Partnering With Environmental Services to Drive Infection Control Excellence

Background Little is known about hand hygiene (HH) policies and practices in long-term care facilities (LTCF). Hence, we decided to study the frequency of HH-related infection control (IC) gaps and the factors associated with it. Methods The Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) in collaboration with NE Department of Health and Human Services conducted in-person surveys and on-site observations to assess infection prevention and control programs (IPCP) in 30 LTCF from 11/2015 to 3/2017. The Centers for Disease Control and Prevention (CDC) Infection Prevention and Control Assessment tool for LTCF was used for on-site interviews and the Centers for Medicare and Medicaid (CMS) Hospital IC Worksheet was used for observations. Gap frequencies were calculated for questions (6 on CDC survey and 8 on CMS worksheet) representing best practice recommendations (BPR). The factors studied for the association with the gaps included LTCF bed size (BS), hospital affiliation (HA), having trained infection preventionists (IP), and weekly hours (WH)/ 100 bed spent by IP on IPCP. Fisher’s exact test and Mann Whitney test were used for statistical analyses. Results HH-related IC gap frequencies from on-site interviews are displayed in Figure 1. Only 6 (20%) LTCF reported having all 6 BPR in place and 10 (33%) having 5 BPR. LTCF with fewer gaps (5 to 6 BPR in place) appear more likely to have HA as compared with the LTCF with more gaps but the difference didn’t reach statistical significance (37.5% vs. 7.1%, P = 0.09). When analyzed separately for each gap, it was found that LTCF with HA are more likely to have a policy on preferential use of alcohol based hand rubs than the ones without HA. (85.7%, vs. 26.1% P = 0.008). Several IC gaps were also identified during observations (Figure 2) with one of them being overall HH compliance of <80%. LTCF that have over 90% HH compliance are more likely to have higher median IP WH/100 beds dedicated towards IPCP as compared with the LTCFs with less than 90% compliance (16.4 vs. 4.4, P < 0.05). Conclusion Many HH-related IC gaps still exist in LTCF and require mitigation. Mitigation strategies may include encouraging LTCF to collaborate with IP at local acute care hospitals for guidance on IC activities and to increase dedicated IP times towards IPCP in LTCF. Disclosures All authors: No reported disclosures.

Infection Prevention and Control Programs in US Nursing Homes: Results of a National Survey

Antimicrobial Stewardship and Infection Prevention and Control in Low- and Middle-income Countries: Current Status and Best Practices.

Antimicrobial resistance and self-reported hand hygiene awareness before and after an infection prevention and control programme: A 7-year analysis in a small animal veterinary teaching hospital

BackgroundCritical Access Hospitals (CAH) may face challenges with limited resources in their infection prevention and control (IPC) program. As part of the Project Firstline collaborative, the University of Nebraska Medical Center and its clinical partner Nebraska Medicine sought to identify needs and develop resources to mitigate IPC program gaps in small and rural hospitals, including CAHs. Since, little is known about the resources needed by CAHs to strengthen their IPC program, a needs assessment survey was deployed to Federal Emergency Management Agency Region VII CAHs.MethodsA 49-question Research Electronic Data Capture (REDCap) survey was distributed via email to infection preventionists in Region VII CAHs. The survey had 4 sections with questions focused on IPC program infrastructure, competency-based training, audit and feedback, and identification and isolation of high-risk pathogens/serious communicable diseases. An IPC practice score was assigned to each CAH by totaling “yes” responses. A “no” or “not sure” response was considered an IPC gap. Respondents who selected “no” were asked to identify resources that would assist in mitigating identified gaps. Descriptive analyses evaluated frequency of gaps and most cited resources. Welch t-test was used to study differences in IPC practice score between states.Results50 CAHs (33 in NE, 16 in IA and 1 in KS) and 1 small NE hospital (not licensed as CAH but included in the analyses as CAH) participated in the survey. Majority (n=38) responded to all sections with IPC scores ranging from 13 to 48. There was no significant difference between IPC practice scores of CAHs in NE and IA (average score 33 vs 36; p = 0.38). Specific IPC practice gaps present in > 50% of CAHs were related to audit and feedback practices (Table 1). Additional gaps included lack of drug diversion program, absence of input from IPC team prior to purchasing equipment and failure to conduct risk assessment for the laboratory. Most CAHs cited a standardized audit tool and staff training materials as much needed resources (Table 1).Table 1. Needs/Resources for the identified Infection Prevention and Control Gaps.ConclusionMajor IPC gaps exist in CAHs with many of them related to implementing audit and feedback practices that are an essential component of a successful IPC program. Focus should be directed on developing resources to mitigate identified IPC gaps.DisclosuresM. Salman Ashraf, MBBS, Merck & Co. Inc (Grant/Research Support, I have recieved grant funding for an investigator initiated research project from Merck & Con. Inc. However, I do not see any direct conflict of interest related to the submitted abstract)

A Needs-Assessment Survey of Healthcare Professionals Accountable for Infection Prevention and Control in Hemodialysis Setting

