Implementation of the infection prevention and control core components at the national level: a global situational analysis

Tartari, Ermira; Tomczyk, Sara; Pires, David; Zayed, Bassem; Rehse, Ana Paula Coutinho; Kariyo, P.; Stempliuk, Valeska; Zingg, Walter; Pittet, Didier; Allegranzi, Benedetta

doi:10.1016/j.jhin.2020.11.025

Cited by 66 publications

(76 citation statements)

References 28 publications

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“…24 25 A WHO survey of 88 countries to assess implementation of the WHO core components of an IPC programme found that only 54% had in-service IPC training. 26 Over half (18 of 32) of national nursing associations reported IPC training had not been provided within 6 months of the pandemic's start. 27 Supportive supervision and mentorship for health facilities are also part of an effective IPC programme 2 and contribute to improved quality of care and strengthened health systems.…”

Section: Summary Boxmentioning

confidence: 99%

“…29 Second, programme monitoring and systematic use of data are needed to identify persistent gaps and to implement evidence-based policies; however, only 66% (58 of 88) of WHO-surveyed countries monitored IPC-related indicators, with a lower proportion among LMICs. 26 Third, limited resources and infrastructure in LMICs pose even greater challenges, [29][30][31][32] 33 which was later adapted and published by the Africa Centres for Disease Control and Prevention, 34 was developed in both English and French based on the IPC hierarchy-source controls, administrative controls, environmental controls and PPE 35 -for use by implementing partners at primary healthcare settings.…”

Section: Summary Boxmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 26 Third, limited resources and infrastructure in LMICs pose even greater challenges, 29–32 and only 26% (23 of 88) of WHO-surveyed countries had a dedicated and protected IPC budget. 26 …”

Section: Introductionmentioning

confidence: 99%

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Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

et al. 2021

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Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

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Section: Summary Boxmentioning

confidence: 99%

Section: Summary Boxmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

et al. 2021

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“…In a large multi-country study, national IPC focal points were interviewed to assess the level of implementation of IPC programmes at the national level [ 8 ]. Among the low-income countries interviewed, only nine (45%) reported the existence of a national IPC programme; four (20%) had documents on implementation strategies; one (5%) monitored compliance with IPC practices.…”

Section: Introductionmentioning

confidence: 99%

Infection prevention and control (IPC) implementation in low-resource settings: a qualitative analysis

Tomczyk

Storr

Kilpatrick

et al. 2021

Antimicrob Resist Infect Control

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Background The coronavirus disease-2019 (COVID-19) pandemic has again demonstrated the critical role of effective infection prevention and control (IPC) implementation to combat infectious disease threats. Standards such as the World Health Organization (WHO) IPC minimum requirements offer a basis, but robust evidence on effective IPC implementation strategies in low-resource settings remains limited. We aimed to qualitatively assess IPC implementation themes in these settings. Methods Semi-structured interviews were conducted with IPC experts from low-resource settings, guided by a standardised questionnaire. Applying a qualitative inductive thematic analysis, IPC implementation examples from interview transcripts were coded, collated into sub-themes, grouped again into broad themes, and finally reviewed to ensure validity. Sub-themes appearing ≥ 3 times in data were highlighted as frequent IPC implementation themes and all findings were summarised descriptively. Results Interviews were conducted with IPC experts from 29 countries in six WHO regions. Frequent IPC implementation themes including the related critical actions to achieve the WHO IPC core components included: (1) To develop IPC programmes: continuous advocacy with leadership, initial external technical assistance, stepwise approach to build resources, use of catalysts, linkages with other programmes, role of national IPC associations and normative legal actions; (2) To develop guidelines: early planning for their operationalization, initial external technical assistance and local guideline adaption; (3) To establish training: attention to methods, fostering local leadership, and sustainable health system linkages such as developing an IPC career path; (4) To establish health care-associated (HAI) surveillance: feasible but high-impact pilots, multidisciplinary collaboration, mentorship, careful consideration of definitions and data quality, and “data for action”; (5) To implement multimodal strategies: clear communication to explain multimodal strategies, attention to certain elements, and feasible but high-impact pilots; (6) To develop monitoring, audit and feedback: feasible but high-impact pilots, attention to methods such as positive (not punitive) incentives and “data for action”; (7) To improve staffing and bed occupancy: participation of national actors to set standards and attention to methods such as use of data; and (8) To promote built environment: involvement of IPC professionals in facility construction, attention to multimodal strategy elements, and long-term advocacy. Conclusions These IPC implementation themes offer important qualitative evidence for IPC professionals to consider.

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Identifying a competency improvement strategy for infection prevention and control professionals: A rapid systematic review and cluster analysis

Chen,

Li,

Kuang

et al. 2024

Health Care Science

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Remarkable progress has been made in infection prevention and control (IPC) in many countries, but some gaps emerged in the context of the coronavirus disease 2019 (COVID‐19) pandemic. Core capabilities such as standard clinical precautions and tracing the source of infection were the focus of IPC in medical institutions during the pandemic. Therefore, the core competences of IPC professionals during the pandemic, and how these contributed to successful prevention and control of the epidemic, should be studied. To investigate, using a systematic review and cluster analysis, fundamental improvements in the competences of infection control and prevention professionals that may be emphasized in light of the COVID‐19 pandemic. We searched the PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, and CBM databases for original articles exploring core competencies of IPC professionals during the COVID‐19 pandemic (from January 1, 2020 to February 7, 2023). Weiciyun software was used for data extraction and the Donohue formula was followed to distinguish high‐frequency technical terms. Cluster analysis was performed using the within‐group linkage method and squared Euclidean distance as the metric to determine the priority competencies for development. We identified 46 studies with 29 high‐frequency technical terms. The most common term was “infection prevention and control training” (184 times, 17.3%), followed by “hand hygiene” (172 times, 16.2%). “Infection prevention and control in clinical practice” was the most‐reported core competency (367 times, 34.5%), followed by “microbiology and surveillance” (292 times, 27.5%). Cluster analysis showed two key areas of competence: Category 1 (program management and leadership, patient safety and occupational health, education and microbiology and surveillance) and Category 2 (IPC in clinical practice). During the COVID‐19 pandemic, IPC program management and leadership, microbiology and surveillance, education, patient safety, and occupational health were the most important focus of development and should be given due consideration by IPC professionals.

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Implementation of the infection prevention and control core components at the national level: a global situational analysis

Cited by 66 publications

References 28 publications

Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

Infection prevention and control (IPC) implementation in low-resource settings: a qualitative analysis

Identifying a competency improvement strategy for infection prevention and control professionals: A rapid systematic review and cluster analysis

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