Infection prevention and control program: Difference between revisions
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== Background == |
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= Core Components = |
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* IPAC programs result in fewer healthcare-associated infections, reduced length of stay, less antimicrobial resistance, and decreased cost of infection treatments |
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* Surveillance |
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* See also [[Infection control precautions by disease]] |
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** Process measures, often requiring audits |
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== Components == |
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* 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 |
** Outcome measures, such as rates hospital-acquired infections |
||
**System for detecting, investigating, and controlling outbreaks |
|||
**Reportable disease reporting to public health agencies |
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* Policies and procedures |
* Policies and procedures |
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**IPAC policies and procedures |
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**Care policies and procedures that impact IPAC |
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* Compliance and accreditation |
* Compliance and accreditation |
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* Occupational health and safety |
* Occupational health and safety |
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** Includes requirement for annual influenza vaccination as a rerequisite of employment |
** Includes requirement for annual influenza vaccination as a rerequisite of employment |
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* Education and training |
* Education and training |
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**Continuing education for healthcare providers in IPAC |
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**Education of clients, patients, residents, and visitors |
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*[[Antimicrobial stewardship program]] |
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== Miscellaneous Components == |
=== Miscellaneous Components === |
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* Hand hygeine program |
* Hand hygeine program |
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* Routine practices and precautions program |
* Routine practices and precautions program |
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*Resident health program for longterm care facilities, such as immunization programs |
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*Timely access to microbiology laboratory reports and expertise |
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*Active participation in facility maintenance standards, facility design, and construction and renovation |
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*Product review and evaluation |
|||
*Continuous quality improvement activities |
|||
*Review of practices for reprocessing of equipment |
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*Review of practices for environmental cleaning |
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*Participation in research activities for programs affiliated with academic health science centres, teaching hospitals, and other settings |
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=== Process Surveillance === |
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= Staffing Requirements = |
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{| class="wikitable" |
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!Component |
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!Acute Care |
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!CCC |
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!LTC |
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!HHC |
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|- |
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|Adherence to ARO screening protocols for clients, patients, and residents |
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|X |
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|X |
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|X |
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| |
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|- |
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|Adherence to ARI screening protocols for clients, patients, and residents |
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|X |
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|X |
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|X |
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|X |
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|- |
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|Adherence to screening protocols for TB in clients and residents |
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| |
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|X |
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|X |
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| |
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|- |
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|Adherence to screening protocols for acute GI infections in clients, patients, and residents |
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|X |
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|X |
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|X |
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|X |
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|- |
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|Influenza vaccination rates for clients and residents |
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| |
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|X |
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|X |
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| |
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|- |
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|Pneumococcal vaccination rates in clients and residents |
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| |
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|X |
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|X |
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| |
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|- |
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|Adherence to screening protocols for hepatitis, MRSA, and VRE in hemodialysis patients |
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|X |
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|X |
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|X |
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| |
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|- |
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|Tuberculosis screening for staff |
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|X |
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|X |
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|X |
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|X |
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|- |
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|Vaccination rates including influenza vaccination for staff |
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|X |
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|X |
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|X |
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|X |
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|- |
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|Sharps injury surveillance |
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|X |
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|X |
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|X |
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|X |
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|- |
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|Adherence to central line protocols |
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|X |
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|X |
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|X |
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|X |
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|- |
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|Adherence to ventilator use protocols |
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|X |
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|X |
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| |
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| |
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|- |
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|Adherence to protocols related to surgical procedures (e.g. preoperative antibiotics) |
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|X |
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| |
|||
| |
|||
| |
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|- |
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|Adherence to hand hygiene protocols |
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|X |
|||
|X |
|||
|X |
|||
|X |
|||
|- |
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|Adherence to Routine Practices protocols and PPE |
|||
|X |
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|X |
|||
|X |
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|X |
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|- |
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|Adherence to reprocessing practices protocols |
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|X |
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|X |
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|X |
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|X |
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|- |
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|Adherence to environmental cleaning protocols |
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|X |
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|X |
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|X |
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| |
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|- |
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|Adherence to IPAC construction and renovation protocols |
|||
|X |
|||
|X |
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|X |
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| |
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|- |
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|Adherence to recommendations of the ASP |
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|X |
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|X |
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|X |
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| |
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|- |
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|Adherence to practices limiting the use of urinary catheters |
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|X |
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|X |
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|X |
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|X |
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|} |
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* CCC = complex continuing care; LTC = long-term care; HHC = home healthcare |
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== IPAC committee == |
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=== Outcome Surveillance === |
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* Membership must includes ICPs, IPAC physician, OHS representation, public health, environmental services representation, nursing and MD representatives, and management |
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{| class="wikitable" |
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* Can also include representatives from microbiology, ID, equipment processing, OR, epidemiology, and quality assurance |
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!Component |
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!Acute Care |
|||
!CCC |
|||
!LTC |
|||
!HHC |
|||
|- |
|||
|Facility-acquired respiratory infection in clients, patients, and residents |
|||
|X |
|||
|X |
|||
|X |
|||
| |
|||
|- |
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|Facility-acquired ARO in clients, patients, and residents |
|||
|X |
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|X |
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|X |
|||
| |
|||
|- |
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|Facility-acquired [[Clostridioides difficile]] disease in clients, patients, and residents |
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|X |
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|X |
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|X |
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| |
|||
|- |
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|Facility-acquired acute GI infection in clients, patients, and residents |
|||
|X |
|||
|X |
|||
|X |
|||
| |
|||
|- |
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|Facility-acquired group A streptococcal infections in clients, patients, and residents |
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|X |
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|X |
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|X |
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| |
|||
|- |
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|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 |
|||
| |
|||
|- |
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|Skin and soft tissue infections in clients and residents |
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| |
|||
|X |
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|X |
|||
| |
|||
|} |
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== Staffing Requirements == |
|||
== Infection Control Professional (ICP) == |
|||
=== 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 |
* 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 |
** This number can vary based on complexity of patient care |
||
== IPAC MD == |
=== IPAC MD === |
||
* Must have available a physician trained in IPAC |
* Must have available a physician trained in IPAC |
||
* Sits on the committee and is available as-needed otherwise |
* Sits on the committee and is available as-needed otherwise |
||
== Administrative Assistant == |
=== Administrative Assistant === |
||
* Helps to coordinate the program |
* Helps to coordinate the program |
||
= Guidelines & Resources = |
== Guidelines & 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. |
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* 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. |
* 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. |
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* Association for Professions in Infection Control and Epidemiology (APIC) |
* 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. |
* 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 |
* 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] |
* [https://www.cdc.gov/infectioncontrol/guidelines/index.html CDC Guidelines Library] |
||
[[Category:Infection prevention and control]] |
|||
Latest revision as of 22:27, 6 November 2022
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
