A nationwide survey on the implementation of infection prevention and control components in 1442 hospitals in the Republic of Korea: comparison to the WHO Infection Prevention and Control Assessment Framework (IPCAF)

Abstract

Background The current SARS-CoV-2 pandemic continues to underscore the inadequacy of infection prevention and control (IPC) and the importance of its sound establishment in healthcare facilities. The Infection Prevention and Control Assessment Framework (IPCAF) by the World Health Organization allows systematic assessment of IPC capacity in healthcare facilities and has been applied in many national-level surveys. This study aims to assess the IPC capacity of Korean hospitals as well as their strengths and pitfalls by analyzing the results of the first government-led nationwide IPC survey in comparison to the IPCAF frame. Methods The Korean National Infection Prevention and Control Survey (KNIPCS) was conducted from February to March 2018. The survey questionnaire for KNIPCS was developed through a series of expert consultations and a round of pre-testing in two randomly selected hospitals. The survey questionnaire was distributed to a total of 2108 hospitals. Although the survey preceded the release of IPCAF, its contents complied with IPCAF to a large extent, allowing exploration of its results with regards to IPCAF. Results All tertiary hospitals and 96.5% of general hospitals had implemented IPC teams, whereas the percentage was lower for long-term care hospitals (6.3%). A similar trend was observed for IPC surveillance and monitoring activities across hospital types. The percentage of interactive IPC training was lower than 30% in all hospital groups. Disinfection was frequently monitored in all hospital types (e.g. 97.3% in general hospitals and 85.3% in long-term care hospitals). However, activities regarding antimicrobial resistance, such as multi-drug resistant pathogen screening, were weak in hospitals (25%) and long-term care hospitals (25%), compared to tertiary hospitals (83.3%) and general hospitals (57.7%). Conclusions In general, essential IPC structures, such as IPC teams and programs, were well in place in most tertiary and general hospitals in Korea. These hospital groups also actively conducted various IPC activities. As most previous legislative and multimodal policy measures have targeted these hospital groups, we speculate that future policy efforts should encompass long-term care hospitals and smaller-sized hospitals to strengthen the IPC capacity of these hospital groups. Efforts should also be put forth to promote IPC training and antimicrobial activities.

Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the Autonomous District of Abidjan (Cote d'Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF)

“…Developed countries have implemented key aspects of the IPC program and have achieved good levels of implementation through mostly advanced practices [23,24]. These results can be explained by the contribution of existing legislation the strong involvement of policy makers, the implementation of IPC budget [19]. Indeed, in 2011, the German Infection Protection Act ("Infektionsschutzgesetz") was revised, increasing the importance of IPC in hospitals [17].…”

“…Although studies have proven the feasibility and effectiveness of these guidelines using the evaluation frameworks proposed by the WHO in several countries around the world [15][16][17][18], much remains to be done, especially in developing countries [9,11,13,19].…”

Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the Autonomous District of Abidjan (Cote d'Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF)

“…Developed countries have implemented key aspects of the IPC program and have achieved good levels of implementation through mostly advanced practices [23,24]. These results can be explained by the contribution of existing legislation, the strong involvement of policy makers, and the implementation of the IPC budget [19]. Indeed, in 2011, the German Infection Protection Act ("Infektionsschutzgesetz") was revised, increasing the importance of IPC in hospitals [17].…”

Core Components of Infection Prevention and Control Programs at the Facility Level in Kazakhstan: Key Challenges and Opportunities

“…The assessment tool was based on a modi ed version of the IPC Assessment Framework (IPCAF) on Core Components of IPC and the recommendations included in the WHO "Guidelines on Core Components of Infection Prevention and Control Programs at the National and Acute Health Care Facility Level" (WHO, 2018). The IPCAF is primarily intended to be used by facilities as a self-assessment tool but can also be successfully used for the purpose of joint external assessments (Deryabina et al, 2021;Jeong et al, 2022). A study published in 2020 highlights that effective utilization of the IPCAF tool requires a deep understanding of the WHO terminology and underlying concepts to avoid misinterpretation and misreporting of data (Tomczyk et al, 2020).…”

“…Our results show that guidelines and SOPs on prevention of MDR pathogens were available only at 10% of hospitals. Limited availability of guidelines on antibiotic stewardship and prevention of MDR pathogens was also noted in facility-level studies conducted in other countries, such as Georgia and Korea(Deryabina et al, 2021;Jeong et al, 2022).Although 45% of hospitals reported conducting routine HCAI surveillance, only one hospital had an HAI surveillance system that included all of the key WHO recommendations. A global survey of national-level IPC core components published in 2021 showed that less than half of the 88 countries surveyed had established national surveillance networks on HAIs(Tartari et al, 2021).…”