Key lessons from the establishment of a nurse-led infection prevention and control program for COVID-19 in an Australian hotel quarantine and isolation service

Healthcare-associated infections (HAIs) and rising antimicrobial resistance (AMR) have posed a major challenge in patient care across the globe, more so in lower-middle-income countries (LMICs). Studies have shown that implementation of an effective infection prevention and control (IPC) program reduces incidence of HAI to a large extent. However, implementation of such a program in low-resource setting has many challenges. Research have shown that gaps exist due to absence of political will, trained manpower, and alternate healthcare priorities. With progress in science of healthcare epidemiology and digital communication, opportunities to establish an effective IPC program at minimal cost is possible. In this review, we explore ways the existing challenges can be mitigated in LMICs. In recent times, the UN general assembly along with World Health Organization (2015) and member countries took a resolution to come up with an action plan to tackle the rising threat of AMR by strengthening IPC programs at national level. We reviewed the progress made by the developing countries in their efforts to implement the program.

US policies require robust nursing home (NH) infection prevention and control (IPC) programs to ensure safe care. We assessed IPC resources and practices related to catheter and non-catheter-associated urinary tract infection (CAUTI and UTI) prevention among NHs. We conducted a mixed-methods study from April 2018 through November 2019. Quantitative surveys assessed NH IPC program resources, practices, and communication during resident transfer. Semistructured qualitative interviews focused on IPC programs, CAUTI and UTI prevention practices, and resident transfer processes. Using a matrix as an analytic tool, findings from the quantitative survey data were combined with the qualitative data in the form of a joint display. Representatives from 51 NHs completed surveys; interviews were conducted with 13 participants from 7 NHs. Infection preventionists (IPs) had limited experience and/or additional roles, and in 36.7% of NHs, IPs had no specific IPC training. IP turnover was often mentioned during interviews. Most facilities were aware of their CAUTI and UTI rates and reported using prevention practices, such as hydration (85.7%) or nurse-initiated catheter discontinuation (65.3%). Qualitative interviewees confirmed use of these practices and expressed additional concerns about overuse of urine testing and antibiotics. Although transfer sheets were used by 84% to communicate about infections, the information received was described as suboptimal. NHs identified IP challenges related to turnover, limited education, and serving multiple roles. However, most NHs reported awareness of their CAUTI and UTI rates as well as their use of prevention practices. Importantly, we identified opportunities to enhance communication between NHs and hospitals to improve resident care and safety.

Dear Editor, Healthcare-associated infections are among the most common adverse health outcomes globally, with at least one in ten patients acquiring an infection while receiving care in low-and middle-income countries (1).This infection is significantly influenced by factors such as weakened patient immune systems, invasive treatments, inadequate sanitation, and antibiotic-resistant germs.These infections result in serious outcomes, including higher death rates, longer hospital stays, increased healthcare expenses, and great strains on both patients and healthcare systems.Furthermore, the rising use of antibiotics to manage these infections contributes to the spread of antimicrobial resistance, with nosocomial infections also posing a risk of transmission from patients to healthcare workers (2).Effective infection prevention and control are critical for eliminating avoidable hospital-acquired infections and are integral to providing safe, effective, and high-quality healthcare services (3).The World Health Organization estimates that effective infection prevention and control programs can reduce hospital-acquired infection rates by up to 30% (4).Healthcare professionals have a crucial role in preventing infections, actively educating patients, and grounding their practices in current scientific research.Nurses, as patient advocates, are uniquely positioned to champion improvements in patient care protocols and standards.The most important nursing intervention for infection prevention is hand hygiene, and nurses must use personal protective equipment when handling body fluids.However, implementing effective infection control in hospitals faces several challenges that can impact patient care quality and healthcare worker safety.Some of these challenges include: 1. Resistance to change: Many healthcare staff resist new

This systematic review aims to underscore the adoption and implementation of infection prevention and control (IPC) practices based on the World Health Organization's Infection Prevention and Control Assessment Framework (IPCAF) in low- and middle-income countries (LMICs). Systematic review. Cochrane Handbook for systematic reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Google Scholar, Web of Science, Scopus, Cochrane, grey literature and reference lists of studies published between January 2018 and September 2024. Peer reviewed full length, cross-sectional, mixed method and quasi-experimental studies written in English, conducted in LMICs and used IPCAF as assessment tool. Data were extracted on a data extraction form and quality of studies was evaluated by using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. Evidence was generated as a group of themes. In total, 24 studies were selected based on eligibility criteria. IPC program was implemented to a varying degree in healthcare facilities (HCFs) of LMICs. Key barriers reported were; no allocation of budget for IPC, insufficient staffing of full-time IPC professionals, absence of clear IPC goals, challenges in staff training, lack of resources, no periodic monitoring and inconsistent availability of IPC supplies. There was an evidence on implementation of IPC program in the HCFs of LMICs, however, LMICs faced substantial challenges in achieving consistent and effective IPC.

