Kristy Weinshel1, Angela Dramowski2, Ágnes Hajdu3, Saul Jacob4, Basudha Khanal5, Maszárovics Zoltán6, Katerina Mougkou7, Chimanjita Phukan8, Maria Inés Staneloni9, Nalini Singh10. 1. 1Society for Healthcare Epidemiology of America,Arlington,Virginia. 2. 2Stellenbosch University,Cape Town,South Africa. 3. 3National Center for Epidemiology,Budapest,Hungary. 4. 4George Washington University,Washington,DC. 5. 5B. P. Koirala Institute of Health Sciences,Nepal. 6. 6Markhot Ferenc Teaching Hospital and Outpatient Clinic,Eger,Hungary. 7. 7National Kapodistrian University,Athens School of Medicine,Athens,Greece. 8. 8Gauhati Medical College and Hospital,Guwahati,India. 9. 9Hospital Italiano de Buenos Aires,Buenos Aires,Argentina. 10. 10Children's National Medical Center,George Washington University,Washington,DC.
Abstract
BACKGROUND: Healthcare-associated infection rates are higher in low- and middle-income countries compared with high-income countries, resulting in relatively larger incidence of patient mortality and disability and additional healthcare costs. OBJECTIVE: To use the Infection Control Assessment Tool to assess gaps in infection control (IC) practices in the participating countries. METHODS: Six international sites located in Argentina, Greece, Hungary, India, Nepal, and South Africa provided information on the health facility and the surgical modules relating to IC programs, surgical antibiotic use and surgical equipment procedures, surgical area practices, sterilization and disinfection of equipment and intravenous fluid, and hand hygiene. Modules were scored for each country. RESULTS: The 6 international sites completed 5 modules. Of 121 completed sections, scores of less than 50% of the recommended IC practices were received in 23 (19%) and scores from 50% to 75% were received in 43 (36%). IC programs had various limitations in many sites and surveillance of healthcare-associated infections was not consistently performed. Lack of administration of perioperative antibiotics, inadequate sterilization and disinfection of equipment, and paucity of hand hygiene were found even in a high-income country. There was also a lack of clearly written defined policies and procedures across many facilities. CONCLUSIONS: Our results indicate that adherence to recommended IC practices is suboptimal. Opportunities for improvement of IC practices exist in several areas, including hospital-wide IC programs and surveillance, antibiotic stewardship, written and posted guidelines and policies across a range of topics, surgical instrument sterilization procedures, and improved hand hygiene.
BACKGROUND: Healthcare-associated infection rates are higher in low- and middle-income countries compared with high-income countries, resulting in relatively larger incidence of patient mortality and disability and additional healthcare costs. OBJECTIVE: To use the Infection Control Assessment Tool to assess gaps in infection control (IC) practices in the participating countries. METHODS: Six international sites located in Argentina, Greece, Hungary, India, Nepal, and South Africa provided information on the health facility and the surgical modules relating to IC programs, surgical antibiotic use and surgical equipment procedures, surgical area practices, sterilization and disinfection of equipment and intravenous fluid, and hand hygiene. Modules were scored for each country. RESULTS: The 6 international sites completed 5 modules. Of 121 completed sections, scores of less than 50% of the recommended IC practices were received in 23 (19%) and scores from 50% to 75% were received in 43 (36%). IC programs had various limitations in many sites and surveillance of healthcare-associated infections was not consistently performed. Lack of administration of perioperative antibiotics, inadequate sterilization and disinfection of equipment, and paucity of hand hygiene were found even in a high-income country. There was also a lack of clearly written defined policies and procedures across many facilities. CONCLUSIONS: Our results indicate that adherence to recommended IC practices is suboptimal. Opportunities for improvement of IC practices exist in several areas, including hospital-wide IC programs and surveillance, antibiotic stewardship, written and posted guidelines and policies across a range of topics, surgical instrument sterilization procedures, and improved hand hygiene.
Authors: Muhammad Nasir Ayub Khan; Daniëlle M L Verstegen; Abu Bakar Hafeez Bhatti; Diana H J M Dolmans; Walther Nicolaas Anton van Mook Journal: Eur J Clin Microbiol Infect Dis Date: 2018-08-10 Impact factor: 3.267