Healthcare-associated infections (HAIs) and the rise of antibiotic resistance continue to confront healthcare facilities around the world. Even though a large portion of HAIs are preventable through effective infection prevention and control (IPC) measures the World Health Organization (WHO) recently reported that seven percent of patients in developed countries and 10 percent in developing countries will acquire at least one HAI.1 They are a major public health issue with a significant impact on morbidity, mortality and quality of life. They represent an economic burden to health systems around the globe with a direct cost to hospitals ranging from 28 billion all the way to 45 billion dollars.2 The WHO takes the prevalence of HAIs as a serious issue and updated its 2009 guidelines for the core components of an effective infection prevention program.3
Effective Infection Prevention
Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO) decided to prioritize the development of global recommendations on the core components of effective IPC programs both at the national and acute health care facility level, based on systematic literature reviews and expert consensus.
Breaking Down the Guidelines
The updated WHO guidelines were followed by an article examining the guidelines that were published in the journal Antimicrobial Resistance & Infection Control in early January.4 The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications and the feasibility and acceptability of the recommendations. The following eight key components that should be instituted by every healthcare facility were the result of the Guideline Development Groups’ (GDG) work:
1. Institute an infection prevention program with dedicated and trained staff to prevent HAIs and combat antibiotic resistance.
2. Establish evidence-based guidelines for HAI and monitor healthcare worker adherence to those guidelines.
3. Staff education should be a key component of the infection prevention program. Educational efforts should include bedside simulations designed to put HAI reduction strategies into practice.
4. HAI rates should be tracked both within the facility and on a national scale to guide infection prevention interventions.
5. Healthcare organizations should use multimodal strategies for HAI reduction. These strategies should be designed to meet goals of national healthcare initiatives and facility accreditation bodies when applicable.
6. Infection prevention programs and relevant staff should be regularly audited and provided with performance feedback.
7. A healthcare organization’s bed occupancy should not exceed the standard capacity established for the facility. Provider staffing levels should be adequately aligned with the patient workload.
8. Healthcare facilities should implement WHO standards for quantity and appropriate position of hand hygiene materials and meet WHO standards for drinking water quality and sanitation. Equipment and the patient environment should also be cleaned appropriately.
Many of these standards are very similar to already created initiatives similar to Medline’s Infection Prevention program. These are evidence based guidelines using evidence-based best practices to implement system change, proper education, bundle-based strategies, leadership engagement and increased accountability.
1. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level, World Health Organization. http://www.who.int/gpsc/ipc-components-guidelines/en/. Accessed January 29, 2017
2. Storr J. Twyman A. Zingg W. et al. Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations, Antimicrobial Resistance & Infection Control 6(6):1-18 · https://aricjournal.biomedcentral.com/articles/10.1186/s13756-016-0149-9. January 2017.
3. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. http://www.who.int/gpsc/ipc-components-guidelines/en/. World Health Organization. Accessed March 10, 2017.
4. Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations. https://aricjournal.biomedcentral.com/articles/10.1186/s13756-016-0149-9. Antimicrobial Resistance & Infection Control. Published January 10, 2017.