Effect of an Intervention Training Program on Hospital Acquired Infection Rates in Intensive Care Units of Governmental Hospitals in Egypt

Abstract

Nosocomial infection or health care associated infection” is an infection acquired in health care facility by a patient who was admitted for a reason other than that infection, this infection is not present or incubating at admission. Infection occurring more than 48 hours after admission is usually considered nosocomial infection. Health care associated infections are among the leading causes of death and they cause significant morbidity among patients who receive health care. The highest prevalence of nosocomial infections occurs in intensive care units. Infection rates are higher among patients with increased susceptibility because of old age, underlying disease, or immunosupression. Healthcare-associated infections are serious, common, and important patient safety issues in health care today. Infection prevention is a cornerstone of continuous quality improvement.

Surveillance as an element of epidemiological practice is “the ongoing systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know. The final link in the surveillance chain is the application of these data to prevention and control. Surveillance of HAI is a critical component of prevention efforts, particularly in infection control programs newly introduced into hospitals. It is proven that intensive surveillance, in combination with other aspects of an infection control program, is associated with significantly reduced rates of HAIs. . Objectives (d) To measure the incidence rates of health care associated infections within intensive care units of some Ministry of Health and Population hospitals in Egypt. (e) To implement an intervention program in the form of training of health care workers in the selected hospitals on infection control standard precautions. (f) To evaluate the intervention training program by comparing incidence rates of health care associated infections in the selected hospitals before and after conducting the program. Subjects and methods This intervention study was carried out over 13 months to measure the health care associated infection rates before and after training of health care workers on infection control standard precautions in intensive care units (ICUs). The study was conducted in four MOH hospitals including two general hospitals and two specialized medical hospitals (also called international hospitals) comprising eleven ICUs that were chosen by the MOH to implement a laboratory based surveillance system for hospital acquired infections within these ICUs. All hospitalized ICU patients were followed up starting from the date of their ICU admission till occurrence of one or more HAI. All age groups were included in the study. Case definitions of HAIs included in the study were based on CDC/NHSN Surveillance Case Definitions of Healthcare-Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting (CDC/NHSN, 2012) were used to define each type of the following infections: