Effectiveness and core components of infection prevention and control programmes in long-term care facilities: a systematic review

Abstract

Background: Infection prevention and control (IPC) is a measure to prevent healthcareassociated infections in healthcare settings. There is limited evidence of the effectiveness of IPC programmes in long-term care facilities (LTCFs). Aim: To review and analyse the effectiveness and the components of IPC programmes in LTCFs for older adults. Methods: Electronic databases (PubMed, EMBASE, CINAHL and Cochrane CENTRAL) were searched systematically for English-language articles assessing IPC interventions in LTCFs, published over the last decade (2007e2016). The components of IPC programmes were analysed based on the World Health Organization (WHO) manuals for improving IPC activities. Two reviewers independently assessed the quality of studies using the Cochrane risk-of-bias tool and the risk-of-bias assessment tool for non-randomized studies. Findings: Seventeen studies met the eligibility criteria; 10 studies were randomized trials (58.8%) and the others were non-randomized trials to examine the impact of IPC programmes on infection and/or performance outcomes of healthcare workers. None of the included studies implemented all of the WHO core components. Behavioural change strategies using education, monitoring and feedback were reported to be successful interventions for reducing the threat of healthcare-associated infections. Generally, studies using four or more elements of the WHO multi-modal strategy reported significant reductions in infection rates. Conclusions: There is some evidence for the effectiveness of IPC interventions using education, monitoring, feedback and four or more elements of the WHO multi-modal strategy to control healthcare-associated infections in LTCFs.

Infections Prevention and Control (IPC) Programs in Hospitals

“…The implementation of the IPC program must be balanced with the provision of facilities and infrastructure that meet the requirements so that the program's implementation can run optimally. This was in line with several studies which stated that limited facilities and infrastructure was one of the factors that influence the inadequate implementation of IPC in hospitals (24)(25)(26). However, hospital management often paid less attention to this matter because the provision of these facilities and infrastructure requires a large amount of money, so that budget limitations constrained it.…”

Prevention of the spread of multidrug-resistant organisms in nursing homes

“…Table 1 summarizes all aspects responsible for the great heterogeneity among European LTCFs. The different typology of LTCFs [6], the regulatory processes [7], the quality monitoring [8], the local epidemiology of MDRO [9][10][11][12][13], the variability of infection control [14,15] and antimicrobial stewardship (AS) programs [3] account for the high heterogeneity among LTCFs in Europe.…”

Influência da Infraestrutra na Incidência de Infecções Relacionadas à Assistência em um Hospital Universitário

“…A CCIH da instituição deve formular protocolos adequados à realidade da instituição, principalmente em relação à limpeza, desinfecção e/ou esterilização dos materiais. [12][13][14] Dessa maneira, entende-se que, embora possa contribuir para evitar IRAS, a estrutura física pode não ser um fator determinante para a ocorrência das infecções no HU investigado. As IRAS podem ser mantidas sob controle mesmo em instituições de saúde que estejam funcionando em condições de infraestrutura física diferentes daquelas normatizadas pelos órgãos de controle dos serviços de saúde.…”