Infection

WORLD HEALTH ORGANIZATION

control
AIDE-MEMOIRE
For infection prevention and control in a health-
care facility
; Checklist

Health care-associated infections lead to death, disability and excess Management

medical costs. Introduction of new technologies, in the absence of … Infection prevention and
infrastructure to use them safely, may lead to adverse events. control policy, with committee
Infection prevention and control maximize patient outcomes and and officer
are part of the government's responsibility to provide effective, … Initial infection control
efficient and quality health services. They must be achieved through assessment
collaboration with the public and private sectors. Health-care … Assignment of responsibilities
facilities must implement infection prevention and control policies … Choice of appropriate
technologies
supported by institutional management. An overall approach to an
… Costing, budgeting and
infection prevention and control policy at the health-care facility financing
level is based upon: … Quality standards
ƒ Management; … Monitoring & supervision
ƒ Information, Education and Communication (IEC); … Performance assessment
ƒ Continuous availability of essential equipment and supplies;
ƒ Surveillance. Information, Education and
Examples of core infection prevention and control interventions Communication (IEC)
are listed overleaf. In addition, specific activities include: … Adoption of best practice
ƒ Health-care worker protection; standards
ƒ Isolation protocols for specific infectious diseases (e.g. … Standard precautions
tuberculosis, SARS) and high-risk settings (e.g. dialysis); … Pre-service training
ƒ Rational use of anti-microbials; … In-service training
ƒ Safe and appropriate use of injections and infusions; Equipment and supply
ƒ Safe and appropriate use of blood and blood products; … Establishment of a list of
ƒ Hospital sanitation. essential infection control
equipment and supplies
Words of advice … Forecasting of needs
ƒ Conduct an initial assessment … Costing, budgeting and
financing
ƒ Establish an infection prevention and control committee … Procurement
coordinated by the infection prevention and control … Inventory control and stock
officer management
ƒ Formulate an Action Plan, with costing, budgeting and … Maintenance
financing
Surveillance
ƒ Develop an IEC strategy for health-care workers and … Surveillance
strengthen supervision
… Feedback
ƒ Ensure the continuous availability of supplies and … Outbreak investigation
equipment for patient care management … Evaluation using indicators of:
ƒ Surveillance ƒ Structure
ƒ Process (practices)
ƒ Confirm value through monitoring, providing data and ƒ Outcomes
measuring the impact of interventions (incidence of infections)

© World Health Organization 2004. All rights reserved. WHO/EHT/04.15. Printed October 2004
 Core infection prevention and control interventions for
health-care facilities at a glance

Critical process
Specific Equipment and supply indicators for
interventions Target groups needs * monitoring
Hand hygiene ƒ All health-care ƒ Clean running water ƒ Proportion of staff
workers † ƒ Soap (mounted preferable) observed performing
ƒ Visitors ƒ Sinks or basins hand hygiene before
ƒ Patients ƒ Towels attending patients
ƒ Alcohol-based solutions
Personal ƒ All health-care ƒ Gloves ƒ Proportion of staff
protective workers † ƒ Gowns observed wearing
equipment gloves when exposure
to blood or body fluids
is anticipated
Isolation ƒ Nurses ƒ Gloves ƒ Average time between
precautions ƒ Physicians ƒ Gowns admission and
ƒ Nursing aids ƒ Masks isolation for
ƒ Other ƒ Eye protection tuberculosis patients
Aseptic technique ƒ Nurses ƒ Antiseptics ƒ Proportion of
ƒ Physicians ƒ Sterile gloves intravenous lines
ƒ Laboratory ƒ Sterile devices and inserted using aseptic
technicians instruments technique
ƒ Dental surgeons ƒ Sterile barrier devices
Cleaning and ƒ Nurses ƒ Cleaning fluids ƒ Proportion of rooms
disinfection ƒ Nursing aids ƒ Cleaning equipment appropriately
ƒ Housekeeping staff ƒ Disinfectant disinfected after
ƒ Laboratory staff patients' discharge
Sterilization ƒ Sterilization staff ƒ Autoclaves and steam ƒ Proportion of
ƒ Nurses sterilizers sterilized devices
ƒ Laboratory ƒ Test strips whose sterility is
technicians ƒ Chemicals documented with test
ƒ Dental surgeons strips
Waste ƒ Health-care workers ƒ Sharps boxes and other ƒ Presence of health-care
management ƒ Waste handlers collection containers waste in the
ƒ Logisticians ƒ Storage space and container surroundings of the
for interim storage health-care facility
ƒ Final disposal options
ƒ Personal protection equip-
ment for waste handlers
Antibiotic use ƒ Physicians ƒ Essential list of antibiotics ƒ Proportion of
protocol prescriptions including
an antibiotic
Immunization and ƒ All health-care ƒ Hepatitis B vaccine and ƒ Three-dose hepatitis B
exposure workers † other appropriate vaccines vaccine coverage
management among nurses,
physicians and
laboratory technicians

*
Key indicator: Proportion of essential supplies stocked out.
†
Include nursing staff, physicians, dental staff, laboratory staff, housekeeping staff, waste management staff and morgue staff.

Department of Essential Health Technologies (EHT), World Health Organization

20 Avenue Appia, 1211 Geneva 27, Switzerland. Fax: +41 22 791 4836. Email: sign@who.int. Internet: www.who.int/injection_safety