Focusing on the III Strategic Priority of National Action Plan on Antimicrobial Resistance Through the Baseline Assessment of Indicators of Infection Prevention and Control in a Provincial Hospital in Nepal: A Quality Improvement Project
Nabin Pathak, Prerana Shrestha, Shreya Dhungana, Sachita Barma, Sujil Manandhar, Prabhat Kumar Jha, Subash Karki, Surendra Dev Badu, Prashant Bidari, Sunil ShresthaIntroduction
Infection Prevention and Control (IPC) is a science-based, practical approach that protects patients and healthcare workers by reducing hospital-associated infections (HAIs) and tackling antimicrobial resistance (AMR). The study aims to assess the baseline status of IPC in a provincial hospital in Nepal to help propose an action plan for implementation and mitigate the burgeoning issue of AMR.
Method
A cross-sectional study was conducted as a quality improvement project at one of the provincial hospital of Nepal using the structured World Health Organization (WHO) Infection Prevention and Control Assessment Framework (IPCAF) tool to perform a baseline assessment. The IPCAF tool’s 8 core components and 81 indicators were assessed to determine the hospital's IPC status and to propose an action plan to facilitate IPC-related activities. After receiving the data, it was entered into MS Excel 2013, analyzed for the indicator scores, and visualized using R Version 4.5.2.
Result
The total score for the eight basic IPC indicators was 397.5/800, indicating that the facility operated at a “basic” IPC level (score range: 201-400). The highest score was in Monitoring/audits of IPC practices and feedback (77.5), indicating relative strength. Moderate scores were seen in IPC programme (60) and IPC guidelines (62.5), followed by HAI surveillance (55) and IPC education and training (50). Three indicators scored below 50, indicating poor adherence to the international guideline (IPCAF) and critical gaps that underscore the need for urgent attention.
Conclusion
This first IPC assessment at one of the provincial hospital revealed a “Basic” IPC status, highlighting critical gaps in areas like Multimodal strategies, workload, staffing and bed occupancy, resources, materials, and equipment for IPC, and IPC education and training. Despite a few strengths, the findings call for an urgent, time-limited, and team-based approach with effective implementation and ongoing monitoring of the IPC action plan.