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1 INTRODUCTION

1.1 Background

Infection prevention and control (IPC) is integral to the provision of a safe healthcare environment for both patients and healthcare workers (HCWs) across the continuum of care. Lack of adherence to safe practices or inadvertent exposure to pathogens in the healthcare environment can lead to significant morbidity and mortality in patients and HCWs alike. A safe working environment includes the provision of a safe physical environment, the use of safe clinical practices, the availability of adequate resources, the provision of safe equipment and consumable items, and a culture of safety for all. Safety in healthcare also includes mechanisms for reporting events that result from an unsafe environment or practice [4].

Infection prevention and control, particularly in healthcare facilities, is a critical element in interrupting the transmission of priority infectious diseases in the region. Communication, accessibility of expertise, and technical advice are recognised as areas in need of improvement in facilitating infection control response to infectious disease threats.

1.2 Purpose

The purpose of the IPC guideline is to provide regional guidance on IPC standards for adaptation and implementation by all Pacific Island countries and territories. The update of the 2010 PPHSN IPC guidelines is based on the World Health Organization core components of infection prevention and control.

1.3 Objective

The overall objective of these guidelines is to provide guidance on IPC standards for Pacific countries to use as a framework to develop their own national and institutional guidelines.

More specifically, these guidelines cover the following:

• management of the IPC programme

• healthcare associated infections and IPC

• the application of standard and transmission-based precautions

• hand hygiene

• principles of personal protective equipment

• safe handling and disposal of sharps

• environmental cleaning

• safe reprocessing of reusable medical equipment

• safe handling of laundry

• airborne precautions

• droplet precautions

• contact precautions

• IPC in special care areas

• guidelines for the management of occupational exposure

• vaccine preventable diseases for staff health

• surveillance for IPC

• environmental management practices

• food safety

• outbreak management situations

• infections by selected diseases.

1.4 Guidelines use

These guidelines are generic and should be used in every healthcare facility in the region. As with any generic guidelines, they must be adapted to suit national and local healthcare facilities.
To aid adaptation of the guidelines into practice, the seven conditions below are important for ministry of health policy leaders.

1. There must be strong national commitment for development and enforcement of IPC policy.

2. Development of national and facility level IPC guidelines and programme recommendations to help foster, develop and reinforce a culture of patient and health care worker safety and IPC.

3. Infrastructure/system: ensure availability of human resources for IPC at national and facility level, access to the necessary equipment and supplies, and an environment that is designed and planned to facilitate the guideline recommendations.

4. Promote accountability for IPC by incorporating IPC indicators into the ministry of health’s strategic and operational plans.

5. Training and education: a programme of routine training, education, and periodic annual training for ALL personnel responsible for IPC.

6. Monitoring, evaluation and feedback: a programme of regular supervision and feedback is in place in relation to the guideline recommendations, including a surveillance programme.

7. Safety culture: managers and leaders AT EVERY LEVEL of healthcare service delivery demonstrate commitment and accountability for implementation of the national IPC guidelines.

Below are the minimum requirements recommended by the World Health Organization core components of infection prevention and control programmes at the national and health care facility level [5].