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Table 1 Key and core components for effective infection prevention and control in health care facilities

From: Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1)

  Key components (ECDC) [5] Core components (WHO) [6]
1 An effective infection control program in an acute care hospital must include at least: one full-time specifically trained IPC nurse per 250 beds; a dedicated physician trained in IPC; microbiological support; data management support. An IPC program with a dedicated, trained team should be in place in each acute healthcare facility for the purpose of preventing HAI and combating AMR through IPC good practices.
2 To make sure that the ward occupancy does not exceed the capacity for which it is designed and staffed; staffing and workload of frontline healthcare workers must be adapted to acuity of care; and the number of pool/agency staff minimized. In order to reduce the risk HAI and the spread of AMR, the following should be addressed: 1) bed occupancy should not exceed the standard capacity of the facility; 2) healthcare worker staffing levels should be adequately assigned according to patient workload.
3 Sufficient availability of and easy access to material and equipment and optimized ergonomics. At the facility level, patient care activities should be undertaken in a clean and/or hygienic environment that facilitates practices related to the prevention and control of HAI, as well as AMR; including all elements around the WASH infrastructure and services and the availability of appropriate IPC materials and equipment.
4 Use of guidelines in combination with practical education and training. Evidence-based guidelines should be developed and implemented for the purpose of reducing HAI and AMR. Education and training of the relevant healthcare workers on guideline recommendations should be undertaken to achieve successful implementation.
5 Education and training involves frontline staff, and is team- and task-oriented. At the facility level, IPC education should be in place for all healthcare workers by utilizing team- and task-based strategies that are participatory and include bedside and simulation training to reduce the risk of HAI and AMR.
6 Organizing audits as a standardized (scored) and systematic review of practice with timely feedback. Regular monitoring/audit and timely feedback of healthcare practices should be undertaken according to IPC standards to prevent and control HAIs and AMR at the healthcare facility level. Feedback should be provided to all audited persons and relevant staff.
7 Participating in prospective surveillance and offering active feedback, preferably as part of a network. Facility-based HAI surveillance should be performed to guide IPC interventions and detect outbreaks, including AMR surveillance with timely feedback of results to healthcare workers and stakeholders and through national networks.
8 Implementing IPC programs follows a multimodal strategy including tools such as bundles and checklists, developed by multidisciplinary teams and taking into account local conditions. At the facility level, IPC activities should be implemented using multimodal strategies to improve practices and reduce HAI and AMR.
9 Identifying and engaging champions in the promotion of a multimodal intervention strategy. NA
10 A positive organisational culture by fostering working relationships and communication across units and staff groups. NA
  1. AMR, Antimicrobial resistance; ECDC, European Centre for Disease Prevention and Control; HAI, Healthcare-associated infection; IPC, Infection prevention and control; NA, not applicable; WASH, Water, sanitation and hygiene; WHO, World Health Organization