Future Trends in Hospitals’ Obstetric HAI Prevention and Control
Understanding the Current Landscape
Hospitals are continually evolving to combat healthcare-associated infections (HAIs) in obstetric units. Recent studies in western China highlight discrepancies between secondary and tertiary hospitals in their HAI prevention and control capabilities.
Secondary and tertiary hospitals in western China currently face significant challenges in maintaining optimal infection prevention and control (IPC) standards. A key issue is the inadequate number of full-time Infection Preventionists (IPs). According to the National Health Commission of China, the recommended ratio is one IP for every 150–200 beds. However, the median number of IPs per 100 beds in these hospitals is only 1.0. This falls short of the American standard (1.2) and exceeds that of Zhejiang Province, China (0.5) [13, 14].
Shortage of Effectives IPs or Infection Preventionist
The urgency of this situation is magnified by the fact that nearly 50% of the surveyed hospitals do not meet the minimum requirements for IPs. Hospital leaders’ perceived lack of commitment to infection control, as well as limited career development opportunities and low wages, are cited as major contributing factors. The lack of IPs can lead to a rise in HAIs, negatively impacting patient outcomes and healthcare costs.
Comparatively, tertiary hospitals have a more balanced composition of IPs, with a higher proportion of clinical and public health physicians compared to nurses. This aligns with their higher educational background, suggesting a potential correlation between the IP levels and the incidence of HAIs [15]. Tertiary hospitals may conduct more extensive epidemiological investigations and statistical analyses, indicating better preparedness for managing HAIs. However, both secondary and tertiary hospitals need to focus on optimizing the structure and qualification of their IPs.
The Training Gap
Training is another crucial aspect of IPC. Although both secondary and tertiary hospitals establish infection management teams, provide regular training, and develop emergency response plans, there is a noticeable shortage of expert-led training. Fewer than 2% of surveyed tertiary hospitals invite experts for training, indicating a lack of professional training resources.
A key area of concern is the lack of patient training. Only a minority of hospitals (38.5%) owned up to implementing infection prevention and control training for patients or family members [16]. Studies have shown that educating patients on infection protocol can significantly improve hand hygiene and reduce infection rates [17, 18].
Did you know? Improving infection prevention knowledge through targeted training can cut patients’ hand hygiene efficiency by 50%.
Patient education is indispensable to HAI prevention and needs to be as rigorous as staff training.
Tackling Monitoring and Surveillance
HAI surveillance is an essential tool for improving patient outcomes. Although secondary hospitals may not match the information level of tertiary hospitals, surveillance and feedback on HAI have proven effective. Implementing a real-time automatic nosocomial infection surveillance system (RT-NISS) can enhance the accuracy and speed of case monitoring and intervention [22].
Environmental Hygiene Enhancements
Ensuring a physically safe healthcare environment is vital. Both secondary and tertiary hospitals have taken steps to set up separate maternity, medical staff, and waste passages. However, some tertiary hospitals lack a separate medical waste passage due to space constraints. There are better outcomes for tertiary hospitals with more Labor, Delivery, and Recovery (LDR) rooms. Mother-family exposure to hospital space can maintain high hygiene levels.
promoting Healthcare Environmental Hygiene
Effective cleaning and disinfection are fundamental to preventing and controlling HAIs. Tertiary care hospitals generally have higher standards in this area, though much improvement is necessary. Pathogenic bacteria evolve rapidly, contaminating surfaces only hours after disinfection, despite following stringent protocols. Therefore, hospitals ought to constantly review and enhance cleaning policies.
Comparing Trends between Secondary and tertiary Hospitals
| KEY ASPECT | Secondary Hospitals | Tertiary Hospitals |
|---|---|---|
| IPs per 100 beds | Generally lower | Generally higher |
| Professional Structure | Higher proportion of nurses | More balanced (nurses, clinical physicians, public health physicians) |
| Educational Background | Lower | Higher |
| Training Resources | Less availability of expert-led training | More availability of expert-led training |
| Environmental Monitoring | Poor monitoring | More IA monitoring |
| Cleaning and Disinfection | Lower hygiene standards | Higher hygiene standards |
Pro Tips
Clinical Health Professionals need to make monitoring training accessible to the public in order to highlight the discrepancies between the protocols followed in secondary and tertiary hospitals. Medical staff and cleaning workers must insist on stringent processes.
FAQs
What impact can insufficient Infection Preventionists (IPs) have on hospitals?
A shortage of IPs can lead to increased HAIs, negatively affecting patient outcomes and healthcare costs.
How does patient training in infection prevention compare to staff training?
Less than 2% of hospitals offer infection prevention training to patients, while staff training is more comprehensive, indicating a significant gap in patient knowledge and practice.
What are the benefits of setting up separate passages in hospitals?
Separate paths for maternity, medical staff, and waste management ensure better environmental hygiene and minimize cross-infection risks.
How effective are current surveillance systems in fighting HAI?
While surveillance systems help, real-time automatic systems like RT-NISS can significantly enhance accuracy and monitoring speed, which is why they are a top priority.
Conclusion
Tackling HAIs requires addressing IPs’ shortages, standardizing protocols, promoting patient education, and improving monitoring and cleaning practices. Hospitals worldwide can learn from each other to combat this persistent threat, thus ensuring better patient outcomes.