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Health care  –  Interventions

Basic interventions

A variety of basic actions can be used to prevent and control infections.

WHO’s basic set of infection prevention and control guidelines promote the use of standard precautions such as:

  • Hand hygiene. Hand hygiene is the single most effective measure to stop transmission of health care associated pathogens.
  • Sterilization and disinfection of medical material
  • Aseptic technique
  • Prevention and management of injuries from sharp instruments
  • Early detection of disease and isolation precautions such as patient placement, use of personal protective equipment
  • Waste management

Improved water sanitation and hygiene heavily reduced wound sepsis after C-section

Description: Health care in Sierra Leone crippled in the post-conflict period. A lack of electricity, water and basic supplies used for infection prevention and control made safe deliveries difficult. At one hospital – the Bo District Hospital – 60% of women who gave birth through caesarian-section got sepsis due to infected wounds. To address these issues, development partners in Sierra Leone that worked on maternal and newborn health shifted the focus of their programs. Boreholes were drilled, water storage facilities were introduced and a generator was supplied to the operating theatre of the Bo District Hospital. Staff was trained in water sanitation and hygiene and wound care.

Place: Bo District Hospital, Sierra Leone.

Setting: Maternity unit

Finding: Within a period of 3 months, post-caesarian wound sepsis decreased from 60% to 10%. Use of antibiotics decreased dramatically. Within 6 months, more than twice as many women chose to deliver at this maternity unit since their improved services quickly became known to patients.

A selection of resources for basic interventions are found in the table below. In addition, many countries have their own guidelines that are adapted to the local circumstances.

Educational materials for health care workers are collected in RAISE AWARENESS: Education and training.

For tools and guidance how to measure the effects of interventions, go to MEASURE.

Selected Resources

Resource Description
WHO Clean Care is Safer Care: Tools and resources Information portal. WHO tools and resources for hand hygiene interventions, including:

  • WHO Guidelines on Hand Hygiene in Health Care
  • A hand hygiene self-assessment framework
  • A guide to handhygiene Improvement
  • A guide to local production of hand rub formulations
  • Template Action Plan for WHO Framework
  • Links out to additional pages on for example training and education and feedback
A Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy This WHO manual assist health care facilities to implement improvements in hand hygiene in accordance with the WHO guidelines on hand hygiene in health care. Available in English and French.
Five moments for hand hygiene The key moments for hand hygiene described in simple terms and images. Aims to add value to existing hand hygiene improvement strategies, developed by the WHO. Available in English and French.
Infection Control Assessment Tool (ICAT) for Primary Health Care Facilities This document identifies tools on how to improve practices for the prevention and control of infections and highlight deficiencies in current practices as well as proposing reformatory actions.
A quick desk reference for infection prevention and control in resource limited settings. Available in English and French (Earlier version in Spanish). Step-by-step instructions for how to perform critical procedures.
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. See for example chapters on:

The guide is also available in Spanish.

Water and Sanitation for Health Facility Improvement Tool ‘WASH FIT’ Practical guidelines on how to improve quality of care through water, sanitation, and hygiene (WASH) in health care facilities. Largely designed for primary, and in some instances secondary, health care facilities in resource-limited settings. The WASH FIT Mobile is a free complementary tool for the same purpose available here.
Best Practices for Environmental Cleaning in Healthcare Facilities in Resource-Limited Settings Manual from Infection Control Africa Network (ICAN) and CDC. The best practices are divided into three chapters focusing on 1) environmental cleaning programs 2) supplies and euipment and 3) procedures. Should be used and implemented within the framework of existing IPC programs.
Natural ventilation for infection control in health-care settings The document gives an overview on natural ventilation and its design requirements in relation to infection control in health care settings.
Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study Intervention example. Describes the implementation of a multifaceted infection control and antibiotic stewardship program with good results in terms of reducing hospital-acquired infections and antibiotic use.
Tackling Antimicrobial Resistance: Supporting national measures to address infection prevention and control, and water, sanitation and hygiene in health care settings (PDF) Fact sheet. WHO and UNICEF fact sheet on AMR, infection prevention and water, sanitation and hygiene with recommended actions.
Guidelines library – Resources toward elimination of HAIs Guidelines from CDC on strategies for surveillance, prevention, and control of healthcare-associated infections, antimicrobial resistance and related events in healthcare settings. The page includes for example:

Guideline for Disinfection and Sterilization
Guideline for Isolation Precautions

Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care CDC summary guide of infection prevention recommendations for outpatient (ambulatory care) settings based primarily upon elements of Standard Precautions and represents the minimum infection prevention expectations for safe care in ambulatory care settings.

