Background
- IPAC programs result in fewer healthcare-associated infections, reduced length of stay, less antimicrobial resistance, and decreased cost of infection treatments
- See also Infection control precautions by disease
Components
- Surveillance, based on systematic data collection and subsequent data analysis and dissemination
- Process measures, often requiring process audits
- Outcome measures, such as rates hospital-acquired infections
- System for detecting, investigating, and controlling outbreaks
- Reportable disease reporting to public health agencies
- Policies and procedures
- IPAC policies and procedures
- Care policies and procedures that impact IPAC
- Compliance and accreditation
- Occupational health and safety
- Includes requirement for annual influenza vaccination as a rerequisite of employment
- Education and training
- Continuing education for healthcare providers in IPAC
- Education of clients, patients, residents, and visitors
- Antimicrobial stewardship program
Miscellaneous Components
- Hand hygeine program
- Routine practices and precautions program
- Resident health program for longterm care facilities, such as immunization programs
- Timely access to microbiology laboratory reports and expertise
- Active participation in facility maintenance standards, facility design, and construction and renovation
- Product review and evaluation
- Continuous quality improvement activities
- Review of practices for reprocessing of equipment
- Review of practices for environmental cleaning
- Participation in research activities for programs affiliated with academic health science centres, teaching hospitals, and other settings
Process Surveillance
| Component | Acute Care | CCC | LTC | HHC |
|---|---|---|---|---|
| Adherence to ARO screening protocols for clients, patients, and residents | X | X | X | |
| Adherence to ARI screening protocols for clients, patients, and residents | X | X | X | X |
| Adherence to screening protocols for TB in clients and residents | X | X | ||
| Adherence to screening protocols for acute GI infections in clients, patients, and residents | X | X | X | X |
| Influenza vaccination rates for clients and residents | X | X | ||
| Pneumococcal vaccination rates in clients and residents | X | X | ||
| Adherence to screening protocols for hepatitis, MRSA, and VRE in hemodialysis patients | X | X | X | |
| Tuberculosis screening for staff | X | X | X | X |
| Vaccination rates including influenza vaccination for staff | X | X | X | X |
| Sharps injury surveillance | X | X | X | X |
| Adherence to central line protocols | X | X | X | X |
| Adherence to ventilator use protocols | X | X | ||
| Adherence to protocols related to surgical procedures (e.g. preoperative antibiotics) | X | |||
| Adherence to hand hygiene protocols | X | X | X | X |
| Adherence to Routine Practices protocols and PPE | X | X | X | X |
| Adherence to reprocessing practices protocols | X | X | X | X |
| Adherence to environmental cleaning protocols | X | X | X | |
| Adherence to IPAC construction and renovation protocols | X | X | X | |
| Adherence to recommendations of the ASP | X | X | X | |
| Adherence to practices limiting the use of urinary catheters | X | X | X | X |
- CCC = complex continuing care; LTC = long-term care; HHC = home healthcare
Outcome Surveillance
| Component | Acute Care | CCC | LTC | HHC |
|---|---|---|---|---|
| Facility-acquired respiratory infection in clients, patients, and residents | X | X | X | |
| Facility-acquired ARO in clients, patients, and residents | X | X | X | |
| Facility-acquired Clostridioides difficile disease in clients, patients, and residents | X | X | X | |
| Facility-acquired acute GI infection in clients, patients, and residents | X | X | X | |
| Facility-acquired group A streptococcal infections in clients, patients, and residents | X | X | X | |
| Tuberculin skin test or IGRA conversions in staff | X | X | X | X |
| Procedure-specific surgical site infections | X | X | ||
| Central line-associated bloodstream infections in high risk areas | X | X | ||
| New acquisition of hepatitis in hemodialysis patients | X | X | X | |
| Skin and soft tissue infections in clients and residents | X | X |
Staffing Requirements
IPAC Committee
- Membership must includes ICPs, the IPAC physician (or medical director of LTC facilities), an OHS representative, a public health representative, an environmental services representative, senior nursing and MD representatives, and a senior management representative
- Can also include microbiologist or infectious diseases specialist, a pharmacy representative, am equipment processing representative, an OR representative, an epidemiologist, and a quality assurance or risk management representative
Infection Control Professional (ICP)
- In general, for an acute care facility, should have around 1 ICP per 100 occupied beds
- This number can vary based on complexity of patient care
IPAC MD
- Must have available a physician trained in IPAC
- Sits on the committee and is available as-needed otherwise
Administrative Assistant
- Helps to coordinate the program
Guidelines & Resources
- Public Health Agency of Canada. Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings. Ottawa, ON: November 2016.
- Ontario Agency for Health Protection and Promotion. Provincial Infectious Diseases Advisory Committee. Best Practices for Infection Prevention and Control Programs in All Health Care Settings, 3rd edition. Toronto, ON: Queen's Printer for Ontario; May 2012.
- Association for Professions in Infection Control and Epidemiology (APIC)
- Heymann D. Control of Communicable Diseases Manual. 20th edition. Washington, DC: American Public Health Association; 2008.
- American Academy of Pediatrics. Red Book: 2018-2021 Report of the Committee on Infectious Diseases. 31st edition. Elk Grove Village, IL: American Academy of Pediatrics; 2018.
- CDC Guidelines Library
