Contextual barriers to infection prevention and control program implementation in hospitals in Latin America: a mixed methods evaluation.
| Title: | Contextual barriers to infection prevention and control program implementation in hospitals in Latin America: a mixed methods evaluation. |
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| Authors: | Fabre V; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, 600 N Wolfe St, Halstead 840, Baltimore, MD, 21287, USA. mfabre1@jhmi.edu.; Secaira C; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, 600 N Wolfe St, Halstead 840, Baltimore, MD, 21287, USA.; Herzig C; International Infection Control Program, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.; Bancroft E; International Infection Control Program, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.; Bernachea MP; Clinica Conciencia, Neuquen, Argentina.; Galarza LA; Clínica Universitaria Privada Reina Fabiola, Córdoba, Argentina.; Aquiles B; Hospital Sociedad de Lucha Contra el Cáncer, Guayaquil, Ecuador.; Arauz AB; Hospital Santo Tomas, Panama, Panama.; Departamento de Medicina, Universidad de Panamá, Panama, Panama.; Bangher MDC; Instituto de Cardiología de Corrientes 'Juana Francisca Cabral', Corrientes, Argentina.; Bernan ML; Hospital Interzonal General de Agudos San Roque, Buenos Aires, Argentina.; Burokas S; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Canton A; Pacifica Salud, Hospital Punta Pacifica, Panamá, Panama.; Cazali IL; Hospital Roosevelt, Guatemala City, Guatemala.; Colque A; Hospital Medico Policial Churruca Visca, Buenos Aires, Argentina.; Comas M; Hospital El Cruce, Buenos Aires, Argentina.; Contreras RV; Hospital Dr. Marcial V. Quiroga, San Juan, Argentina.; Cornistein W; Hospital Universitario Austral, Buenos Aires, Argentina.; Cordoba MG; Hospital Medico Policial Churruca Visca, Buenos Aires, Argentina.; Correa SM; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, 600 N Wolfe St, Halstead 840, Baltimore, MD, 21287, USA.; Campero GC; Hospital Angel C. Padilla, Tucumán, Argentina.; Chamorro Ayala MI; Hospital Zonal General de Agudos Dr. Alberto Eurnekian, Buenos Aires, Argentina.; Chavez N; Hospital Regional de Zacapa, Zacapa, Guatemala.; De Ascencao G; Hospital Provincial de Rosario, Rosario, Argentina.; García CC; Hospital Sociedad de Lucha Contra el Cáncer, Guayaquil, Ecuador.; Esquivel C; Hospital San Benito, Peten, Guatemala.; Ezcurra C; Hospital Alemán, Buenos Aires, Argentina.; Fabbro L; Hospital Universitario Austral, Buenos Aires, Argentina.; Falleroni L; Hospital Provincial de Rosario, Rosario, Argentina.; Fernandez J; Hospital Dr. Guillermo Rawson, San Juan, Argentina.; Ferrari S; Hospital Dr. Guillermo Rawson, San Juan, Argentina.; Freire V; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Garzón MI; Hospital Universitario Privado de Cordoba, Cordoba, Argentina.; Gonzales JA; Hospital Irma de Lourdes Tzanetatos, Panama, Panama.; Guaymas L; Clinical Privada Provincial, Merlo, Argentina.; Guerrero-Toapanta F; Hospital Carlos Andrade Marín, Quito, Ecuador.; Laplume D; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Lambert S; Hospital El Cruce, Buenos Aires, Argentina.; Lemir CG; Hospital San Bernardo, Salta, Argentina.; Lazarte PR; Maternidad Nuestra Señora De Las Mercedes De Tucumán, Tucumán, Argentina.; Lopez IL; Clinica Hospital San Fernando, Panama, Panama.; Maldonado H; Universidad del Valle, Guatemala, Guatemala.; Unidad De Cirugía Cardiovascular De Guatemala, Guatemala, Guatemala.; Martínez G; Hospital San Bernardo, Salta, Argentina.; Maurizi DM; Hospital Municipal de Agudos Dr. Leonidas Lucero, Bahía Blanca, Argentina.; Mesplet F; Hospital Cesar Milstein, Buenos Aires, Argentina.; Moreno Izquierdo C; Hospital Metropolitano, Quito, Ecuador.; Moya GL; Clinica Conciencia, Neuquen, Argentina.; Nájera M; Unidad De Cirugía Cardiovascular De Guatemala, Guatemala, Guatemala.; Nuccetelli Y; Instituto de Diagnostico, La Plata, Argentina.; Olmedo A; Pacifica Salud, Hospital Punta Pacifica, Panamá, Panama.; Palacio B; Sanatorio Allende Nueva Córdoba, Córdoba, Argentina.; Pellice F; Hospital Dr. Marcial V. Quiroga, San Juan, Argentina.; Raffo CL; Hospital Municipal de Trauma Dr. Federico Abete, Malvinas Argentinas, Argentina.; Ramos C; Hospital Santo Tomas, Panama, Panama.; Reino F; Hospital Carlos Andrade Marín, Quito, Ecuador.; Rodriguez V; Hospital Alemán, Buenos Aires, Argentina.; Romero F; Sanatorio Allende Nueva Córdoba, Córdoba, Argentina.; Romero JJ; Hospital Vozandes, Quito, Ecuador.; Sadino G; Clínica Universitaria Privada Reina Fabiola, Córdoba, Argentina.; Sandoval