What is Infection Prevention and Control?

According to the World Health Organization (WHO), infection prevention and control (IPC) is a scientific methodology and a practical way to prevent infections among patients and health care workers. It is a branch of epidemiology but also serves an essential function in infectious diseases, social sciences and global health.

Effective IPC practices are essential for every healthcare organization as it is a significant factor that determines the organization’s healthcare quality. Thus it is considered a key indicator for quality control.

Effective IPC is a public health issue that is fundamental in patient safety and health system strengthening. The prevention of healthcare-associated infections (HAI), epidemics (including the 2013-2016 Ebola virus disease outbreak), and pandemics of international concern (i.e. 2009 flu pandemic and the coronavirus disease 2019) are rooted in effective IPC measures.

The WHO principle that guides IPC practice in organizations is “access to health care services designed and managed to minimize the risks of avoidable HAI for patients and health care workers is a basic human right”.

Why is IPC important in healthcare practices?

Healthcare-Associated Infections (HAI) are a global burden for all clinical and public health organizations. The more we neglect this component, the more our organization’s cost, practices, and reputation will be affected. Thus, following proper IPC guidelines will put you in a position to reduce the likelihood of one of the most common health care complications.

The recent data shows that HAIs affect between five and 10 per cent of hospitalized patients in the US each year, resulting in 99,000 deaths and sparking an estimated $20 billion in healthcare costs.

It is impossible to provide high-quality health care without effective IPC. Hand hygiene, surgical site infections, injection safety, antibiotic resistance, and how hospitals operate during and outside of emergencies are all affected by infection prevention and control.

How can nurses implement Infection Prevention and Control Practices?

Nurses are essential members of the healthcare team. In fact, they are greatly involved in providing patients with positive healthcare experiences as well as negative ones. They also make a significant impact in reducing the patient potential for acquiring an HAI.

Nurses can implement infection control practices by implementing the following strategies:

Performing hand hygiene

Nurses can perform hand hygiene in two ways; alcohol-based hand rub and hand washing. However, it is important to know the moments of performing hand hygiene. WHO has recommended five moments of hand hygiene. These are mentioned below;

Moment 1 – before touching a patient.

Moment 2 – before a procedure.

Moment 3 – after a procedure or body fluid exposure risk.

Moment 4 – after touching a patient.

Moment 5 – after touching a patient’s surroundings.

Implementing Standard Precautions

Other than hand hygiene, standard precautions include use of Personal Protective Equipment (PPE) such as gloves, mask, eye protection, face shield, and gown, proper handling of patient-care equipment and linen, environmental control, prevention of injury from sharps devices, and patient placement (such as room assignments) within healthcare facilities.

Applying Transmission-based Precautions

Airborne precautions

Patients with airborne infections such as pulmonary TB, measles etc., may require airborne isolation. This includes placing the patient in an isolation room with negative air pressure, and the room needs to be closed. In addition, the assigned nurse will wear an N95 mask at all times while providing care to these patients.

Droplet precautions

While providing care to a client with droplet infections, the nurse must wear a surgical face mask, and the patient’s door can be kept open.

Contact precautions

Contact precautions are applied to the patients who are suspected of having a serious infectious disease that can be transmitted through direct contact. When possible, the patient requiring contact isolation is placed in a private room to facilitate hand hygiene and decrease environmental contamination. Masks aren’t needed, and doors don’t need to be closed. However, gloves and gowns need to be worn at all times while providing care.

What leadership can do to improve IPC in a healthcare setting?

The World Health Organization has recommended certain essential elements that leadership and management can implement to improve infection prevention and control practices. These include:

• System change, including the availability of alcohol-based hand rub at the point of patient care and/or access to a safe, continuous water supply and soap and towels;
• Training and education of healthcare professionals regarding best practices;
• Monitoring of hand hygiene practices and performance feedback;
• Frequent reminders and cues for infection control practices in the workplace;
• The creation of a hand hygiene safety culture with the participation of both individual healthcare workers and senior hospital managers;
• Using evidence-based practices and technology for behavioural change and compliance among staff for IPC practices.

Current JCI Guidelines for IPC

The Prevention and Control of Infections (PCI) is the second chapter of JCI. PCI contains 20 standards and 68 measurable elements.

Standard 1: This individual(s) is/are qualified in infection prevention and control practices through education, training, experience, or certification.

Standard 2: There is a designated coordination mechanism for all infection prevention and control activities that involves physicians, nurses, and others based on the size and complexity of the hospital.

Standard 3: The infection prevention and control program should be based on current scientific knowledge, accepted practice guidelines, state laws and regulation.

Standard 4: Organizational leadership should also provide resources to support the infection prevention and control program.

Standard 5: The hospital designs and implements a comprehensive program to reduce the risks of healthcare-associated infections in patients and health care workers.

Standard 6: The hospital uses a risk-based approach in establishing the focus of the healthcare-associated infection prevention and reduction program.

Standard 7: The hospital identifies the procedures and processes associated with the risk of infection and implements strategies to reduce infection risk.

Standard 8: The hospital provides barrier precautions and isolation procedures that protect patients, visitors, and staff from communicable diseases and protects immunosuppressed patients from acquiring infections to which they are uniquely prone.

Standard 9: PPEs and hand hygiene resources are available whenever needed.

Standard 10: The IPC process is integrated with the hospital’s overall program for quality improvement and patient safety, using measures that are epidemiologically important to the hospital.

Standard 11: The hospital provides education on infection prevention and control practices to staff, physicians, patients, families, and other caregivers when their involvement in care is indicated.

In conclusion, infection prevention and control play an essential role in providing high quality and competent services. In addition, it decreases HAIs, which further lowers the healthcare cost, resources, care burden and psychological stress. WHO has recommended certain strategies that nurses, healthcare providers and organizational leaders must implement to improve infection control practices.