Strengthening Healthcare Facilities Through Water, Sanitation, and Hygiene (WASH) Improvements: A Pilot Evaluation of “WASH FIT” in Togo

Weber, Nicole; Martinsen, Andrea; Sani, Amidou; Assigbley, Elom Kokou Eric; Azzouz, Chedly; Hayter, Arabella; Ayite, Komlan; Baba, Amivi Afefa Bibiane; Davi, Kokou Mawule; Gelting, Rick

doi:10.1089/hs.2018.0042

Cited by 26 publications

(25 citation statements)

References 9 publications

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“…WASH is highly dependent on a range of health systems factors [10]. To understand the causes for the performance outcomes we measured, and the context of the survey results, the underlying health system components that support WASH activities were also investigated, including the availability of ‘soft’ and ‘hard’ infrastructure, material resources, local guidelines, and appropriate budgets.…”

Section: Methodsmentioning

confidence: 99%

Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya

et al. 2019

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BackgroundWater Sanitation and Hygiene (WASH) in healthcare facilities is critical in the provision of safe and quality care. Poor WASH increases hospital-associated infections and contributes to the rise of antimicrobial resistance (AMR). It is therefore essential for governments and hospital managers to know the state of WASH in these facilities to set priorities and allocate resources.MethodsUsing a recently developed survey tool and scoring approach, we assessed WASH across four domains in 14 public hospitals in Kenya (65 indicators) with specific assessments of individual wards (34 indicators). Aggregate scores were generated for whole facilities and individual wards and used to illustrate performance variation and link findings to specific levels of health system accountability. To help interpret and contextualise these scores, we used data from key informant interviews with hospital managers and health workers.ResultsAggregate hospital performance ranged between 47 and 71% with five of the 14 hospitals scoring below 60%. A total of 116 wards were assessed within these facilities. Linked to specific domains, ward scores varied within and across hospitals and ranged between 20% and 80%. At ward level, some critical indicators, which affect AMR like proper waste segregation and hand hygiene compliance activities had pooled aggregate scores of 45 and 35% respectively. From 31 interviews conducted, the main themes that explained this heterogenous performance across facilities and wards included differences in the built environment, resource availability, leadership and the degree to which local managers used innovative approaches to cope with shortages.ConclusionSignificant differences and challenges exist in the state of WASH within and across hospitals. Whereas the senior hospital management can make some improvements, input and support from the national and regional governments are essential to improve WASH as a basic foundation for averting nosocomial infections and the spread of AMR as part of safe, quality hospital care in Kenya.

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Section: Methodsmentioning

confidence: 99%

Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya

et al. 2019

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“…The World Health Organization (WHO) offers a variety of guideline documents and tools, which enable healthcare facilities to evaluate certain IPC processes and structures [3][4][5][6]. In an attempt to release an overarching tool that addresses not only selected IPC aspects, but infection control in its entire complexity, the WHO released the Infection Prevention and Control Assessment Framework (IPCAF) in 2018 [7].…”

Section: Introductionmentioning

confidence: 99%

Evaluating infection prevention and control programs in Austrian acute care hospitals using the WHO Infection Prevention and Control Assessment Framework

