View source for Infection prevention and control program

== 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 ===
{| class="wikitable"
!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 ===
{| class="wikitable"
!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 &amp; Resources ==

* Public Health Agency of Canada. ''[https://www.canada.ca/en/public-health/services/publications/diseases-conditions/routine-practices-precautions-healthcare-associated-infections.html 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. [https://www.publichealthontario.ca/en/eRepository/BP_IPAC_Ontario_HCSettings_2012.pdf ''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. [https://redbook.solutions.aap.org/ ''Red Book: 2018-2021 Report of the Committee on Infectious Diseases'']. 31st edition. Elk Grove Village, IL: American Academy of Pediatrics; 2018.
* [https://www.cdc.gov/infectioncontrol/guidelines/index.html CDC Guidelines Library]

[[Category:Infection prevention and control]]