Disertation presentation on infection prevention

Infection Prevention and Control

1. Assessment of the Level of Implementation of Infection Prevention and Control Practices in District and Regional Hospitals in Dar es Salaam, Tanzania Investigator: Mohd Bakar Supervisors: Dr. Frank Msafiri Ms. Lilian Nkinda

2. Outline Introduction/Background   Objectives Methodology Results Discussion Conclusion

3. Background Implementation of infection prevention and control (IPC) is cornerstone for prevention of healthcare associated infections (HCAIs) as well as antimicrobial resistance International Health Regulations (IHR) regarded an IPC as a central strategy for combating public health threats of international concern IPC is a broad scientific approach and activities intended to prevent and control infections to patients and health workers during healthcare delivery

4. Background cont.. IPC measures are categorized into two broad approaches . These are:- Standard precautions Transmission based- precautions Globally, the reductions in the prevalence of HCAIs have been successfully for over two decades; however, a significant disproportionate amount of the disease burden remains in Sub-Saharan Africa

5. Objectives Broad objective : To assess the level of implementation of infection prevention and control measures at Regional and District Hospitals in Dar es Salaam Specific objectives: To identify the level of implementation of IPC measures at district and regional hospitals in Dar es Salaam To identify IPC gaps at district and regional hospitals in Dar es Salaam

6. Methodology Study design : A cross-sectional study Study population: P ublic district and regional RRH in Dar es Salaam with their respective IPC focal persons Sampling technique : Purposive sampling technique was used to obtain the health facilities for this study Exclusion criteria: All hospital below and above district and regional hospitals

7. Methodology cont.. Sample size : Eight hospitals have been purposeful selected for the assessment of implementation of IPC Study procedures: IPC focal person and/or administrator responsible for an IPC will be interviewed to provide IPC data An IPCAF tool was used as a reference tool to assess the current IPC level in selected hospitals

8. Methodology cont.. Data analysis: Data was analysed using SPSS software Scores for each IPC Core component for each hospital has been presented, summarized into frequency The minimum and maximum score and the average score has been presented along with standard deviation Total IPCAF score for individual and total hospitals have been displayed as well as the standard deviation

9. Results cont..

10. Results cont..

11. Key IPC gaps at selected hospitals IPC Core components Gaps frequency % (n/N)         IPC Program IPC program available with action plan, but no IPC committee to support IPC team   8 100   IPC team available but senior facility leaders are not a part of the team or committee 7 87% IPC guidelines IPC guideline available but no regular monitoring of implementation of at least some guidelines such as hand hygiene 4 50% IPC education Cleaners are not regularly receiving training   8 100%   Regular training for new employee and for other staffs is not mandatory regularly done 6 75%   No regular evaluation of education program 8 100%

12. Key IPC gaps cont.. IPC Core components Gaps frequency % (n/N) HCAIs Surveillance is not a component of IPC program   5 62.5%   Surveillance is not done for surgical site infection 2 25%   Surveillance is not done for device associated infections 8 100% Multimodal strategies IPC education and training is not done by oral/written information and interactive bedside or simulation 7 87.5% Monitoring of IPC   IPC monitoring plan and targets 2 25%   Monitoring of antimicrobial consumption 5 62.5%

13. Discussion Findings from this study has revealed that adherence to proper IPC measures are not efficiently for some IPC core components S ome IPC CCs such as IPC guidelines, IPC environment , material, equipment, IPC program are in place, but some other such as surveillance of HCAIs, Bed capacity workload, IPC education and IPC monitoring a re not sufficiently implemented, indicating that substantial improvement is required

14. Conclusion Due to the ongoing occurrence of pandemic disease and the high extent of HCAIs there is a need to assess the current IPC scenario and to design strategic improvement plans Almost al RRH are highly congested with patients even exceeding the bed capacity and overloading the health staffs compromising the delivery of quality healthcare services

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