WHO and Infection Prevention and Control in the Primary Care Setting: Guiding IP (Programs) Along the Continuum of Care

Author: Holly Montejano, MS, CIC, CPHQ, VA-BC

Categories: Antibiotic Stewardship, General Infection Prevention & Hand Hygiene October 14, 2021
Hand wiping

Infection prevention and control (IPC) efforts in the acute care setting have proven imperative to patient safety initiatives and good patient outcomes.  The IPC focus in healthcare is to help prevent healthcare-associated infections (HAI) and halt disease transmission; at the community level, many of these practices have and continue to be public health teachings, especially given the onset of the COVID-19 pandemic.

Unfortunately, these practices do not always seamlessly transition to the primary care setting, and while many of the IPC guidance applies to primary care, sorting through the various World Health Organization (WHO) resources for setting pertinent content can be cumbersome.  The WHO recently highlighted relevant content in the recent publication “Strengthening infection prevention and control in primary care: A collection of standards, measurements and implementation resources”1.

The target audience is IPC practitioners, policymakers, senior managers, and others involved with program development and strengthening in the primary care setting.  The WHO document consists of two parts:

  • Part A provides the standards and measurement for infection prevention and control in primary care
  • Part B provides implementation resources for IPC in primary care, with a focus on hand hygiene improvement1.

As expressed in the WHO document and important to note, IPC work does not stop with those listed above and needs to be the responsibility of all healthcare workers (HCW).

This segues us to the minimum core components for an IPC program in the primary care setting: guidelines, education and training, surveillance, multi-modal strategies, monitoring and feedback, workload staffing and bed occupancy,  the built environment, materials, and equipment.

A Closer Look at the Resource

Part A addresses IPC in primary care and the outpatient setting from a global perspective, being mindful of resource variations within and across different countries and healthcare settings. The minimum IPC requirements are nicely outlined for each core component including who is responsible for the action, how to measure progress, why the rationale exists, and reference to additional tools and resources.

Part B focuses on general implementation principles and multi-modal improvement strategy (MMIS), hand hygiene and primary care, and resource considerations for investing in hand hygiene improvement in health care facilities1.  MMIS provides the roadmap for system change to support IPC progress and measurable benefits for patients and HCWs.  Hand hygiene is a priority focus of resource allocation and education within the IPC program in primary care.  And rightfully so, as hand hygiene is a foundation of infection prevention. The WHO highlights their model for hand hygiene encompassed in the “My five moments for hand hygiene”2 which includes:

  1. Before touching a patient
  2. Before clean/aseptic procedure
  3. After body fluid exposure risk
  4. After touching a patient
  5. After touching the patient’s surroundings

Hand hygiene in the outpatient setting- especially in terms of the patient zone- varies a bit from the inpatient setting and this is nicely highlighted as a special consideration, complete with educational posters for the various outpatient care scenarios.

Making Infection Prevention and Control Top of Mind

Bringing IPC to the forefront of the primary care setting is no small task- and certainly, resource disparities across the globe create barriers to successful implementation.  The WHO resource provides a comprehensive guide to building an IPC program across various outpatient care settings from preparing for action to maintaining sustainability amidst competing priorities, celebrating IPC wins, and creating growth plans. The WHO addresses the IPC implementation process as a continual performance improvement project, which is the cornerstone of infection prevention and patient safety.

PDI provides a full portfolio of infection prevention products, including hand hygiene products that are applicable to all healthcare settings, as well as educational materials for product use- to include staff, patients, and visitors, and mounts and stands for easy access to support compliance.  PDI products and educational resources serve to support IPC initiatives around hand hygiene from initial system change (Build it), to training and education (Teach it), reminders and communications (Sell it), and ultimately the safety climate and culture change (Live it)1.

 

Citation:
1 Strengthening infection prevention and control in primary care: a collection of existing standards, measurement and implementation resources. Geneva: World Health Organization; 2021. (https://www.who.int/publications/i/item/9789240035249)
2. https://www.who.int/gpsc/5may/Your_5_Moments_For_Hand_Hygiene_Poster.pdf Accessed 10/7/2021

Author

Holly Montejano MS, CIC, CPHQ, VA-BC
holly Clinical Science Liaison, PDI Gulf Coast

Profile

Holly’s passion for infectious disease epidemiology developed during her undergraduate studies at University of Connecticut, where she studied biology and anthropology – and the profound impact of disease on people, public health and within healthcare systems. This passion led to a graduate program focused in infectious disease epidemiology and a post-graduate epidemic intelligence service (EIS) fellowship in public health, and a graduate certification in infection control at the University of South Florida.

After several years as a public health epidemiologist, Holly transitioned into infection prevention and healthcare epidemiology where she currently is part of a dynamic clinical affairs team, supporting the Gulf Coast region as a Clinical Science Liaison (CSL).

Contact

Phone: 321.439.7923

Company Website: Pdihc.com

Email: Holly.Montejano@pdihc.com

Hobbies

Interior design
Beach staycations
Little League baseball and softball

Education

University of Connecticut, Storrs, CT
Bachelor of Science in Biology and Anthropology

Colorado State University, Fort Collins, CO
Master of Science in Environmental and Radiological Health Sciences (Epidemiology and Infectious Disease)

Certification
Certification Board of Infection Control (CBIC)- CIC
Certified Professional in Healthcare Quality (NAHQ)- CPHQ
Vascular Access- Board Certified (VA-BC)
Lean Six Sigma Yellow Belt Certification
Prosci Change Management Certification

Why I love what I do

Infectious disease epidemiology – from both a biological and anthropological standpoint – have always been a passion of mine. Studying the effects of disease on populations (from a public health standpoint and from that of an Infection Preventionist) has fueled my interest in patient safety and quality outcomes initiatives. My work of providing clinical expertise and evidence-based guidance on infection prevention products (which are used in communities and healthcare systems daily) bolsters the satisfaction I experience in this role.

Areas of Expertise

Microbiology and infectious disease transmission
Infection Prevention
Patient Safety and healthcare quality
Safety culture
Public Health
Vascular access
Environmental disinfection
Performance Improvement
Education

More about Holly Montejano Less about Holly Montejano