Background: Preventing healthcare-associated infections (HAIs) is essential for delivering safe and high-quality healthcare services. Globally, HAIs remain a significant public health concern, contributing to increased morbidity, mortality, and healthcare costs. Although many of these infections are preventable through cost-effective infection prevention and control (IPC) measures, healthcare facilities in sub-Saharan Africa often lack effective IPC programs. In Ethiopia, limited data exist on healthcare workers’ knowledge, attitudes, and practices (KAP) regarding infection prevention and patient safety. Objective: To assess the knowledge, attitude, and practice of infection prevention and patient safety among healthcare professionals in public health facilities in Asella town, Ethiopia, in 2025. Methods: A descriptive cross-sectional study was conducted from February 7 to March 20, 2025, among healthcare professionals working in Asella public health facilities. Participants were selected using simple random sampling. Data were collected using a standardized, pre-tested questionnaire. Ethical clearance was obtained from the Arsi University Ethics Committee, and formal permission was secured from the respective health facilities. Results: The study found that healthcare professionals’ knowledge of infection prevention was significantly associated with educational level (AOR = 3.248; 95% CI: 1.360–7.759), type of hospital (AOR = 0.304; 95% CI: 0.102–0.906), and the availability of bathing facilities (AOR = 0.101; 95% CI: 0.011–0.974). Conclusion: Educational level, hospital type, and the availability of bathing facilities are key factors influencing healthcare professionals’ knowledge and practices regarding infection prevention and patient safety. Strengthening IPC programs and addressing infrastructure gaps at the facility level may improve compliance and safety outcomes. Policy efforts should focus on institutionalizing regular IPC training and upgrading basic hygiene infrastructure across all public health facilities.

A cross-Canada survey of infection prevention and control in long-term care facilities

Introduction Nigeria faces a critical health workforce shortage, with only 1.83 skilled workers per 1,000 people, well below the WHO-recommended 4.5. Healthcare workers (HCWs) are at increased risk of Lassa fever infection, yet the drivers of nosocomial transmission remain poorly understood. HCW deaths continue to occur during outbreak seasons, highlighting the urgent need to strengthen infection prevention and control (IPC). Understanding exposure patterns and care-seeking behaviour is essential to optimizing IPC strategies and protecting the health system’s frontline. Methods This is a descriptive cross-sectional study using data from healthcare workers (HCWs) infected with Lassa fever in 2023 and 2024. The Infection Prevention and Control (IPC) pillar of the National Lassa Fever Technical Working Group routinely investigates RT-PCR-confirmed Lassa fever cases among HCWs using standardized case investigation forms. Results A total of 60 PCR-confirmed HCW infections were investigated. Most occurred in outpatient units, accounting for 94.5%, while isolation and theatre units contributed 3.7% and 1.9%, respectively. The majority were aged 31–40 years (40.0%), with females comprising 60.0% and males 40.0%. Infections were mostly reported from tertiary facilities (70.0%), followed by PHCs (15.0%) and secondary/general hospitals (11.7%). Public facilities accounted for 78.3% of cases; private, 21.7%. Only 41.7% had IPC programmes; 51% did not use appropriate PPE during patient care, and 53.3% had no IPC training. Most HCWs (84%) could not identify their exposure source. Of the 16 (26.7%) that could, the mean interval from exposure to medical attention was 15 days; from exposure to symptom onset, 8 days; and from symptom onset to care, 6 days. Over one-third of HCWs delayed care by more than three days after symptom onset. Conclusion Active monitoring, strengthened IPC, regular training, and early intervention are urgently needed to reduce infection risk and protect HCWs in high-burden outpatient settings.

BackgroundHospital infection prevention and control (IPC) programs are often insufficient to meet the needs of pediatric oncology units (POUs) in low-resource settings. Accordingly, we established partnerships to build and sustain dedicated IPC teams for two POUs in Ecuador and Guatemala.MethodsEach partnership comprised four phases: (1) planning and preparation; (2) developing the IPC team; (3) sustaining the IPC team; and (4) integrating the IPC team into the institution. The impact of the IPC teams was assessed by monitoring healthcare-associated infections (HAIs) and compliance with IPC practices.ResultsAt Hospital SOLCA–Quito, Ecuador, local champions were identified and trained. These in turn built local IPC teams that led healthcare improvement by using surveillance for outcome measures, monitoring practices for processes measures, and staff training. As the collaboration progressed, infection rates decreased steadily. At SOLCA–Quito, there were 9 HAIs/1000 patient days at baseline in 2010, whereas at the end of 2019, there were 2.6 HAIs/1000 patient days. A similar program was developed at the UNOP hospital in Guatemala, where the HAI rate decreased from 9.9/1000 patient days in 2011 to 5.37/1000 patient days in 2019 and the CLABSI rate decreased from 32.75/1000 catheter days in 2008 to 3.11/1000 catheter days in 2019. Towards the end of the collaborations, the IPC teams were integrated into the institutional structures. The Ecuadorean IPC team was integrated as a link team between the pediatric oncology service and the hospital IPC program. The Guatemalan team became the institutional IPC program staff.ConclusionsOur collaborations decreased HAIs in two POUs. The model proved sustainable and became part of the institutional structures, and it has been replicated in POUs elsewhere.