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

2019 ◽  
pp. 135-140
Author(s):  
Geneviève Cadieux ◽  
Abha Bhatnagar ◽  
Tamara Schindeler ◽  
Chatura Prematunge ◽  
Donna Perron ◽  
...  

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.

2017 ◽  
Vol 65 (12) ◽  
pp. 1963-1973 ◽  
Author(s):  
Andi L Shane ◽  
Rajal K Mody ◽  
John A Crump ◽  
Phillip I Tarr ◽  
Theodore S Steiner ◽  
...  

Abstract These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.


Author(s):  
Anna L. Costa ◽  
Gaetano Pierpaolo Privitera ◽  
Giorgio Tulli ◽  
Giulio Toccafondi

AbstractHealthcare-associated infections (HAI) are adverse events exposing patients to a potentially avoidable risk of morbidity and mortality. Antimicrobial resistance (AMR) is increasingly contributing to the burden of HAIs and emerging as of the most alarming challenges for public health worldwide. Practically, harm mitigation and risk containment demand cross-sectional initiatives incorporate both approaches to infection prevention and control and methodologies from clinical risk management.


2020 ◽  
Vol 32 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Ilka Rondinelli ◽  
Gillian Dougherty ◽  
Caitlin A Madevu-Matson ◽  
Mame Toure ◽  
Adewale Akinjeji ◽  
...  

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.


2021 ◽  
Author(s):  
Eric Tchouaket ◽  
Stephanie Robins ◽  
Sandra Boivin ◽  
Drissa Sia ◽  
Kelley Kilpatrick ◽  
...  

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.


2021 ◽  
Vol 1 (S1) ◽  
pp. s53-s54
Author(s):  
Mohammed Alsuhaibani ◽  
Takaaki Kobayashi ◽  
Stephanie Holley ◽  
Angie Dains ◽  
Oluchi Abosi ◽  
...  

Background: The COVID-19 pandemic has affected healthcare systems worldwide, but the impact on infection prevention and control (IPC) programs has not been fully evaluated. We assessed the impact of the COVID-19 pandemic on IPC consultation requests. Methods: The University of Iowa Hospitals & Clinics comprises an 811-bed hospital that admits >36,000 patients yearly and >200 outpatient clinics. Questions about IPC can be addressed to the Program of Hospital Epidemiology via e-mail, in person, or through our phone line. We routinely record date and time, call source, reason for the call, and estimated time to resolve questions for all phone line requests. We defined calls during 2018–2019 as the pre–COVID-19 period and calls from January to December 2020 as the COVID-19 period. Results: In total, 6,564 calls were recorded from 2018 to 2020. In the pre–COVID-19 period (2018–2019), we received a median of 71 calls per month (range, 50–119). The most frequent call sources were inpatient units (n = 902; 50%), department of public health (n = 357; 20%), laboratory (n = 171; 9%), and outpatient clinics (n = 120; 7%) (Figure 1). The most common call topics were isolation and precautions (n = 606; 42%), outside institutions requests (n = 324; 22%), environmental and construction (n = 148; 10%), and infection exposures (n = 149; 10%). The most frequent infection-related calls were about tuberculosis (17%), gram-negative organisms (14%), and influenza (9%). During the COVID-19 period, the median monthly call volume increased 500% to 368 per month (range, 149–829). Most (83%) were COVID-19 related. The median monthly number of COVID-19 calls was 302 (range, 45–674). The median monthly number of non–COVID-19 calls decreased to 56 (range, 36–155). The most frequent call sources were inpatient units (57%), outpatient clinics (16%), and the department of public health (5%). Most calls concerned isolation and precautions (50%) and COVID-19 testing (20%). The mean time required to respond to each question was 10 minutes (range, 2–720). The biggest surges in calls during the COVID-19 period were at the beginning of the pandemic (March 2020) and during the hospital peak COVID-19 census (November 2020). Conclusions: In addition to supporting a proactive COVID-19 response, our IPC program experienced a 500% increase in consultation requests. Planning for future bioemergencies should include creative strategies to provide additional resources to increase response capacity within IPC programs.Funding: NoDisclosures: None


Author(s):  
Eric Tchouaket Nguemeleu ◽  
Stephanie Robins ◽  
Sandra Boivin ◽  
Drissa Sia ◽  
Kelley Kilpatrick ◽  
...  

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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