Overcoming Current and Preventing Future Nosocomial Outbreaks during the COVID-19 Pandemic: Lessons Learned at Three Hospitals in Japan

Abstract

Hospitals are increasingly challenged by nosocomial infection (NI) outbreaks during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Although standardized guidelines and manuals regarding infection prevention and control (IPC) measures are available worldwide, case-studies conducted at specified hospitals that are required to cope with real settings are limited. In this study, we analyzed three hospitals in Japan where large-scale NI outbreaks occurred for hints on how to prevent NI outbreaks. We reviewed openly available information from each hospital and analyzed it applying a three domain framework: operation management; identification of infection status; and infection control measures. We learned that despite having authorized infection control teams and using existing standardized IPC measures, SARS-CoV-2 may still enter hospitals. Early detection of suspected cases and confirmation by PCR test, carefully dealing with staff-to-staff transmission were the most essential factors to prevent NI outbreaks. It was also suggested that ordinary training on IPC for staff does not always provide enough practical knowledge and skills; in such cases external technical and operational supports are crucial. It is expected that our results will provide insights into preventing NI outbreaks of COVID-19, and contribute to mitigate the damage to health care delivery systems in various countries.

Consideration of COVID-19 beyond the human-centred approach of prevention and control: the ONE-HEALTH perspective

“…[ 42–48 ]. In Osaka, Japan, three hospitals that never admitted infected patients, still found cluster infections, which may have been caused by virus contamination or defects in the hospital prevention and control system [ 43 ]. The private hospital in KwaZulu Natal Province in South Africa has strict existing prevention and control programmes, and serious nosocomial infections are still occurring, suggesting that intensive and pervasive infection control procedures need to be improved [ 49 ].…”

Factors Influencing Clinicians’ Use of Hospital Information Systems for Infection Prevention and Control: Cross-Sectional Study Based on the Extended DeLone and McLean Model

“…Despite the potential benefits of information technology support in IPC practices, there are still several shortcomings that need to be addressed. First, there is a lack of timely response and user-friendly information systems at the system quality level, with system failure being the most common problem [ 8 , 9 ]. Second, at the level of information quality, the data are scattered across multiple systems, resulting in low-quality information lacking integrity and readability that cannot support analysis and decision-making [ 10 - 12 ].…”

Factors Influencing Clinicians’ Use of Hospital Information Systems for Infection Prevention and Control: Cross-Sectional Study Based on the Extended DeLone and McLean Model (Preprint)

“…Despite the potential benefits of information technology support in IPC practices, there are still several shortcomings that need to be addressed. First, there is a lack of timely response and user-friendly information systems at the system quality level, with system failure being the most common problem [8,9]. Second, at the level of information quality, the data are scattered across multiple systems, resulting in low-quality information lacking integrity and readability that cannot support analysis and decision-making [10][11][12].…”