Abstract：
Infection prevention and control (IPC) in healthcare settings is imperative for the safety of patients as well as healthcare providers. To measure current IPC activities, resources, and gaps at the facility level, WHO has developed the Infection Prevention and Control Assessment Framework (IPCAF). This study aimed to assess the existing IPC level of selected tertiary care hospitals in Bangladesh during the COVID-19 pandemic using IPCAF to explore their strengths and deficits.
Between September and December 2020, we assessed 11 tertiary-care hospitals across Bangladesh. We collected the information from IPC focal person and/or hospital administrator from each hospital using the IPCAF assessment tool.. The score was calculated based on eight core components and was used to categorize the hospitals into four distinct IPC levels- Inadequate, Basic, Intermediate, and Advanced. Key performance metrics were summarized within and between hospitals.
The overall median IPCAF score was 355.0 (IQR: 252.5-397.5) out of 800. The majority (73%) of hospitals scored as \'Basic\' IPC level, while only 18% of hospitals were categorized as \'Intermediate\'. Most hospitals had IPC guidelines as well as environments, materials and equipments. Although 64% of hospitals had IPC orientation and training program for new employees, only 30% of hospitals had regular IPC training program for the staff. None of the hospitals had an IPC surveillance system with standard surveillance case definitions to track HAIs. Around 90% of hospitals did not have an active IPC monitoring and audit system. Half of the hospitals had inadequate staffing considering the workload. Bed occupancy of one patient per bed in all units was found in 55% of hospitals. About 73% of hospitals had functional hand hygiene stations, but sufficient toilets were available in only 37% of hospitals.
The majority of sampled tertiary care hospitals demonstrate inadequate IPC level to ensure the safety of healthcare workers, patients, and visitors. Quality improvement programs and feedback mechanisms should be implemented to strengthen all IPC core components, particularly IPC surveillance, monitoring, education, and training, to improve healthcare safety and resilience.
Between September and December 2020, we assessed 11 tertiary-care hospitals across Bangladesh. We collected the information from IPC focal person and/or hospital administrator from each hospital using the IPCAF assessment tool.. The score was calculated based on eight core components and was used to categorize the hospitals into four distinct IPC levels- Inadequate, Basic, Intermediate, and Advanced. Key performance metrics were summarized within and between hospitals.
The overall median IPCAF score was 355.0 (IQR: 252.5-397.5) out of 800. The majority (73%) of hospitals scored as \'Basic\' IPC level, while only 18% of hospitals were categorized as \'Intermediate\'. Most hospitals had IPC guidelines as well as environments, materials and equipments. Although 64% of hospitals had IPC orientation and training program for new employees, only 30% of hospitals had regular IPC training program for the staff. None of the hospitals had an IPC surveillance system with standard surveillance case definitions to track HAIs. Around 90% of hospitals did not have an active IPC monitoring and audit system. Half of the hospitals had inadequate staffing considering the workload. Bed occupancy of one patient per bed in all units was found in 55% of hospitals. About 73% of hospitals had functional hand hygiene stations, but sufficient toilets were available in only 37% of hospitals.
The majority of sampled tertiary care hospitals demonstrate inadequate IPC level to ensure the safety of healthcare workers, patients, and visitors. Quality improvement programs and feedback mechanisms should be implemented to strengthen all IPC core components, particularly IPC surveillance, monitoring, education, and training, to improve healthcare safety and resilience.
摘要：
背景：医疗保健机构中的感染预防和控制（IPC）对于患者和医疗保健提供者的安全至关重要。为了测量当前的IPC活动，资源,和设施层面的差距，世卫组织制定了感染预防和控制评估框架（IPCAF）。这项研究旨在使用IPCAF评估COVID-19大流行期间孟加拉国部分三级保健医院的现有IPC水平，以探索其优势和不足。
方法：在2020年9月至12月之间，我们评估了孟加拉国的11家三级医院。我们使用IPCAF评估工具从每个医院的IPC联络人和/或医院管理员那里收集信息。.分数是根据八个核心组成部分计算的，用于将医院分为四个不同的IPC级别-不足，基本,中间,和先进的。总结了医院内部和医院之间的关键绩效指标。
结果：总IPCAF评分中位数为800分的355.0分（IQR：252.5-397.5分）。大多数(73%)的医院得分为“基本”IPC水平，而只有18%的医院被归类为“中级”。大多数医院都有IPC指南和环境，材料和设备。尽管64%的医院有针对新员工的IPC定向和培训计划，只有30%的医院为员工提供定期的IPC培训计划。没有一家医院具有IPC监测系统，该系统具有标准的监测病例定义来跟踪HAIs。大约90％的医院没有有效的IPC监控和审核系统。考虑到工作量，一半的医院人员配备不足。在55％的医院中，发现所有单位中每张床都有一名患者的床位占用。约73%的医院设有功能性手部卫生站,但只有37%的医院有足够的厕所。
结论：大多数抽样的三级保健医院显示IPC水平不足以确保医护人员的安全，病人,和游客。应实施质量改进计划和反馈机制，以加强所有IPC核心组件，特别是IPC监控，监测,教育,和培训，提高医疗保健的安全性和韧性。
方法：在2020年9月至12月之间，我们评估了孟加拉国的11家三级医院。我们使用IPCAF评估工具从每个医院的IPC联络人和/或医院管理员那里收集信息。.分数是根据八个核心组成部分计算的，用于将医院分为四个不同的IPC级别-不足，基本,中间,和先进的。总结了医院内部和医院之间的关键绩效指标。
结果：总IPCAF评分中位数为800分的355.0分（IQR：252.5-397.5分）。大多数(73%)的医院得分为“基本”IPC水平，而只有18%的医院被归类为“中级”。大多数医院都有IPC指南和环境，材料和设备。尽管64%的医院有针对新员工的IPC定向和培训计划，只有30%的医院为员工提供定期的IPC培训计划。没有一家医院具有IPC监测系统，该系统具有标准的监测病例定义来跟踪HAIs。大约90％的医院没有有效的IPC监控和审核系统。考虑到工作量，一半的医院人员配备不足。在55％的医院中，发现所有单位中每张床都有一名患者的床位占用。约73%的医院设有功能性手部卫生站,但只有37%的医院有足够的厕所。
结论：大多数抽样的三级保健医院显示IPC水平不足以确保医护人员的安全，病人,和游客。应实施质量改进计划和反馈机制，以加强所有IPC核心组件，特别是IPC监控，监测,教育,和培训，提高医疗保健的安全性和韧性。
