The status of infection prevention and control structures in secondary and tertiary hospitals in Northwest China: findings from WHO Infection Prevention and Control Assessment Framework (IPCAF).

BACKGROUND

Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) pose significant challenges to healthcare institutions worldwide. Implementing effective infection prevention and control (IPC) measures is crucial for reducing the risk of HAIs. However, limited research has been conducted on the current status of IPC in secondary and tertiary hospitals in Shaanxi Province, China. This study aims to comprehensively and quantitatively evaluate the IPC practices in these hospitals using the IPC Assessment Framework (IPCAF).

METHODS

A cross-sectional study was conducted in Shaanxi Province, China, from February to April 2024, in collaboration with the Provincial Center for Nosocomial Infection Control and Quality Improvement (NICQI) and 10 regional NICQIs. Using a stratified multistage sampling approach, secondary and tertiary hospitals were selected. Data were collected via electronic questionnaires distributed through WeChat groups. To ensure data quality, a pilot survey was performed, and standardized training was provided to all investigators.

RESULTS

A total of 171 hospitals participated in the survey, with 108 secondary hospitals (63.16%) and 63 tertiary hospitals (36.84%). The overall median IPCAF score was 642.5 (inter-quartile range [IQR]: 545-710), with secondary hospitals scoring 600 (IQR: 507.5-682.5) and tertiary hospitals 705 (IQR: 637.5-755), indicating significant differences between hospital grades (P < 0.05). According to WHO criteria, 106 hospitals (61.99%) achieved an "advanced" IPC level. Among core component (CC) scores, CC5 (Multimodal strategies) and CC7 (Workload, staffing and bed occupancy) had the lowest median scores (75), while CC8 (Built environment, materials and equipment for IPC at the facility level) and CC2 (IPC guidelines) had the highest median score.

CONCLUSIONS

Secondary and tertiary hospitals in Shaanxi Province have demonstrated a relatively high level of IPC. However, resource allocation and facility upgrades in secondary hospitals require enhancement. The identified strengths and areas for improvement are in accordance with those observed in other upper-middle income countries, particularly with respect to multimodal strategies.