Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
Centers for Disease Control and Prevention (CDC), Bangladesh Country Office, Dhaka, Bangladesh.
Antimicrob Resist Infect Control. 2022 Oct 6;11(1):125. doi: 10.1186/s13756-022-01161-4.
Infection prevention and control (IPC) in healthcare settings is imperative for the safety of patients as well as healthcare providers. To measure current IPC activities, resources, and gaps at the facility level, WHO has developed the Infection Prevention and Control Assessment Framework (IPCAF). This study aimed to assess the existing IPC level of selected tertiary care hospitals in Bangladesh during the COVID-19 pandemic using IPCAF to explore their strengths and deficits.
Between September and December 2020, we assessed 11 tertiary-care hospitals across Bangladesh. We collected the information from IPC focal person and/or hospital administrator from each hospital using the IPCAF assessment tool.. The score was calculated based on eight core components and was used to categorize the hospitals into four distinct IPC levels- Inadequate, Basic, Intermediate, and Advanced. Key performance metrics were summarized within and between hospitals.
The overall median IPCAF score was 355.0 (IQR: 252.5-397.5) out of 800. The majority (73%) of hospitals scored as 'Basic' IPC level, while only 18% of hospitals were categorized as 'Intermediate'. Most hospitals had IPC guidelines as well as environments, materials and equipments. Although 64% of hospitals had IPC orientation and training program for new employees, only 30% of hospitals had regular IPC training program for the staff. None of the hospitals had an IPC surveillance system with standard surveillance case definitions to track HAIs. Around 90% of hospitals did not have an active IPC monitoring and audit system. Half of the hospitals had inadequate staffing considering the workload. Bed occupancy of one patient per bed in all units was found in 55% of hospitals. About 73% of hospitals had functional hand hygiene stations, but sufficient toilets were available in only 37% of hospitals.
The majority of sampled tertiary care hospitals demonstrate inadequate IPC level to ensure the safety of healthcare workers, patients, and visitors. Quality improvement programs and feedback mechanisms should be implemented to strengthen all IPC core components, particularly IPC surveillance, monitoring, education, and training, to improve healthcare safety and resilience.
医疗机构内的感染预防和控制（IPC）对于患者和医护人员的安全至关重要。为了衡量设施层面当前的 IPC 活动、资源和差距，世卫组织制定了感染预防和控制评估框架（IPCAF）。本研究旨在使用 IPCAF 评估孟加拉国选定的三级保健医院在 COVID-19 大流行期间的现有 IPC 水平，以探索其优势和不足。
2020 年 9 月至 12 月，我们评估了孟加拉国的 11 家三级保健医院。我们从每家医院的 IPC 焦点人员和/或医院管理人员那里使用 IPCAF 评估工具收集信息。得分根据八项核心要素计算，并用于将医院分为四个不同的 IPC 级别-不足、基础、中级和高级。关键绩效指标在医院内和医院间进行了总结。
800 分的 IPCAF 总中位数评分为 355.0（IQR：252.5-397.5）。大多数（73%）医院的 IPC 评分为“基础”水平，而只有 18%的医院被归类为“中级”。大多数医院都有 IPC 指南以及环境、材料和设备。尽管 64%的医院有针对新员工的 IPC 定向和培训计划，但只有 30%的医院为员工提供定期的 IPC 培训计划。没有一家医院拥有带有标准监测病例定义的 IPC 监测系统来跟踪医院获得性感染。大约 90%的医院没有活跃的 IPC 监测和审计系统。考虑到工作量，一半的医院人员配备不足。所有单位中每个床位一个病人的床位占用率在 55%的医院中发现。约 73%的医院有功能齐全的手卫生站，但只有 37%的医院有足够的厕所。
大多数抽样的三级保健医院的 IPC 水平不足，无法确保医护人员、患者和访客的安全。应实施质量改进计划和反馈机制，以加强所有 IPC 核心要素，特别是 IPC 监测、监测、教育和培训，以提高医疗保健安全性和恢复力。
