Advertisement
Major article| Volume 41, ISSUE 4, P317-321, April 2013

Download started.

Ok

Evaluating infection control: A review of implementation of an infection prevention and control program in a low-income country setting

Published:October 24, 2012DOI:https://doi.org/10.1016/j.ajic.2012.05.007

      Background

      This study was conducted to review the status of the comprehensive infection prevention and control program (IPCP) established in the Republic of Kiribati in 2005, and to identify opportunities to continue and expand the integration of the IPCP into health service delivery.

      Methods

      The review was conducted in 2010 using 2 empirical tools: a pilot IPCP evaluation (IPCPE) tool that evaluated the activities of the program and its implementation, and a previously validated self-administered survey that assessed health care worker (HCW) knowledge, application, and confidence in infection control principles and practice. The survey was given to all 186 clinicians at Tungaru Central Hospital; the response rate was 59.7%.

      Results

      The Kiribati IPCP demonstrated a minimum level of compliance (75%) with the activity standards set out in the IPCPE tool. The mean scores on the HCW survey were 62% for knowledge, 63% for application, and 79% for confidence. Significant correlations were found among knowledge, application, and confidence.

      Conclusions

      This evaluation of the Kiribati IPCP with our IPCPE tool provides valuable insight into the status of a recently adopted comprehensive program and how it has translated into the knowledge, application, and confidence of HCWs in their clinical practice. The HCW survey provides evidence that the IPCP has translated into confidence and ability in the application of infection prevention practices.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rosenthal V.
        • Guzman S.
        • Orellano P.
        Nosocomial infections in medical-surgical intensive care units in Argentina: attributable mortality and length of stay.
        Am J Infect Control. 2003; 31: 291-295
        • Yalcin A.
        Socioeconomic burden of nosocomial infections.
        Indian J Med Sci. 2003; 57: 450-456
        • Starling C.
        Infection control in developing countries.
        Curr Opin Infect Dis. 2001; 14: 461-466
        • Isturiz R.
        • Carbon C.
        Antibiotic use in developing countries.
        Infect Control and Hosp Epidemiol. 2000; 21: 394-397
        • World Health Organization
        Prevention of hospital acquired infections: a practical guide.
        2nd ed. World Health Organization, Geneva, Switzerland2002
        • Huskins W.
        • Soule B.
        • O’Boyle C.
        • Gulacsi L.
        • O’Rourke E.
        • Goldmann D.
        Hospital infection prevention and control: a model for improving the quality of hospital care in low- and middle-income countries.
        Infect Control Hosp Epidemiol. 1998; 19: 125-135
        • Zimmerman P.
        Innovation in the time of SARS: the Kiribati infection and control programme [thesis].
        University of Wollongong, New South Whales, Australia2012
        • World Health Organization
        Western Pacific country health information profiles, 2010 revision.
        World Health Organization, Manila, Philippines2010
        • World Health Organization
        Western Pacific country health information profiles, 2008 Revision.
        World Health Organization, Manila, Philippines2008
        • Informal Network on Infection Prevention and Control in Health Care
        Core components of infection prevention and control programmes. Report of the Second Meeting Informal Network on Infection Prevention and Control in Health Care. WHO/HSE/EPR/2009.1.
        World Health Organization, Geneva, Switzerland2009
        • Bryce E.
        • Sharf S.
        • van Knippenberg-Gordebeke G.
        • Walker M.
        Audits in infection prevention and control.
        in: Friedman C. Newsom W. Basic concepts of infection control. International Federation of Infection Control, London2007
        • Hay A.
        Audit in infection control.
        J Hosp Infect. 2006; 62: 270-277
        • Pittet D.
        • Hugonnet S.
        • Harbarth S.
        • Mourouga P.
        • Sauvan V.
        • Touveneau S.
        • et al.
        Effectiveness of a hospital-wide programme to improve compliance with hand hygiene.
        Lancet. 2000; 356: 1307-1312
        • Saizy-Callaert S.
        • Causse R.
        • Furhmam C.
        Impact of a multidisciplinary approach to the control of antibiotic prescription in a general hospital.
        J Hosp Infect. 2003; 53: 177-182
        • Infection Control Nurses Association
        Audit tools for monitoring infection control standards.
        Infection Control Nurses Association, London2004
        • Millward S.
        • Barnett J.
        • Thomlinson D.
        A clinical infection control audit programme: evaluation of an audit tool used by infection control nurses to monitor standards and assess effective staff training.
        J Hosp Infect. 1993; 24: 219-232
        • Millward S.
        • Barnett J.
        • Thomlinson D.
        Evaluation of the objectivity of an infection control audit tool.
        J Hosp Infect. 1995; 31: 229-233
        • Pan American Health Organization
        Nosocomial infection program rapid evaluation guide.
        Pan American Health Organization, Washington, [DC]2005
        • Chelenyane M.
        • Endacott R.
        Self-reported infection control practices and perceptions of HIV/AIDS risk amongst emergency department nurses in Botswana.
        Accid Emerg Nurs. 2006; 14: 148-154
        • Wu C.-J.
        • Gardner G.E.
        • Chang A.M.
        Taiwanese nursing students’ knowledge, application and confidence with standard and additional precautions in infection control.
        J Clin Nurs. 2008; 18: 1105-1112
        • Nyamogoba H.
        • Obala H.
        Nosocomial infections in developing countries: cost-effective infection control and prevention.
        East Afr Med J. 2002; 79: 435-441
        • Mortensen N.
        How countries with more resources can help.
        J Hosp Infect. 1991; 18: 382-387
        • Sobayo E.
        Nursing aspects of infection control in developing countries.
        J Hosp Infect. 1991; 18: 388-391
        • Nettleman M.
        Global aspects of infection control.
        Infect Control Hosp Epidemiol. 1993; 14: 646-648
        • Zimmerman P.
        • Yeatman H.
        • Jones M.
        • Murdoch H.
        SARS and Kiribati: eyes wide open.
        Int J Infect Control. 2012; 8: 27-34
        • Rhinehart E.
        • Goldmann D.
        • O’Rourke E.
        Adaptation of the Centers for Disease Control guidelines for the prevention of nosocomial infection in a pediatric intensive care unit in Jakarta, Indonesia.
        Am J Med. 1991; 91: S213-S220
        • Raza M.
        • Kazi B.
        • Mustafa M.
        • Gould F.
        Developing countries have their own characteristic problems with infection control.
        J Hosp Infect. 2004; 57: 294-299
        • Ponce de Leon S.
        The needs of developing countries and the resources required.
        J Hosp Infect. 1991; 18: 376-381
        • Kermode M.
        • Jolley D.
        • Langkham B.
        • Thomas M.S.
        • Holmes W.
        • Gifford S.
        Compliance with Universal/Standard Precautions among health care workers in rural north India.
        Am J Infect Control. 2005; 33: 27-33
        • Rosenthal V.
        • Guzman S.
        • Pezzotto S.
        • Crnich C.
        Effect of an infection control program using education and performance feedback on rates of intravascular device–associated bloodstream infections in intensive care units in Argentina.
        Am J Infect Control. 2003; 31: 405-409
        • Sagoe-Moses C.
        • Pearson R.
        • Perry J.
        • Jagger J.
        Risks to health care workers in developing countries.
        N Engl J Med. 2001; 345: 538-541