Reducing the risks of disease causing bacteria in healthcare settings is among the most important tasks that a healthcare facility should pay attention to.
The burden of Healthcare Associated Infections
According to the International Nosocomial Infection Control Consortium (INICC), 1 in 20 in the United States, 1 in 10 in the European Union and 1 in 4 patients admitted to a healthcare facility in developing countries such as India get an infection from the healthcare facility, known as Healthcare Associated Infection (HAI) or nosocomial Infection. The prevalence of HAIs in developing countries can be as high as 30-50% compared to developed countries and therefore leads to longer hospital stays, increased treatment costs, and in some cases, death.
The 2011 Global Antibiotic Resistance Partnership (GARP) report, Situation Analysis: Antibiotic Use and Resistance in India, states that a large proportion of these HAIs are preventable with increased infection control measures. One of the key recommendation from the Ministry of Health and Family Welfare that aims to reduce the prevalence of HAIs is that “All hospitals create an infection control plan, committee and team.” But, in spite of implementing infection control practices, studies have shown a very low compliance by healthcare professionals. This is because just establishing an infection control committee or team cannot bring about changes. Infection control activities constantly face challenges like high rate of nursing staff turnover, time spent training new staff, heavy clinical workload, etc. and the resources dedicated to infection control are too frequently insufficient.
Role of the healthcare facility
As per a 2015 report from the European Society of Clinical Microbiology and Infectious Diseases the minimum requirements for any healthcare facility to prevent infection are:
- Health care administrators and managers should consider infection control like other activities related to patient safety as an institutional priority
- The infection control committee should be multidisciplinary in nature
- The Infection control program should have clearly defined objectives and indicators, which should be periodically evaluated, however the existence of the infection control program does not guarantee its functionality or adequate infection control practices.
- The Multidisciplinary infection control team, includes at least an epidemiologists, infectious disease specialists, microbiologists, pharmacists, and infection control nurses. The team should liaison with other key stakeholders, such as intensive-care or surgical specialties. These teams must work in close coordination with the antimicrobial stewardship team
- One full-time infection control nurse or equivalent per 100 beds in acute-care centres
- Clearly Defined roles and competencies for infection control team, and specific training according to those competencies
- Access to electronic charts and tools
- Appropriate cleaning and disinfection/sterilization services
- Appropriate ward staffing levels, and education for ward staff in infection control related issues
- Appropriate infrastructure and related aspects (such as enough individual rooms, clean–dirty circuits where needed, and access to hand hygiene points)
- Access to appropriate microbiological support and tools, both for rapid identification and susceptibility testing of pathogens causing infections, in a timely manner
Role of the Healthcare staff and their training
The activities to be performed in infection control are numerous, varied, and complex, and requires specialized training and competencies. Regardless of how a person becomes a member of the Infection Control Committee, it is very important that they get trained in a comprehensive Infection Control Program. Studies have shown that if you have trained Infection Control officers and Infection Control Nurses in your organization it leads to higher implementation of the infection prevention and control practices.
A good infection control training program consists of focus areas like:
- Basic concepts of Infection Control
- Standard and Transmission based precautions
- Cleaning, Disinfection & Sterilization
- Surveillance and Outbreak Management
- Control of multi resistant microorganisms
- Promoting staff health
- Auditing Infection Control Practices
- Communication and Change management, etc.
Such Infection Control Training Programs are not that frequent to find. The challenge of transferring the knowledge acquired in training the work place still remains.
You may like to check out the infection Control Training Program offered by Aarohan Healthcare Services based out of Gurgaon.