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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 at the facility level (PDF, 698kb) 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. Core components for IPC – Implementation tools and resources holds additional resources.
Infection Control Assessment Tool (ICAT) for Primary Health Care Facilities This manual 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 This document is an 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 as well as ICAT checklists that all aim to identify, control, and prevent health care-associated infections. It also provides specific recommendations for improving practices.
WHO Western Pacific Regional Infection Control Assessment Tool for Infection Control Link Persons in Lesser Resourced Settings (PDF) Assessment tool designed for use in low-resource settings, to be used at national, district/regional, or healthcare facility level. It aims to provide standardized data sets to analyze policy gaps and options, measure progress and outcomes achieved in relation to infection prevention and control.
IFIC Basic Concepts of Infection Control This manual provides a scientific foundation for basic infection control principles mainly to countries with limited resources. The 2016 Edition available in English. The 2011 Edition is available in Spanish, Italian, French, Hungarian, Arabic and Bulgarian. Several chapters may be useful including:

  • Chapter 28: Risk management. Describes process to identify and evaluate risks to set priorities for action
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 countries during their development and implementation of national antimicrobial resistance action plans together with inphographics including the problems and the solutions for the antimicrobial resistance issue. A summary of the document is available here (PDF).
Rapid evaluation guide for hospital programs for prevention and control of nosocomial infections A guide to provide orientation on review and improvement of infection prevention and control programs and advice from Latin American experts.
Workload Indicators of Staffing Need (WISN) 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.
Infection Control Assessment Tools CDC tool to assess infection prevention practices and guide quality improvement activities.

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