N; Hospital Roosevelt, Guatemala City, Guatemala.; Suarez M; Hospital Interzonal General de Agudos San Roque, Buenos Aires, Argentina.; Suayter MV; Hospital Universitario Privado de Cordoba, Cordoba, Argentina.; Ureña MA; Maternidad Nuestra Señora De Las Mercedes De Tucumán, Tucumán, Argentina.; Valle M; Hospital Municipal de Agudos Dr. Leonidas Lucero, Bahía Blanca, Argentina.; Vence Reyes L; The Panama Clinic, Panama, Panama.; Perez SVA; Hospital Angel C. Padilla, Tucumán, Argentina.; Videla H; Instituto de Diagnostico, La Plata, Argentina.; Villamandos S; Instituto de Cardiología de Corrientes 'Juana Francisca Cabral', Corrientes, Argentina.; Villarreal O; Hospital Irma de Lourdes Tzanetatos, Panama, Panama.; Viteri MA; Hospital Cesar Milstein, Buenos Aires, Argentina.; Warley E; Clinical Privada Provincial, Merlo, Argentina.; Quiros RE; Sanatorio Las Lomas, Av. Diego Carman 555, San Isidro, Provincia de Buenos Aires, B1642 , Argentina. quiros.re@gmail.com. |
| Source: | Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2024 Nov 03; Vol. 13 (1), pp. 132. Date of Electronic Publication: 2024 Nov 03. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 101585411 Publication Model: Electronic Cited Medium: Internet ISSN: 2047-2994 (Electronic) Linking ISSN: 20472994 NLM ISO Abbreviation: Antimicrob Resist Infect Control Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central |
| MeSH Terms: | Cross Infection*/prevention & control ; Infection Control*/methods; Humans ; Latin America ; Surveys and Questionnaires ; Hospitals |
| Abstract: | Background: Infection prevention and control (IPC) programs are essential to prevent and control the spread of multidrug-resistant organisms in healthcare facilities (HCFs). The current implementation of these programs in Latin America remains largely unknown.; Methods: We conducted a mixed-methods evaluation of IPC program implementation in HCFs from Guatemala, Panama, Ecuador, and Argentina, March-July 2022. We used the World Health Organization (WHO) IPC Assessment Framework (IPCAF) survey, a previously validated structured questionnaire with an associated scoring system that evaluates the eight core components of IPC (IPC program; IPC guidelines; IPC education and training; healthcare-associated infection [HAI] surveillance; multimodal strategies; monitoring and audit of IPC practices and feedback; workload, staffing, and bed occupancy; and the built environment and materials and equipment for IPC). Each section generates a score 0-100. According to the final score, the HCF IPC program implementation is categorized into four levels: inadequate (0-200), basic (201-400), intermediate (401-600), or advanced (601-800). Additionally, we conducted semi-structured interviews among IPC personnel and microbiologists using the Systems Engineering Initiative for Patient Safety model to evaluate barriers and facilitators for IPC program implementation. We performed directed content analysis of interview transcripts to identify themes that focused on barriers and facilitators of IPC program implementation which are summarized descriptively.; Results: Thirty-seven HCFs (15 for-profit and 22 non-profit) completed the IPCAF survey. The overall median score was 614 (IQR 569, 693) which corresponded to an "advanced" level of IPC implementation (32% [7/22] non-profit vs. 93% [14/15] for-profit HCFs in this category). The lowest scores were in workload, staffing and bed occupancy followed by IPC training and multimodal strategies. Forty individuals from 16 HCFs were interviewed. They perceived inadequate staffing and technical resources, limited leadership support, and cultural determinants as major barriers to effective IPC guideline implementation, while external accreditation and technical support from public health authorities were perceived as facilitators.; Conclusions: Efforts to strengthen IPC activities in Latin American HCFs should focus on improving support from hospital leadership and public health authorities to ensure better resource allocation, promoting safety culture, and improving training in quality improvement.; (© 2024. The Author(s).) |
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| Grant Information: | 75D30121C11933 United States CC CDC HHS |
| Contributed Indexing: | Keywords: Antimicrobial resistance; Infection prevention; Latin America |
| Entry Date(s): | Date Created: 20241104 Date Completed: 20241104 Latest Revision: 20241106 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11533356 |
| DOI: | 10.1186/s13756-024-01484-4 |
| PMID: | 39491033 |
| Database: | MEDLINE |
Journal Article