Healthcare-associated infection prevention and control practices in Israel: results of a national survey

Abstract

Background Healthcare-associated infection (HAI) is a common and largely preventable cause of morbidity and mortality. The COVID-19 pandemic has presented unprecedented challenges to health systems. We conducted a national survey to ascertain hospital characteristics and the use of HAI prevention measures in Israel. Methods We e-mailed surveys to infection prevention and control (IPC) leads of acute care hospitals in Israel. The survey included questions about the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). The survey also assessed COVID-19 impact and healthcare worker well-being. Results IPC leads from 15 of 24 invited hospitals (63%) completed the survey. Only one-third of respondents reported strong support for IPC from hospital leadership. Although several prevention practices were used by all hospitals (e.g., maximum sterile barrier precautions for CLABSI and real-time assessment of environmental cleaning for CDI), use of other practices was suboptimal—particularly for CAUTI and VAP. COVID-19 had a profound impact on Israeli hospitals, with all hospitals reporting opening of new units to care for COVID patients and most reporting moderate to extreme financial hardship. All hospitals reported highly successful plans to vaccinate all staff and felt confident that the vaccine is safe and effective. Conclusion We provide a status report of the IPC characteristics and practices Israeli hospitals are currently using to prevent HAIs during the COVID-19 era. While many globally accepted IPC practices are widely implemented, opportunities to increase the use of certain IPC practices in Israeli hospitals exist. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07721-8.

Navigating a Pandemic: Leadership Dynamics and Challenges within Infection Prevention and Control Units in Israel

“…High-level leaders include those in hospital administration and heads of IPC units, who need to demonstrate high self-efficacy, address barriers effectively, and champion a culture of clinical excellence. These leaders should be adept, assertive, professional, and capable of advocating for resources and empowering frontline workers [4,15,23,[56][57][58][59][60]. The gap in high-level leadership has widened due to insufficient awareness and support for IPC initiatives [15].…”

“…Additionally, the challenges of bacterial and fungal co-infections in COVID-19 patients have stressed the ongoing need for IPC leaders to refine their strategies [24]. Insights from national surveys, like those conducted in Israel, have pointed out the critical nature of adaptable IPC practices in response to evolving pathogens [23]. While IPC protocols are fundamental, the core of effective IPC is grounded in leadership approaches.…”

“…The demands of the pandemic have forged abilities in rapid decision-making, adaptability, and crisis management [67]. IPC managers often faced the need for immediate decisions made on partial information, with significant consequences [23]. This reality points to an IPC field where agility and foresight in crisis response are increasingly indispensable.…”

“…The COVID-19 pandemic has added layers of complexity to the already challenging domain of HAIs, leading to increased rates of infections such as CLABSIs, CAUTIs, VAEs, and MRSA bacteremia, while also exacerbating the issue of antimicrobial resistance. The response of healthcare systems to these heightened challenges, particularly during pandemic conditions, reflects a pressing need for adaptability and reinforcement of HAI prevention strategies [19][20][21][22][23][24][25][26].…”

“…The COVID-19 pandemic has posed significant challenges to hospitals and healthcare facilities around the world. These challenges include increased workload and stress, changes in infection control protocols, limited resources, increased patient numbers, staffing challenges, and other operational changes that limit the implementation and effectiveness of standard IPC practices [19][20][21][22][23]. Trust in guidelines, protocols, and leadership plays a critical role in ensuring effective implementation of IPC practices and maintaining healthcare professional motivation in these challenging circumstances [1,2].…”