Aghdassi

Grisold

Wechsler-Fördös

et al. 2020

Antimicrob Resist Infect Control

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Background: Infection prevention and control (IPC) is crucial for patient safety. The World Health Organization (WHO) has released various tools to promote IPC. In 2018, the WHO released the Infection Prevention and Control Assessment Framework (IPCAF) that enables acute care healthcare facilities to evaluate IPC structures and practices. Data regarding IPC implementation in Austria are scarce. To deliver insights into this topic and promote the IPCAF within the Austrian IPC community, we decided to invite all Austrian hospitals participating in the German nosocomial infection surveillance system to conduct a self-assessment using the WHO IPCAF. Methods: The IPCAF follows the eight WHO core components of IPC. A German translation of the IPCAF was sent to 127 Austrian acute care hospitals. The survey period was from October to December 2018. Participation in the survey, data entry and transfer to the German national reference center for surveillance of healthcare-associated infections was on a voluntary basis. Results: Altogether, 65 Austrian hospitals provided a complete dataset. The overall median IPCAF score of all hospitals was 620 (of a possible maximum score of 800), which corresponded to an advanced level of IPC. Of the 65 hospitals, 38 achieved an advanced IPC level. Deeper analysis of the different core components yielded diverse results. Scores were lowest for core components on multimodal strategies for implementation of IPC interventions, and IPC education and training. Around 26% (n = 17) of hospitals reported that the local IPC team was not steadily supported by an IPC committee. Senior clinical staff was not present in the IPC committee in 23% (n = 15) of hospitals. Only 26% (n = 17) of hospitals reported employing at least one IPC professional per ≤250 beds. Surveillance for multidrug-resistant pathogens was not conducted in 26% (n = 17) of hospitals.

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“…Previous studies have investigated the applicability and feasibility of other WHO tools, such as the WHO Hand Hygiene Self-Assessment Framework and the multimodal approach at hand hygiene in general [15–18], as well as the Water and sanitation for health facility improvement tool (WASH FIT) [19]. Studies have repeatedly demonstrated the feasibility and reliability of these tools and approaches.…”

Section: Introductionmentioning

confidence: 99%

A national survey on the implementation of key infection prevention and control structures in German hospitals: results from 736 hospitals conducting the WHO Infection Prevention and Control Assessment Framework (IPCAF)

Aghdassi

Hansen

Bischoff

et al. 2019

Antimicrob Resist Infect Control

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Background Healthcare-associated infections (HAI) pose a burden on healthcare providers worldwide. To prevent HAI and strengthen infection prevention and control (IPC) structures, the WHO has developed a variety of tools and guidelines. Recently, the WHO released the Infection Prevention and Control Assessment Framework (IPCAF), a questionnaire-like tool designed for assessing IPC structures at the facility level. The IPCAF reflects the eight WHO core components of IPC. Data on the implementation of IPC measures in German hospitals are scarce. Therefore, it was our objective to utilize the IPCAF in order to gather information on the current state of IPC implementation in German hospitals, as well as to promote the IPCAF to a broad audience. Methods The National Reference Center for Surveillance of Nosocomial Infections (NRZ) sent a translated version of the IPCAF to 1472 acute care hospitals in Germany. Data entry and transfer to the NRZ was done electronically between October and December 2018. The IPCAF was conceived in a way that depending on the selected answers a score was calculated, with 0 being the lowest possible and 800 the highest possible score. Depending on the overall score, the IPCAF allocated hospitals to four different “IPC levels”: inadequate, basic, intermediate, and advanced. Results A total of 736 hospitals provided a complete dataset and were included in the data analysis. The overall median score of all hospitals was 690, which corresponded to an advanced level of IPC. Only three hospitals (0.4%) fell into the category “basic”, with 111 hospitals (15.1%) being “intermediate” and 622 hospitals (84.5%) being “advanced”. In no case was the category “inadequate” allocated. More profound differences were found between the respective core components. Components on multimodal strategies and workload, staffing, ward design and bed occupancy revealed the lowest scores. Conclusions IPC key aspects in general are well established in Germany. Potentials for improvement were identified particularly with regard to workload and staffing. Insufficient implementation of multimodal strategies was found to be another relevant deficit. Our survey represents a successful attempt at promoting the IPCAF and encouraging hospitals to utilize WHO tools for self-assessment. Electronic supplementary material The online version of this article (10.1186/s13756-019-0532-4) contains supplementary material, which is available to authorized users.

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Strengthening Healthcare Facilities Through Water, Sanitation, and Hygiene (WASH) Improvements: A Pilot Evaluation of “WASH FIT” in Togo

Cited by 26 publications

References 9 publications

Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya

Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya

Evaluating infection prevention and control programs in Austrian acute care hospitals using the WHO Infection Prevention and Control Assessment Framework

A national survey on the implementation of key infection prevention and control structures in German hospitals: results from 736 hospitals conducting the WHO Infection Prevention and Control Assessment Framework (IPCAF)

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