Current use and measurement of the indicators at the national and local level
| European suggested framework18 | Results in England | ||
|---|---|---|---|
| Component | Indicator | Recommended/mandated at the national level | Data available at the local level (at trust level) |
| 1. Effective organisation of IPC at hospital level | Continuous review of surveillance and prevention programmes, outbreaks and audits | ||
| IPC committee in place | |||
| Inclusion of IPC on the hospital administration agenda | |||
| Defined goals (eg, HCAI rates) | |||
| Appropriate staffing for IPC (as a minimum standard at least one full-time specifically trained IPC nurse per up to 250 beds, a dedicated doctor trained in IPC, microbiological support and data management support) | |||
| Appropriate budget for IPC | |||
| 2. Effective bed occupancy, appropriate staffing and workload, and minimal use of pool (bank)/agency nurses and doctors | Average bed occupancy at midnight | ||
| Average number of frontline healthcare workers | |||
| Average proportion of pool (bank)/agency professionals (nurses and doctors) | |||
| 3. Sufficient availability of, and easy access to, materials and equipment, and optimisation of ergonomics | Availability of alcohol-based handrub at the point of care | ||
| Availability of sinks stocked with soap and single-use towels | |||
| 4. Use of guidelines in combination with practical education and training | Adaptation of guidelines to local situation | ||
| Number of new staff trained with the local guidelines | |||
| Teaching programmes are based on local guidelines | |||
| 5. Education and training (involves frontline staff and is team and task oriented) | Education and training programmes should be audited | ||
| Education and training programmes should be combined with knowledge tests, competency assessments or both | |||
| 6. Organising audits as a standardised (scored) and systematic review of practice with timely feedback | Measurement of the number of audits (overall, and stratified by departments/units and topics) for specified time periods | ||
| 7. Participation in prospective surveillance and offering active feedback, preferably as part of a network | Participation in (inter)national surveillance initiatives | ||
| Number and type of wards with a surveillance system in place | |||
| Regular review of the feedback strategy | |||
| 8. Implementing IPC programmes following a multimodal strategy, including tools such as bundles and checklists developed by multidisciplinary teams, and taking into account local conditions (and principles of behavioural change) | Verification that programmes are multimodal | ||
| Measurement of process indicators (eg, hand hygiene, care procedures) | |||
| Measurement of outcome indicators (eg, HCAI rates, infections with MDROs, transmission of MDROs) | |||
| 9. Identifying and engaging champions in the promotion of intervention strategies | Interviews with frontline staff and IPC professionals | ||
| 10. Positive organisational culture by fostering working relationships and communication across units and staff groups | Questionnaires about work satisfaction | ||
| Human resource assessment of healthcare workers’ turnover and absenteeism | |||
| Assessing crisis management | |||
Key: RAG rating.
Red: not included in national regulations/policies/guidelines, or no data available/accessible at the trust.
Amber: partially included in national regulations/policies/guidelines, or partial data available/accessible at the trust.
Green: included in national regulations/policies/guidelines, or data consistently available/easily accessible at the trust.
HCAI, healthcare-associated infection; IPC, infection prevention and control; MDROs, multidrug-resistant organisms; RAG, Red-Amber-Green.