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Table 1 Infection Prevention and Control Research Priorities (including survey vetting scores)

From: Infection prevention and control research priorities: what do we need to combat healthcare-associated infections and antimicrobial resistance? Results of a narrative literature review and survey analysis

Research priorities Weighted average criticality Priority category Priority ranking
IPC interventions
 1. There is a lack of high-quality studies addressing the effectiveness of hospital-based IPC programmes, including their impact, cost-effectiveness, and ideal composition. 3.20 * High 4
2.87 Medium
2.95 * Medium
IPC guidelines
 2. Many best practice IPC recommendations are based upon weak evidence. For example, the World Health Organization identified, in its Global Guidelines for the Prevention of Surgical Site Infection, 20 recommendations with a “low” quality of evidence. The evidence base supporting IPC guidelines needs to be strengthened. 2.82 Medium 6
2.91 * Medium
2.89 Medium
 3. Situational analyses in different settings (high, medium or low-incomes countries) but also different healthcare settings (intensive care units, short or long stay, medico-social facilities) are needed to better understand potential adaptations of IPC guidelines. 2.45 Medium 7
2.91 * Medium
2.79 Medium
 4. A better understanding of the different patient screening strategies is needed for risk management. This includes who should be screened, when (including start and stop of screening), and how movement between healthcare institutions should trigger screening. Research should include both clinical impact and cost-effectiveness. 2.50 Medium 9
2.78 Medium
2.71 Medium
IPC training
 5. Additional tools are needed to evaluate IPC training programmes and implement them. 2.82 Medium 14
2.44 Medium
2.53 Medium
 6. New innovative ways of training should be evaluated such as e-learning, simulation, self-directed training modules or mentorship for IPC education. There is a lack of study on the impact of these innovative training tools on the practice change and infection rate in healthcare facilities. 2.91 Medium 8
2.66 Medium
2.72 Medium
 7. Minimal standard requirements for the recruitment and training of IPC professionals should be investigated. 2.30 Medium 13
2.63 Medium
2.55 Medium
IPC surveillance and monitoring
 8. Research is needed to assess and validate the reliability of surveillance based on available patient clinical information (syndromic-based surveillance) rather than microbiological data or prescription databases, i.e., data gathered for other primary purposes. 1.90 Low 11
2.78 Medium
2.57 Medium
 9. There is a lack of published standards to monitor IPC practices beyond hand hygiene. Evidence-based standardised audit protocols need to be created addressing, for example, catheter-related bloodstream/urinary tract infections and ventilator-associated pneumonia. 3.09 * High 5
2.84 Medium
2.91 * Medium
 10. There are a number of innovative, new methods to monitor compliance to IPC practices, including electronic and infrared approaches. These need to be tested in multiple settings to assess their value for IPC programmes. 2.73 Medium 15
2.39 Medium
2.48 Medium
Impact of patient environment on HCAI and AMR reduction (facilities and staffing)
11. Insufficient data are available on the impact of infrastructural changes at the facility level on the reduction of infections and resistance. This includes the accessibility to specific equipment, density of hand washing points, availability of single occupancy rooms, and more. 3.00 * High 3
2.94 * Medium
2.95 * Medium
12. Research is needed to explore the impact of patient-to-bed ratio on the spread of infections and resistance, including instances of overcrowding. This should include analyses of staff workload, available staffing (including presence of IPC professionals), bed occupancy, and visitor frequency. 3.36 * High 2
2.97 * Medium
3.07 * High
13. Research is needed to study the interaction between the human and hospital microbiome.** n/a n/a n/a
Behavioural science
14. Studies are needed to assess the demographic, organizational, economic, sociological, and behavioural factors facilitating success but also the barriers and challenges to implement effective IPC programmes. 3.55 * High 1
3.00 * High
3.14 * High
15. Patients and their families are key elements in the chain of transmission in healthcare facilities. Studies addressing the impact of patient and family-oriented education and communication campaigns (involving patients associations) on the rate of hospital-acquired infections are needed. 2.73 Medium 10
2.63 Medium
2.65 Medium
One Health
16. Research is needed to assess the impact of IPC measures in different operational contexts including small farms, industrial farms, feedlots, slaughterhouses, fish farms, and more. IPC measures may include the density of the animal populations, vaccination, hygiene measures and antibiotic use. 2.60 Medium 12
2.56 Medium
2.57 Medium
  1. Through our literature review, we extracted a list of 15 IPC research priorities. They are presented in the first column of this table. Each of them was surveyed by two groups of IPC experts. Experts were asked how urgent each of the identified gap was. Answers were scored a value of 0 to 4 (0 corresponding to “not a priority” and 4 to “critical priority”). Based on this scoring and results from the survey, we calculated the weighted average criticality of each assumption (second column) and assigned them into a priority category (third column). For each assumption, three results are presented. First line corresponds to the results obtained with the first target-group composed of 18 European IPC experts. Second line correspond to the results obtained with the second target-group, EUCIC members. Third line correspond to merged results from both groups. In each group, the top five research needs, according to experts, are highlighted by a * mark. Finally, research priorities were ranked from 1 to 15, from the most to the less urgent one, based on merged results from both groups. Results of this ranking are presented in the fourth column. The survey also allowed to identify an additional research priority. It is highlighted by a ** mark in the table. For this additional priority, no weighted average criticality, priority category nor ranking was calculated as it was not included in the survey