Core components of infection prevention and control programs at the facility level in Georgia: key challenges and opportunities
Core components of infection prevention and control programs at the facility level in Georgia: key challenges and opportunities
复制标题
格鲁吉亚设施一级感染预防和控制计划的核心组成部分：主要挑战和机遇
DOI：
10.21203/rs.3.rs-36574/v1
复制
发表时间：
2021
影响因子：
5.5
通讯作者：
Amy R Kolwaite
中科院分区：
文献类型：
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作者：
A. Deryabina;M. Lyman;Daiva Yee;Marika Gelieshvilli;Lia Sanodze;Lali Madzgarashvili;Jamine Weiss;C. Kilpatrick;M. Rabkin;B. Skaggs;Amy R Kolwaite
背景格鲁吉亚劳动、卫生和社会事务部正在努力加强其感染预防和控制（IPC）计划，但直到最近还缺乏对医院工作人员面临的绩效差距和实施挑战的评估。方法2018年，使用世界卫生组织（WHO）改编的工具对医疗保健医院进行了评估，旨在实施WHO的IPC核心组件。该研究包括对格鲁吉亚273家医院中的41家进行现场评估，然后对109名医院工作人员进行结构化访谈，对IPC实践进行验证观察，并进行后续文件审查。结果所有医院的IPC计划并不全面，许多医院缺乏明确的目标，工作计划，目标和预算。所有医院都至少有一名专门的IPC工作人员，66%的医院有接受过正式IPC培训的IPC工作人员; 78%的医院有IPC指南; 55%的医院有设施特定的标准操作程序。没有一家医院对IPC合规性进行结构化监测，只有44%的医院使用IPC监测结果制定单位/设施特定的IPC改进计划。54%的医院在其HAI监测系统中明确定义了优先医疗相关感染（HAI）、标准病例定义和数据收集方法。85%的医院拥有微生物实验室。所有人都报告说有海报或其他工具来促进手部卫生，29%的人有注射安全。68%的医院在所有护理点都设有正常运行的手部卫生站。88%有单人隔离室; 15%还有集体病人的房间。71%的人报告有适当的废物管理系统。结论在推荐的WHO IPC核心组成部分中，格鲁吉亚医疗保健医院内现有的计划，基础设施，IPC人员配备，工作量和用品应允许实施有效的IPC。制定和传播IPC指南，实施有效的IPC培训系统和系统监测IPC实践将是在医院实施有针对性的IPC改进计划的重要第一步。
Background The Georgia Ministry of Labor, Health, and Social Affairs is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff. Methods In 2018, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews. Results IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system. Conclusions Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.
影响因子：
8.4
作者：
Mdivani, Nino;Zangaladze, Ekaterina;Blumberg, Henry M.
通讯作者：
Blumberg, Henry M.