Table 3 Corrective recommendations to deal with challenges of HAIs reporting in Iran
Challenges | Corrective recommendations | In charge |
|---|---|---|
Problems with case finding and recording of HAIs | ➢ Motivating and engaging physicians for reporting of HAIs cases from their office or clinic | MOH |
➢ Providing required tools to register HAIs cases in INIS | ||
➢ Collaboration of the follow-up unit and ICNs | ||
Budgetary and infrastructure | ➢ Allocating separate funds to the Infection Control Unit in order to carry out educational, research, implementation, and development activities of IPC programs. | |
➢ Correcting resource allocation to physicians, nurses, and IPC programs. | ||
➢ Providing laboratory infrastructures such as PCR for antibiotic resistance detection and confirmation of microorganisms | ||
Hidden pressure | ➢ Evaluation of the case finding and reporting process instead of evaluating the reported results and figures | |
➢ Correct targeting for reporting | ||
➢ Justification of various hospital/university and departmental authorities regarding the purpose of case finding through training courses | ||
Insufficient activity regulations for ICLNs | ➢ Clarifying, writing, and approving job descriptions of infection control practitioners | |
➢ Motivate the ICLNs through incentive payments and certificates that are effective in annually evaluating and promoting customers | ||
Poor quality of training and educational programs | ➢ Training case finding, reporting, and IPC management while studying at university (for various disciplines) | University of Medical Sciences |
➢ Developing master’s degree program in infection prevention and control | ||
➢ Justifying managers to welcome the course and support a trained nurse | ||
➢ Development of short-term in-service training programs for different hospital categories (therapeutic, non-therapeutic), continuous and follow-up courses | ||
➢ Annual job promotion is subject to training courses | ||
➢ Provide real and virtual educational media to educate community-based infection control patients, patients, and caregivers | ||
No financial incentive | ➢ Performance-based payment to Physician of infection control, ICNs and ICLNs | |
Fear of compromising interests | ➢ Clarification of the contribution of each part (system, staff, patients) in HAIs | Hospitals |
➢ Verifying HAIs cases by the physician of the IPC committee | ||
➢ Developing laws and overseeing the proper implementation of the rules regarding surgical indication | ||
➢ Pay attention to the performance of the treatment team (physician, nurse, etc.) associated with infection prevention and control programs in financial payments | ||
➢ Providing feedback to surgeons regarding their performance in the field of IPC | ||
➢ Administrative encouragement and punishment by presenting commendation plates or written notes regarding compliance with infection prevention and control principles during treatment and care of patients. | ||
High workload and Shortage of human resources | ➢ Choosing the right criteria for selecting an infection control expert | |
- Compilation and standardization of the calculation of the number of infection control nurses in each hospital (per hospital beds, per ICU beds, per high-risk patients, per high-risk ward) | ||
➢ Implementing a full-time infection control nurse in hospitals | ||
➢ Removing multiple tasks unrelated to infection control from nurse assigned infection control tasks | ||
➢ Adequate staff allocation to implement and track the affairs of infection control programs | ||
➢ Pay attention to the duties of ICLNs while shifting the duties of the nurse staff by the nurse in charge of the shift. |