The pandemic and other major recent outbreaks have highlighted the extent to which healthcare facilities can contribute to the spread of infections, harming patients, healthcare workers and visitors, if insufficient attention is paid to prevention and infection control (IPC).
However, a new report from the World Health Organization (WHO) shows that when good hand hygiene and other cost-effective practices are followed, 70% of these infections can be prevented.
Nosocomial infections
Today, out of 100 patients in acute care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one hospital-acquired infection (HAI) during their hospital stay. hospital. On average, 1 in 10 patients will die from this infection.
People in intensive care and newborns are particularly at risk. And the report finds that about one in four sepsis cases treated in hospital and almost half of all sepsis cases with organ dysfunction treated in adult intensive care units are healthcare-associated.
Today, on the eve of World Hand Hygiene Day, WHO is previewing the first ever Global Report on Infection Prevention and Control which brings together evidence from the scientific literature and various reports, as well as new data from WHO studies.
Take stock
“The COVID-19 pandemic has revealed many IPC challenges and gaps in all regions and countries, including those with the most advanced IPC programs,” said Dr. Tedros Adhanom Ghebreyesus, Director general of the WHO. “It also provided an unprecedented opportunity to take stock of the situation and rapidly scale up epidemic preparedness and response through IPC practices, as well as strengthen IPC programs across the health system. . Our challenge now is to ensure that all countries are able to allocate the necessary human resources, supplies and infrastructure. »
The new WHO report provides the first-ever global situational analysis of how IPC programs are being implemented in countries around the world, including regional and national priorities. While highlighting the harm to patients and healthcare workers from hospital-acquired infections and antimicrobial resistance, the report also discusses the impact and cost-effectiveness of infection prevention and control programs as well as strategies and resources available to countries to improve them.
HAI and antimicrobial resistance
The impact of nosocomial infections and antimicrobial resistance on people’s lives is incalculable. More than 24% of patients with nosocomial sepsis and 52.3% of patients treated in intensive care units die each year. Deaths are multiplied by two or three when infections are resistant to antimicrobials.
Over the past five years, WHO has conducted global surveys and joint country assessments to assess the status of implementation of national IPC programmes. Comparing data from the 2017-2018 and 2021-22 surveys, the percentage of countries with a national IPC program has not improved; furthermore, in 2021-2022, only four of the 106 countries assessed (3.8%) had all minimum IPC requirements in place at the national level. This is reflected in the inadequate implementation of IPC practices at the point of care, with only 15.2% of health facilities meeting all minimum IPC requirements, according to a WHO survey in 2019.
IPC Focal Points
However, encouraging progress has been made in some areas, with a significant increase in the percentage of countries having a designated IPC focal point, a dedicated IPC budget and a training program for frontline health workers; develop national IPC guidelines and a national HAI surveillance program or plan; use multimodal strategies for IPC interventions; and make hand hygiene compliance a key national indicator.
Many countries are showing strong commitment and progress in scaling up actions to put in place minimum requirements and core components of IPC programs. Progress is strongly supported by WHO and other key players. Sustaining and expanding this long-term progress is a critical need that requires urgent attention and investment.
The report finds that high-income countries are more likely to advance their work on the IPC and are eight times more likely to have more advanced IPC implementation status than low-income countries. Indeed, little improvement has been observed between 2018 and 2021 in the implementation of national IPC programs in low-income countries, despite increased attention generally given to IPC due to the COVID-19 pandemic. WHO will continue to support countries to ensure that IPC programs can be improved in each region.
WHO calls on all countries in the world to increase investment in IPC programs to ensure quality of care and safety for patients and health workers. This will not only protect their populations, but increased investment in IPC has also been shown to improve health outcomes and reduce health care costs and out-of-pocket expenses.
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