scholarly journals Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis

2020 ◽  
Vol 41 (10) ◽  
pp. 1196-1206 ◽  
Author(s):  
M. Saiful Islam ◽  
Kazi M. Rahman ◽  
Yanni Sun ◽  
Mohammed O. Qureshi ◽  
Ikram Abdi ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Global Analysis ◽  
Transmission Dynamics ◽  
World Health ◽  
Current Evidence ◽  
Infection Prevention And Control ◽  
Healthcare Settings ◽  
Surgical Masks ◽  
And Control

AbstractObjective:In the current absence of a vaccine for COVID-19, public health responses aim to break the chain of infection by focusing on the mode of transmission. We reviewed the current evidence on the transmission dynamics and on pathogenic and clinical features of COVID-19 to critically identify any gaps in the current infection prevention and control (IPC) guidelines.Methods:In this study, we reviewed global COVID-19 IPC guidelines by organizations such as the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC). Guidelines from 2 high-income countries (Australia and United Kingdom) and from 1 middle-income country (China) were also reviewed. We searched publications in English on ‘PubMed’ and Google Scholar. We extracted information related to COVID-19 transmission dynamics, clinical presentations, and exposures that may facilitate transmission. We then compared these findings with the recommended IPC measures.Results:Nosocomial transmission of SARS-CoV-2 in healthcare settings occurs through droplets, aerosols, and the oral–fecal or fecal–droplet route. However, the IPC guidelines fail to cover all transmission modes, and the recommendations also conflict with each other. Most guidelines recommend surgical masks for healthcare providers during routine care and N95 respirators for aerosol-generating procedures. However, recommendations regarding the type of face mask varied, and the CDC recommends cloth masks when surgical masks are unavailable.Conclusion:IPC strategies should consider all the possible routes of transmission and should target all patient care activities involving risk of person-to-person transmission. This review may assist international health agencies in updating their guidelines.

scholarly journals Infection Prevention and Control for 2019 Novel Coronavirus (2019 nCoV) in Acute Healthcare Settings: The Canadian Response

2020 ◽  
Vol 41 (S1) ◽  
pp. s17-s18 ◽  
Author(s):  
Toju Ogunremi ◽  
Kathleen Dunn ◽  
Jennie Johnstone ◽  
Joanne Embree
Keyword(s):  
Public Health ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Shared Responsibility ◽  
World Health ◽  
Infection Prevention And Control ◽  
Health Events ◽  
Healthcare Settings ◽  
Acute Healthcare ◽  
And Control

Background: Severe acute respiratory coronavirus virus 2 (SARS-CoV-2), able to cause pneumonia in humans, was discovered in Wuhan, Hubei Province, China. Investigations related to transmissibility are ongoing, but human-to-human transmission involving healthcare workers providing patient care and close contacts of infected patients have been confirmed. Infection control procedures are necessary to prevent transmission during delivery of health care in healthcare settings. Public health in Canada is a shared responsibility among municipal, provincial, territorial, and federal governments. Significant public health events require coordination between all levels of government and a consistent approach across jurisdictions. The objective of this summary is to describe the Public Health Agency (PHAC)’s Infection Prevention and Control (IPC) guideline on SARS-CoV-2. Methods: The PHAC’s interim guideline for infection prevention and control of 2019-nCoV in acute healthcare settings was informed by the currently limited evidence available, and adapted to the context of healthcare delivery in Canada. The guideline is based upon Canadian guidance developed for previous coronavirus outbreaks (eg, SARS and MERS), as well as the World Health Organization (WHO)’s interim guidance. Technical advice was provided by the National Advisory Committee on Infection Prevention and Control (NAC-IPC) of the Government of Canada. Interjurisdictional collaboration and decision making between multiple authorities and levels of government was facilitated using PHACs federal/provincial/territorial (FPT) Public Health Response Plan for Biological events (Fig. 1). Results: In the absence of effective drugs or vaccines, IPC strategies to prevent or limit SARS-CoV-2 transmission in healthcare settings include the following: prompt identification of signs, symptoms and exposure criteria, implementation of appropriate IPC measures (eg, contact and droplet precautions, patient isolation, N95 respirator plus eye protection when performing aerosol-generating medical procedures on a person under investigation), and etiologic diagnosis. Guideline recommendations are informed by collective expert interpretation of available evidence. Recommendations cover all relevant areas including screening and assessment, public health surveillance and notification, laboratory testing and reporting, respiratory hygiene, hand hygiene, patient placement and flow, management of visitors, use of personal protective equipment, environmental cleaning and discontinuation of precautions. Conclusions: This guideline is an ever-changing document. Changes in recommendations provided may be warranted with new evidence, changes in WHO guidelines, or other identified concerns. FPT governments continue to work collaboratively to ensure that Canada is ready to respond to public health events and is prepared to protect the health of Canadians. Opportunities for international collaboration on IPC products, as well as knowledge exchange and mobilization, continue to thrive.Funding: NoneDisclosures: None

scholarly journals A health worker knowledge, attitudes and practices survey of SARS-CoV-2 infection prevention and control in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saiendhra Vasudevan Moodley ◽  
Muzimkhulu Zungu ◽  
Molebogeng Malotle ◽  
Kuku Voyi ◽  
Nico Claassen ◽  
...  
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Health Facilities ◽  
World Health ◽  
Infection Prevention And Control ◽  
Successful Implementation ◽  
And Control

