The Infection Prevention and Control (IPC) measures of healthcare facilities have never been under more scrutiny than in the current, post-pandemic world.
The global devastation of COVID-19 demonstrated how diligent management of IPC is essential to protect the wider community. Far from only being a concern of medical professionals, every individual – whether at home, at work or in public – has been encouraged to understand how infections spread and take action to protect the most vulnerable.
Of course, COVID-19 is not the only infection to threaten public health. MRSA, MSSA, C. difficile and E. coli are all examples of extremely dangerous infections which can be deadly; and, according to the World Health Organization, more than 1.4 million medical patients are affected at any time.
What is most concerning, however, is that the infections named above are healthcare-associated. They occur solely as a result of a medical interaction which permitted the infection to spread.
In response to increasing interest, the World Health Organisation (WHO) released their first global report on Infection Prevention and Control in May 2022.
Their findings have aptly proven how IPC holds a unique position in the medical field; it’s the only element of healthcare to be fundamental to every single medical interaction, from healthcare workers and their patients to the medical environment and its visitors.
Everyone who comes into contact with a care environment must practice IPC in some way. Medical workers will have the largest responsibility, as the nature of their work will naturally pose the biggest risk; but even visitors and external service providers must hold themselves accountable. Practicing basic IPC, such as sanitising hands and staying away from the facility when unwell, are everyone’s responsibility.
The universal importance of IPC means that, if it is mis-managed, there are very serious and far-reaching consequences.
The WHO report found that, out of every 100 patients in acute-care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one health care-associated infection (HCAI) during their hospital stay.
Furthermore, an average of 1 in every 10 affected patients will die from their HCAI.
Almost half of all cases of sepsis with organ dysfunction treated in adult intensive-care units are healthcare-associated. Even in EU/EEA countries – which can generally be considered high-income - the burden of the six most frequent HCAIs in terms of disability and premature mortality accounts for twice the burden of 32 other infectious diseases combined.
Despite the devastating impact of HCAIs being evident, not every country sets a national ICP standard for healthcare workers to adhere to.
In the last five years, WHO has conducted global surveys and country joint evaluations to assess the implementation status of national IPC programmes.
Comparing data from the 2017-18 and the 2021-22 surveys, the percentage of countries that had a formal IPC programme defined at a national level did not increase. To that end, only 15.2% of healthcare facilities surveyed in 2019 met all of the IPC minimum requirements at the point of care.
Although we are not seeing an upward trend in the rollout of national IPC programmes, there other gains being made. The percentage of countries who have an appointed IPC focal point, a dedicated budget for IPC and curriculum for front-line health care workers’ training are on the rise.
In addition, an increasing number of countries are developing national IPC guidelines for HCAI surveillance, using multimodal strategies for IPC interventions and establishing hand hygiene compliance as a key national indicator.
Compared to low-income countries, high-income countries were more than eight times more likely to have a more advanced IPC implementation status.
This isn’t wholly surprising; when you consider the cost of ICP resources – such as advanced training and equipment – the practice needs investment to see results.
However, the WHO report was keen to stress that IPC is highly cost-effective and a “best buy” for public health.
There is a wealth of cost-saving benefits to reducing infection; it can actively shrink the medical intervention a patient will require, as well as supporting a faster route to discharge. In addition, healthcare workers who are protected from infection will not require the additional sick leave, shift cover or increased labour associated with caring for patients suffering with HCAIs.
Whether implemented as a stand-alone intervention or integrated into multifaceted interventions, the WHO report identified hand hygiene as the single most effective measure to reduce the transmission of infection in healthcare settings.
Good hand hygiene doesn’t just save lives. WHO report that improving hand hygiene in health care settings could save about 16.5 USD in reduced health care expenditure for every USD invested.
In today’s infection-conscious world, hands-free technology is an essential defence against cross-infection – and many infection control products, such as hospital macerators, are now operated by hands-free optical sensors. This means that staff can reduce the touch points encounter and minimise the risk of spreading dangerous pathogens.
No country or health system can claim to be free of HCAIs.
WHO insist that it has never been more urgent to actively prevent infection.
Despite the money and time is invested in ICP, infection remains a perpetual threat. The risks can’t be removed – only managed.
With the amount of knowledge and technology currently available to the global medical sector, there is no need for anyone to be exposed to infection due to poor ICP standards. All medical interactions can be controlled to reduce risk - and all medical facilities and professionals must make it their duty to do so.
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It’s time to step up your infection prevention and control measures.