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Prevent infection  –  Health care

Core components

The WHO and other actors have outlined core components of infection prevention and control (IPC) to prevent health care-associated infections (HAIs) and manage antibiotic resistance at the health care facility and on national level.

The WHO core components are outlined below with links for where to find additional information. Components 1–6 contain guidelines for both facility and national levels, whereas components 7 and 8 mainly concern facility level.

1. Infection prevention and control programs

Programs should be developed on both national level and in health care facilities to prevent HAIs and manage antibiotic resistance. Dedicated and trained teams should be created in all acute health care facilities. On a national level, the IPC programs should be linked with other relevant programs and professional organizations.

Health care – Set up a program

POLICY: Implement the plan – Infection prevention and control

2. National and facility level infection prevention and control guidelines

Evidence-based guidelines should be developed, disseminated and implemented. Health care workers need to be educated to understand the theoretical background of the recommendations and how they should be applied in their daily tasks. Adherence to the given guidelines should be monitored and evaluated.

Health care – Interventions

3. Infection prevention and control education and training

Continuous training on the implementation of the guidelines should be provided for all health care workers. Different training strategies and content should be used for IPC specialists, other health care staff and supporting staff. The training should include practical and simulation training, learning to identify risks and preventive measures. Adequate staff should be allocated for education on infection prevention measures and control activities.

RAISE AWARENESS – Education and training (see table Infection prevention and control)

4. Health care-associated infection surveillance

It is recommended that facility surveillance linked with national surveillance programs on HAIs and antimicrobial resistance is established to guide interventions and detect outbreaks. These should also include mechanisms for data feedback to health-care workers and other stakeholders. Microbiology and laboratory capacity and quality are critical components, where standardized definitions and methods should be applied.

Priorities should be established for surveillance of infections and pathogens. Tasks include systematic assessment of compliance and impact of IPC practices, detection of outbreaks for prompt response end description of HAI status.

Health care – Set up a Program – Assess the situation

MEASURE: Antibiotic resistance and Infections

POLICY: Implement the plan – Surveillance

5. Multimodal strategies for implementing infection prevention and control activities

An IPC program should be implemented multimodally, i.e. using an integrated approach with several components. Common components are system change, education and training, monitoring and feedback, reminders, and culture change.

Health care – Set up a program – Plan an intervention

POLICY: Implement the plan – Infection prevention and control

6. Monitoring and evaluation and feedback

Health care practices should be regularly monitored and evaluated on both facility and national levels. Feedback from the evaluations should be given to relevant staff and stakeholders who are able to take action based on the evaluations as well as the audited persons. It is important that the monitoring and feedback is conducted in a blame-free, non-punitive manner.

Health care – Set up a Program – Evaluate

7. Workload, staffing and bed occupancy at the facility level

Overcrowding and understaffing are serious problems in health care facilities. Both contribute to lowered quality of care and increased disease transmission between patients and even between patients and visitors. Standard facility design recommends one patient per bed with at least 1 meter between beds. Adequate staffing based on workload should be ensured.

Health care – Interventions – Basic

8. Built environment, materials and equipment for infection prevention and control at the facility level

Patients should be cared for in a clean, hygienic environment. The cornerstone of all IPC programs is hand hygiene. Washing stations with water, soap, clean towels and alcohol based hand rub should be available in key areas such as toilets and at the point of care. Standards for water quality, sanitation and environmental health should be implemented. Other materials such as personal protective equipment should be available at the point of care and other sites where potentially contaminated material is handled.

Health care – Interventions – Basic

Selected Resources

Resource Description
Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level Evidence-based guidelines from WHO that aims to support development and implementation of infection prevention and control measures. A summary of the document is available here (PDF, 176kb). Available in English and Spanish.
Minimum requirements for infection prevention and control programmes Guidance. Minimum IPC standards that should be in place at the national and facility level, and reference to relevant WHO resources. Based on the WHO core components for IPC programmes above. Intended for IPC/AMR focal points, policy-makers, and professionals interested in strengthening IPC programmes.
Global progress report on WASH in health care facilities: Fundamentals first Report from WHO and UNICEF. Presents data and describes why proper water, sanitation and hygiene (WASH) is fundamental. Aims to stimulate solution-driven actions on existing gaps. Gives four recommendations to countries and partners, health and community leaders, based on presented data. Annex 1 describes practical steps to improve WASH in health care facilities.
The ISID Guide to Infection Control in the Healthcare setting Guide that summarizes principles, interventions, and strategies to reduce healthcare associated infections. Contains more than 60 short chapters on a variety of topics often specifically addressing settings with limited resources. The guide is also available in Spanish.
Infection Prevention – A reference booklet for health care providers Quick desk reference for infection prevention and control in resource limited settings. Available in English and French.
Core competencies for infection prevention and control professionals Document from WHO that can be used as a guide for identifying the needs of health care organizations with regards to IPC professional staff. It can be used to help define who is the IPC professional and what core competencies are needed to be qualified in IPC and at what level, and for assessing the training needs of IPC professionals.
Core competencies for infection control and hospital hygiene professionals in the European Union Document providing a comprehensive list of core competencies that should be adopted by infection control and hospital hygiene professionals across Europe. Core competencies are listed in two columns, one for senior specialists (‘expert level’) and one adapted for junior specialists (‘introductory level’).
Hospital organisation, management and structure for prevention of health-care-associated infection: a systematic review and expert consensus Systematic review that identifies ten crucial elements for setting up infection prevention programmes in hospitals.

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