical and implementable intervention. Results: The prescription of surgical prophylaxis was influenced by five TDF domains including, knowledge, belief in consequences (mistrust towards infection prevention and control measures), environmental factors (lack of prescription guidelines) , professional role and reinforcement (a lack of appropriate follow up actions influenced prescription of surgical prophylaxis). The appropriate set of behaviour change functions of BCW and related activities to improve the current practices included education, enablement, persuasion, environmental restructuring and restriction. Conclusions The study showed that a theory based and context specific intervention can be created by using the TDF and BCW together with knowledge-co creation to improve the prescription of surgical prophylaxis in and Egyptian orthopaedic unit. The intervention need to piloted and scaled up.


Author(s):  
Ermira Tartari ◽  
Carolina Fankhauser ◽  
Sarah Masson-Roy ◽  
Hilda Márquez-Villarreal ◽  
Inmaculada Fernández Moreno ◽  
...  

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.


2019 ◽  
Vol 40 (12) ◽  
pp. 1361-1366
Author(s):  
Eve Dubé ◽  
Armelle Lorcy ◽  
Nathalie Audy ◽  
Nadia Desmarais ◽  
Patrice Savard ◽  
...  

AbstractObjective:To describe barriers and facilitators to the adoption of recommended infection prevention and control (IPC) practices among healthcare workers (HCWs).Methods:A qualitative research design was used. Individual semistructured interviews with HCWs and observations of clinical practices were conducted from February to May 2018 in 8 care units of 2 large tertiary-care hospitals in Montreal (Québec, Canada).Results:We interviewed 13 managers, 4 nurses, 2 physicians, 3 housekeepers, and 2 medical laboratory technologists. We conducted 7 observations by following IPC nurses (n = 3), nurses (n = 2), or patient attendants (n = 2) in their work routines. Barriers to IPC adoption were related to the context of care, workplace environment issues, and communication issues. The main facilitator of the IPC adoption by HCWs was the “development of an IPC culture or safety culture.” The “IPC culture” relied upon leadership support by managers committed to IPC, shared belief in the importance of IPC measures to limit healthcare-associated infections (HAIs), collaboration and good communication among staff, as well as proactivity and ownership of IPC measures (ie, development of local solutions to reduce HAIs and “working together” toward common goals).Conclusions:Adoption of recommended IPC measures by HCWs is strongly influenced by the “IPC culture.” The IPC culture was not uniform within hospital and differences in IPC culture were identified between care units.


2010 ◽  
Vol 31 (9) ◽  
pp. 948-950 ◽  
Author(s):  
Wing Hong Seto ◽  
Fernando Otaíza ◽  
Carmen L. Pessoa-Silva ◽  

Under the leadership of the World Health Organization (WHO), the core components necessary for national and local infection prevention and control programs are identified. These components were determined by a network of international experts who are representatives from WHO regional offices and relevant WHO programs. The respective roles of the national authorities and the local healthcare facilities are delineated.


Author(s):  
Anna Deryabina ◽  
Meghan Lyman ◽  
Daiva Yee ◽  
Marika Gelieshvilli ◽  
Lia Sanodze ◽  
...  

Abstract Background The Georgia Ministry of Labor, Health, and Social Affairs is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff. Methods In 2018, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews. Results IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system. Conclusions Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.


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