Abstract Background Health workers are crucial to the successful implementation of infection prevention and control strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces of South Africa as well as explore some elements of health worker and health facility infection prevention and control practices. Methods A cross-sectional study design was utilised. The study population comprised both clinical and non-clinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A structured self-administered questionnaire was developed using the World Health Organization guidance as the basis for the knowledge questions. COVID-19 protocols were observed during data collection. Results A total of 286 health workers from 47 health facilities at different levels of care participated in the survey. The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%) answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants (50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had received infection prevention and control training. Some participants indicated they did not have access to medical masks (11.8%) and gloves (9.9%) in their departments. Conclusions The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring adequate infection prevention and control training for all staff and universal access to appropriate PPE were identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings that needed to be addressed were provided to the relevant provincial departments of health.

scholarly journals Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis in an Egyptian University Hospital.

2021 ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Iman Heweidy ◽  
Samiha Abdu ◽  
Abouelata Omar ◽  
Caroline Ackley ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Theoretical Domains Framework ◽  
Control Measures ◽  
World Health ◽  
Infection Prevention And Control ◽  
Surgical Prophylaxis ◽  
Context Specific ◽  
And Control

Abstract Background: Antimicrobial resistance (AMR) is increasingly pervasive due to multiple, complex prescribing and consuming behaviours. Accordingly, behaviour change is an important component of response to AMR. Little is known about the best approaches to change antibiotic use practices and behaviours. This project aims to develop a context-specific behaviour change strategy focusing on promoting appropriate prescription practices following the World Health Organization recommendations for surgical prophylaxis in an orthopaedic surgery unit in Egypt.Methods: The project included a formative qualitative research study was based on the Theoretical Domains Framework (TDF) to explore the determinants for inappropriate prescription of surgical antibiotic prophylaxis at an orthopaedic unit. The intervention was developed to following the Behaviour Change Wheel (BCW) in a knowledge co-production workshop with infection prevention and control experts that ensured that the theory based intervention was a culturally acceptable, practical and implementable intervention. Results: The prescription of surgical prophylaxis was influenced by five TDF domains including, knowledge, belief in consequences (mistrust towards infection prevention and control measures), environmental factors (lack of prescription guidelines) , professional role and reinforcement (a lack of appropriate follow up actions influenced prescription of surgical prophylaxis). The appropriate set of behaviour change functions of BCW and related activities to improve the current practices included education, enablement, persuasion, environmental restructuring and restriction. Conclusions The study showed that a theory based and context specific intervention can be created by using the TDF and BCW together with knowledge-co creation to improve the prescription of surgical prophylaxis in and Egyptian orthopaedic unit. The intervention need to piloted and scaled up.

scholarly journals Infection Prevention and Control Policies and Staffing: A National Survey of Home Health Agencies in the United States

2020 ◽  
Vol 41 (S1) ◽  
pp. s301-s301
Author(s):  
Jingjing Shang ◽  
Ashley Chastain ◽  
U. Gayani Perera ◽  
Monika Pogorzelska-Maziarz ◽  
Patricia Stone
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Staff Member ◽  
Antibiotic Stewardship ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
For Profit ◽  
Healthcare Settings ◽  
And Control

