Share the article

Health care  –  Set up a program

Assess the situation

An initial situational assessment of infection prevention and control practices and health care-associated infections will serve both to identify areas for improvement and also to supply baseline information against which to compare findings from later evaluations. The type of assessment depends on the resources available and the scope of the program or intended interventions. Here you find resources to help in the process.

Assess existing or generate new data

Antibiotic resistance: The transfer of resistant bacteria between patients at health care facilities often begins as harmless colonization but becomes a serious threat when a nosocomial infection occurs that is caused by the resistant bacteria. Susceptibility testing done by the clinical microbiology laboratory can inform treatment options, and assist in deciding which pathogens to focus on in the development of interventions.

MEASURE: Antibiotic resistance

Health care-associated infections: Data on the number, types and outcomes of health care-associated infections help to understand the effectiveness of current infection prevention and control measures, quickly identifying outbreaks, estimate the associated burden of morbidity and mortality, and inform the development of infection prevention and control interventions.

MEASURE: Infections in humans

Understand barriers, facilitators and readiness for change

A successful implementation can be enabled or hindered by policies and guidelines, individual responsiveness or level of organizational support. Brainstorming, interviews, focus groups, observations or surveys can be used to help understand the barriers and facilitators to developing effective programs and interventions.

While change can be easy and exciting for some, others find it daunting and can be skeptical of the positive impact it can make. Readiness for change is about being open to something new and willingness to sustain initiatives over time. Receptiveness to change is dependent on strong leadership, clear vision, and good management.

Selected Resources

Resource Description
Infection prevention and control assessment framework (IPCAF) at the facility level Tool (scoring system) from WHO to support baseline assessment to understand current situation, including strengths and weaknesses, to guide action planning for improvement and implementation of the WHO Guidelines on Core Components of Infection Prevention and Control Programmes at the acute health care facility level.
WASH Conditions Assessment Tool (WASHCon) Tool for assessment of water, sanitation and hygiene conditions at health care facilities in low- and middle-income countries. Aims to give an overview of conditions, infrastructure and resources and to provide data for prioritization and action. The tool determines evaluation scores that are color coded for easy overview. Developed by the Center for Global Safe Water, Sanitation, and Hygiene at Emory University.
Infection Control Assessment Tool (ICAT) for Primary Health Care Facilities Manual that provides a simple and practical approach for assessing infection prevention and control practices and highlighting deficiencies in current practices. It also provides specific recommendations for improving practices to prevent health care-associated infections (HAIs).
Infection Control Assessment Tool: A Standardized Approach for Improving Hospital Infection Control Practices Guide. Adaptation of the Infection Control Assessment Tool which was commissioned and published by the South Africa National Department of Health. It entails detailed descriptions of the infection control assessment tool (ICAT) manual, modules and checklists that all aim to identify, control, and prevent health care-associated infections. It also provides specific recommendations for improving practices.
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, many of relevance when assessing the situation within healthcare settings. The guide is also available in Spanish.
Rapid evaluation guide for hospital programs for prevention and control of nosocomial infections Guide from Latin American experts for the review and improvement of infection prevention and control programs, especially oriented towards hospital directors.
Workload Indicators of Staffing Need (WISN) Tool. A human resource management tool for health managers. Provides a systematic way to make staffing decisions to manage valuable human resources well. Software with manual, available in English, French and Spanish. For country implementation experiences (Africa), see here.
Quick Observation Tools (QUOTs) for Infection Prevention Tools. Observation worksheets for quick (few minutes) assessment of infection prevention baseline, gaps and performance within different healthcare environments and patient populations. Of general relevance but adaptation may be needed to fit context.
Infection Control Assessment Tools Tools from CDC to assess infection prevention practices and guide quality improvement activities.

More from "Set up a program"

1.
Australian Commission on Safety and Quality in Healthcare. The OSSIE toolkit for the implementation of the Australian guidelines for the prevention of Infection in Health Care 2010 [Internet]. Commonwealth of Australia; 2010 [cited 2014 Aug 21]. Available from: https://www.safetyandquality.gov.au/sites/default/files/migrated/OSSIE-Toolkit_WEB.pdf
1.
Pan American Health Organization - PAHO. Rapid Evaluation Guide for Hospital programs for prevention and control of nosocomial infections [Internet]. Pan American Health Organization; 2011 [cited 2014 Aug 20]. Available from: https://www.paho.org/hq/dmdocuments/2011/HAI-Evaluation-guide-2011-ENG.pdf
1.
International Society for Infectious Diseases - ISID. Guide to Infection Control in the Healthcare Setting [Internet]. ISID - International Society for Infectious Diseases. [cited 2019 Jul 5]. Available from: https://isid.org/guide/
1.
World Health Organization - WHO. Workload Indicators of Staffing Need (WISN) [Internet]. WHO. 2015 [cited 2017 Oct 26]. Available from: https://www.who.int/publications/i/item/9789241500197
1.
World Health Organization - WHO. Infection prevention and control assessment framework at the facility level [Internet]. 2018. Available from: https://www.who.int/publications/i/item/WHO-HIS-SDS-2018.9
1.
Quick Observation Tools (QUOTs) for Infection Prevention [Internet]. CDC. 2021 [cited 2021 Jun 19]. Available from: https://www.cdc.gov/infectioncontrol/tools/quots.html
1.
WASHCon [Internet]. Water, Sanitation and Hygiene in Healthcare Facilities. [cited 2021 Apr 26]. Available from: http://washconhcf.org/research-tools/washcon/
1.
Centers for Disease Control and Prevention - CDC. Infection Control Assessment Tools [Internet]. [cited 2016 Jun 20]. Available from: http://www.cdc.gov/hai/prevent/infection-control-assessment-tools.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.
South Africa’s Department of Health, Management Sciences for Health. Infection Control Assessment Tool: A Standardized Approach for Improving Hospital Infection Control Practices [Internet]. South Africa’s Department of Health; 2013 [cited 2016 Apr 4]. Available from: http://siapsprogram.org/publication/infection-control-assessment-tool-a-standardized-approach-for-improving-hospital-infection-control-practices/
1.
Moody J, Cosgrove SE, Olmsted R, Septimus E, Aureden K, Oriola S, et al. Antimicrobial stewardship: a collaborative partnership between infection preventionists and health care epidemiologists. Am J Infect Control [Internet]. 2012 Mar;40(2):94–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22381221
1.
Dellit TH, Owens RC, McGowan JE, Gerding DN, Weinstein RA, Burke JP, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis [Internet]. 2007 Jan 15;44(2):159–77. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17173212
1.
Nejad SB, Allegranzi B, Syed S, Ellis B, Pittet D. Health-care-associated infection in Africa: a systematic review. Bulletin of the World Health Organization [Internet]. 2011 Oct 1 [cited 2014 Aug 21];89(10):757–65. Available from: http://www.who.int/bulletin/volumes/89/10/11-088179.pdf