Abstract：
BACKGROUND: Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh.
OBJECTIVE: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh.
METHODS: We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities.
RESULTS: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level.
CONCLUSIONS: The integrated intervention package improved IPCAF score in all facilities.
OBJECTIVE: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh.
METHODS: We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities.
RESULTS: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level.
CONCLUSIONS: The integrated intervention package improved IPCAF score in all facilities.
摘要：
感染预防和控制(IPC)是提供安全、有效,和高质量的医疗保健服务，并消除医疗机构中可避免的医疗保健相关感染（HAIs），主要在人口密集的环境中，如孟加拉国。我们的研究旨在评估综合干预方案在提高孟加拉国卫生机构IPC水平方面的效果。我们在孟加拉国六个地区的六个地区医院（DHs）和13个Upazila健康综合体（UHC）进行了干预前研究。在2021年3月至12月期间，使用经过调整的世界卫生组织感染预防和控制评估框架（WHO-IPCAF）工具进行了基线和终线评估。IPCAF评分,范围从0到800，是通过将八个组成部分的分数相加来计算的，IPC推广和实践水平被归类为不足(0-200)，基本（201-400），中间体（401-600），高级（601-800）。综合干预一揽子计划，包括IPC委员会的组建，医疗保健提供者培训，物流供应，必要的指导方针分配，分诊/流感角建立，所有设施都实施了基础设施建设。所有设施的平均IPCAF得分显着增加，从16％（95％CI：11.5-20.65％）增加到54％（95％CI：51.4-57.1％）。总的来说,IPCAF评分在DHs中增加了34%(p值<0.001),在UHCs中增加了40%(p值<0.001).干预之后,12（3个DHs，9UHC)中的19个设施从不足发展到中级，另外三个DHs在IPC级别方面从基本升级到中级。综合干预方案提高了所有机构的IPCAF评分。
