Development and implementation of a structured, quantitative approach to infection prevention and control within small animal veterinary care across four different European countries.

Most healthcare-associated infections may be prevented and improved infection prevention and control (IPC) has been identified as a key factor. A quantitative assessment would enable practices to evaluate their IPC level, track improvements, and benchmark against other practices. The primary aim of this article was to show the development of an all-encompassing IPC programme, including an antibiotic stewardship element, to be used in veterinary care. The secondary aim was to illustrate the associated scoring system, which could be used in small animal veterinary practices across different countries for quantitative assessment of compliance to the IPC guidelines, help identify strengths and shortcomings, and support decision making. First, available IPC knowledge was collated into an overall framework with seven different core elements representing the distinct aspects of IPC and antibiotic stewardship: (1) Hand hygiene, (2) Clothes, shoes, and personal protective equipment, (3) Environmental hygiene, (4) Infection prevention, (5) Reprocessing, (6) Veterinary care associated infections, and (7) Antibiotic use. Second, a pilot implementation was conducted in 15 IVC Evidensia practices in four European countries during 2020 - 2021 to evaluate the programme and the quantitative scoring system. The practice IPC levels were assessed before and after implementation. Provided with essential resources, practices increased their IPC level significantly between the initial and the final assessment with a median compliance to the pre-defined guidelines of 42 % and 65 %, respectively. This paper highlights that structured and measurable efforts to accomplish a quality-assured IPC level are possible and should be a priority for all veterinary practices worldwide.