The World Health Organization’s (WHO) guidance on the Core Components for Infection Prevention and Control (IPC) programmes is being revised with a view to basing this guidance on the best available evidence in order to support the prevention of healthcare-associated infections (HAI) and the global burden of antimicrobial resistance. With WHO approval, a systematic review was conducted to identify national core components for IPC programmes.
Five databases were searched for papers published between 2000 and 2015 reporting the effectiveness of national IPC programmes. Papers identified were screened against the eligibility criteria and further assessed according to Cochrane’s Effective Practice and Organisation of Care (EPOC) study design criteria. Data were extracted and risk of bias assessments undertaken. The quality of the body of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach, where appropriate.
One hundred and ten studies met the inclusion criteria, of which 26 studies met the EPOC design criteria. Four component themes were identified from the 26 studies: multimodal IPC programmes (n = 16); IPC care bundles (n = 4); IPC policies (n = 4); and IPC surveillance, monitoring and feedback (n = 2). The majority of interventions evaluated in the 26 studies focused on preventing a specified infection (central line-associated bloodstream infections being the most frequent) or HAI more generally, or promoting hand hygiene. Individual studies demonstrated effectiveness; however, only three (of the 26) studies had a low risk of bias.
While, impressively, 26 studies had a robust research design, there was variation in the rigour with which these were conducted. The range of interventions and outcomes measured limited synthesis of the findings, but strong policy-level recommendations can be made under the guidance of the WHO secretariat and expert group, as well as an outline of existing research gaps.
Declaration of interest
I do not have any conflict of interests to declare.
|Journal||Journal of Infection Prevention|
|Publication status||Published - 2016|
- infection prevention
- literature review