Background: Infection prevention and control (IPC) is a national priority in all healthcare settings, and IPC staffing characteristics have been linked to patient safety outcomes. However, there is a lack of knowledge about IPC in home healthcare (HHC), the fastest growing healthcare sector. Our aim was to better understand the current state of IPC in HHC, as well as the HHC staff involved with IPC policy implementation. Methods: A national survey was conducted between October 2018 and November 2019. The participants included (1) agencies recruited from a national HHC conference and (2) a national random sample of 1,501 agencies stratified by census region, ownership status, and rural or urban location. Survey items included staff influenza vaccination policies, antibiotic stewardship, infection surveillance, and IPC staffing. Descriptive statistics were computed, and differences by ownership were calculated using 2 and Student t tests. Results: Of the 535 HHC agencies that responded to the survey (response rate, 33%), 64% were for-profit agencies. Overall, 30.8% of the agencies (17.9% for-profit, 57.6% nonprofit; P < .01) required staff influenza vaccination. Most nonprofit agencies (84.1%) and about half of the for-profit agencies (48.1%) offered free influenza vaccinations to staff (P < .01). During the past influenza season, 62.6% of agencies (81.5% nonprofit vs 51.6% for-profit; P < .01) had 75% of their employees vaccinated for influenza, and 9.3% (2% nonprofit vs 13.5% for-profit; P < .01) reported that they did not track this data. Only 17.9% of HHC agencies used antibiotic prescribing guidelines, and 33.3% reported that they reviewed cases to assess the appropriateness of antibiotic administration and/or indication. Most HHC agencies (86%) reported collecting and reviewing infection data to identify trends, which was often done quarterly or more frequently. Almost every responding agency reported that the staff member in charge of IPC had other responsibilities including administrative, education/training, or quality improvement, and 33.5% of those personnel had received no specific IPC training. Also, ~6% of agencies (12.5% of government-owned agencies) reported that they currently did not have a staff member in charge of IPC. Conclusions: This is the first national study of IPC in HHC, which can be used as a benchmark for quality improvement initiatives in the home care environment. Compared to other healthcare settings, HHC agencies have substantial challenges related to IPC. Most HHC agencies do not have a staff member exclusively dedicated to IPC, and staff training is inadequate. Furthermore, a significant number of agencies have no staff influenza vaccination or antibiotic stewardship policies in place. The situation is worse at for-profit agencies, which dominate the current US HHC industry.Funding: NoneDisclosures: None

scholarly journals Train-the-Trainers in hand hygiene: a standardized approach to guide education in infection prevention and control

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Ermira Tartari ◽  
Carolina Fankhauser ◽  
Sarah Masson-Roy ◽  
Hilda Márquez-Villarreal ◽  
Inmaculada Fernández Moreno ◽  
...  
Keyword(s):  
South Africa ◽  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
World Health ◽  
Infection Prevention And Control ◽  
Rank Test ◽  
Hand Hygiene Improvement ◽  
And Control

Abstract Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.

scholarly journals Infection prevention and control situation in public hospitals of Islamabad

2020 ◽  
Vol 14 (09) ◽  
pp. 1040-1046
Author(s):  
Saba Savul ◽  
Farida Khurram Lalani ◽  
Aamer Ikram ◽  
Muhammad Amjad Khan ◽  
Mumtaz Ali Khan ◽  
...  
Keyword(s):  
Public Sector ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Public Hospitals ◽  
World Health ◽  
Infection Prevention And Control ◽  
Global Public Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
And Control

Introduction: Healthcare-associated infections represent a global public health challenge and are associated with significant mortality and morbidity. Infection Prevention and Control (IPC) is a neglected area in healthcare facilities across Pakistan. The objective of our study was to elucidate the current state of infection prevention and control practices in public sector hospitals of Islamabad to underscore potential areas for improvement. Methodology: A cross-sectional survey was conducted between November and December 2019 at five public sector hospitals of Islamabad. The World Health Organization’s Infection Prevention and Control Assessment Framework (IPCAF) was used to assess the strengths and weaknesses of hospitals regarding infection prevention and control. Adapted tools derived from Centers for Disease Control and Prevention and Infection Prevention Society were used for detailed assessment of various departments. Data was analyzed using Microsoft Excel 2016. Results: In all five hospitals, the total IPCAF score was less than 200 denoting that infection prevention and control implementation is deficient and significant improvement is needed. The median IPCAF score was 117.5 with an interquartile range of 53.75. With the exception of central sterile services unit at one hospital, departments at all hospitals failed to meet even 50% of required IPC standards. Conclusions: Significant change is needed to improve the existent situation of infection prevention and control in public sector hospitals of Islamabad. This would involve establishment of functional programs, development and implementation of infection prevention and control guidelines and provision of adequate supplies.

scholarly journals Core Components for Infection Prevention and Control Programs: A World Health Organization Network Report

2010 ◽  
Vol 31 (9) ◽  
pp. 948-950 ◽  
Author(s):  
Wing Hong Seto ◽  
Fernando Otaíza ◽  
Carmen L. Pessoa-Silva ◽  
Keyword(s):  
World Health Organization ◽  
Prevention And Control ◽  
Infection Prevention ◽  
World Health ◽  
Infection Prevention And Control ◽  
Healthcare Facilities ◽  
Control Programs ◽  
Core Components ◽  
Health Organization ◽  
And Control

Under the leadership of the World Health Organization (WHO), the core components necessary for national and local infection prevention and control programs are identified. These components were determined by a network of international experts who are representatives from WHO regional offices and relevant WHO programs. The respective roles of the national authorities and the local healthcare facilities are delineated.

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