Cadieux G, Brown C, Sachdeva H
Ottawa Public Health, Ottawa, ON (when this study was conducted).
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON.
Can Commun Dis Rep. 2019 Nov 7;45(11):289-295. doi: 10.14745/ccdr.v45i11a03.
Following an update to the provincial in 2015, Ontario public health units have been mandated to investigate infection prevention and control (IPAC) complaints in various settings, including those where regulated health professionals work. No surveillance system exists for IPAC complaints; therefore, little is known about their occurrence. Anecdotal evidence suggests a recent increase in IPAC complaints resulting in increased demand on public health resources.
To describe the occurrence of IPAC complaints and lapses in Ontario in 2015-2018 and the public health response to these.
Ontario public health units were surveyed about the occurrence and key challenges of IPAC complaint investigations through closed- and open-ended questions. The survey was disseminated through the Council of Ontario Medical Officers of Health listserv. Data collection spanned February 4-28, 2019. Descriptive statistical analyses and thematic analysis of free-text responses were performed.
Twenty-one public health units responded for a 60% response rate; fewer responding health units had a population size of less than 100,000. A nearly six-fold increase in IPAC complaints was found, from a total of 79 complaints in 2015 to 451 in 2018. IPAC lapses nearly tripled, with 61 identified in 2015 and 168 in 2018. Whereas variation in the number of IPAC complaints and lapses among public health units was noted, the most common IPAC lapse involved inadequate reprocessing of reusable equipment. Key challenges in investigating IPAC complaints included lack of staff expertise/training, increased workload and costs, interjurisdictional inconsistencies and lack of guidance.
IPAC complaints and lapses have increased in Ontario since 2015 when the Ministry of Health and Long-Term Care changed the IPAC complaint protocol. Public health units identified lack of expertise, increased workload, interjurisdictional inconsistencies and lack of guidance as challenges. Further research to confirm these findings, identify best practices to address these challenges as well as interventions to prevent IPAC lapses would be useful. Prospective surveillance of IPAC complaints, like for reportable diseases, would also be useful.
2015年该省进行更新后，安大略省公共卫生单位受委托对包括受监管卫生专业人员工作场所在内的各种场所的感染预防与控制（IPAC）投诉展开调查。目前尚无针对IPAC投诉的监测系统；因此，对其发生情况了解甚少。轶事证据表明，IPAC投诉近期有所增加，导致对公共卫生资源的需求上升。
描述2015 - 2018年安大略省IPAC投诉及失误情况以及公共卫生部门对此的应对措施。
通过封闭式和开放式问题对安大略省公共卫生单位进行调查，了解IPAC投诉调查的发生情况和主要挑战。该调查通过安大略省卫生官员理事会邮件列表进行传播。数据收集时间为2019年2月4日至28日。对自由文本回复进行描述性统计分析和主题分析。
21个公共卫生单位回复，回复率为60%；回复的卫生单位中，人口规模小于10万的较少。发现IPAC投诉增加了近六倍，从2015年的79起投诉增至2018年的451起。IPAC失误几乎增加了两倍，2015年发现61起，2018年发现168起。虽然注意到公共卫生单位之间IPAC投诉和失误数量存在差异，但最常见的IPAC失误涉及可重复使用设备的再处理不当。调查IPAC投诉的主要挑战包括缺乏工作人员专业知识/培训、工作量和成本增加、跨辖区不一致以及缺乏指导。
自2015年卫生和长期护理部更改IPAC投诉协议以来，安大略省的IPAC投诉和失误有所增加。公共卫生单位将缺乏专业知识、工作量增加、跨辖区不一致和缺乏指导视为挑战。进一步开展研究以证实这些发现、确定应对这些挑战的最佳做法以及预防IPAC失误的干预措施将很有用。对IPAC投诉进行前瞻性监测，就像对可报告疾病进行监测一样，也会很有用。