More from "Interventions"

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Velleman Y, Mason E, Graham W, Benova L, Chopra M, Campbell OMR, et al. From Joint Thinking to Joint Action: A Call to Action on Improving Water, Sanitation, and Hygiene for Maternal and Newborn Health. PLoS Med [Internet]. 2014 Dec 12 [cited 2020 Mar 20];11(12):e1001771. Available from: https://dx.plos.org/10.1371/journal.pmed.1001771
1.
Centers for Disease Control and Prevention - CDC, Infection Control Africa Network - ICAN. Best Practices for Environmental Cleaning in Healthcare Facilities in Resource-Limited Settings [Internet]. 2019 [cited 2020 Feb 10]. Available from: https://www.cdc.gov/hai/pdfs/resource-limited/environmental-cleaning-508.pdf
1.
World Health Organization - WHO, UNICEF. Tackling Antimicrobial Resistance: Supporting national measures to address infection prevention and control and water, sanitation and hygiene in health care settings [Internet]. [cited 2017 Feb 15]. Available from: https://www.washinhcf.org/resource/tackling-antimicrobial-resistance-supporting-national-measures-to-address-infection-prevention-and-control-and-water-sanitation-and-hygiene-in-health-care-settings/
1.
International Society for Infectious Diseases - ISID. The ISID Guide to Infection Control in the Healthcare setting [Internet]. ISID - International Society for Infectious Diseases. [cited 2019 Jul 5]. Available from: https://www.isid.org/education/guide-to-infection-control-in-the-healthcare-setting/
1.
World Health Organization - WHO. Clean Care is Safer Care: Tools and resources [Internet]. Clean Care is Safer Care. 2009 [cited 2016 Mar 22]. Available from: http://www.who.int/gpsc/5may/tools/en/
1.
World Health Organization - WHO. A Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy [Internet]. World Health Organization; 2009 [cited 2014 Aug 19]. Available from: http://www.who.int/infection-prevention/publications/hh_implementation-guide/en/
1.
International Federation of Infection Control - IFIC. IFIC Basic concepts of infection control [Internet]. Portadown: International Federation of Infection Control; 2016. Available from: http://theific.org/basic-concepts-book/
1.
World Health Organization - WHO, UNICEF. WASH FIT Mobile [Internet]. [cited 2017 May 4]. Available from: https://washfit.org/#/
1.
World Health Organization - WHO, UNICEF. Water and Sanitation for Health Facility Improvement Tool “WASH FIT”: A practical guide for improving quality of care through water, sanitation, and hygiene in health care facilities [Internet]. 2016 [cited 2017 Jan 27]. Available from: https://www.washinhcf.org/fileadmin/user_upload/documents/WHO-UNICEF-2017-WASH-FIT_final.pdf
1.
Centers for Disease Control and Prevention - CDC. Guide to Infection Prevention in Outpatient Settings: Minimum Expectations for Safe Care [Internet]. [cited 2016 Jun 20]. Available from: http://www.cdc.gov/HAI/settings/outpatient/outpatient-care-guidelines.html
1.
Centers for Disease Control and Prevention CDC. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 [Internet]. [cited 2017 Jan 27]. Available from: https://www.cdc.gov/hicpac/Disinfection_Sterilization/acknowledg.html
1.
Systems for Improved Access to Pharmaceuticals and Services A. Infection Control Assessment Tool for Primary Health Care Facilities [Internet]. 2013 [cited 2016 Apr 12]. Available from: http://siapsprogram.org/publication/infection-control-assessment-tool-for-primary-health-care-facilities/
1.
World Health Organization - WHO. Core components for infection prevention and control programmes – Report of the Second Meeting of the Informal Network on Infection Prevention and Control in Health Care [Internet]. 2008 [cited 2016 Mar 15]. Available from: http://www.who.int/csr/resources/publications/WHO_HSE_EPR_2009_1/en/
1.
World Health Organization - WHO. Natural ventilation for infection control in health-care settings [Internet]. Atkinson J, Chartier Y, Pessoa-Silva C, Jensen P, Li Y, Seto W-H, editors. Geneva: World Health Organization; 2009. 106 p. Available from: http://www.who.int/water_sanitation_health/publications/natural_ventilation/en/
1.
Murni IK, Duke T, Kinney S, Daley AJ, Soenarto Y. Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study. Arch Dis Child [Internet]. 2015 May [cited 2016 Jan 18];100(5):454–9. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413864/
1.
World Health Organization - WHO. Five moments for hand hygiene [Internet]. WHO. [cited 2015 Dec 21]. Available from: http://www.who.int/gpsc/tools/Five_moments/en/
1.
Engender Health. Infection prevention: a reference booklet for health care providers [Internet]. Engender Health; 2001. Available from: http://www.medbox.org/preview/52951e25-3818-4af1-880c-309f1fcc7b89/doc.pdf