How to prevent hospital infections
The EU-funded PROHIBIT (Prevention of hospital infections by intervention and training) project analysed and structured existing guidelines and practices to prevent HAIs in European hospitals. The project also identified factors that enable and prevent compliance with best practices, and tested the effectiveness of known interventions. The challenge in Europe is language and the many different healthcare systems. A review of current guidelines focusing on various HAIs was conducted for a number of European countries. Scope, detail, terminology and structure of the guidelines varied widely, but this study provided an overview of the recommendations available in the language of local health care workers. The study recommends that access to updated state-of-the-art guidelines in their own language is the key to improvement in quality of care. A Europe-wide survey on infection and prevention control (IPC) measures, as well as on the organisation and structure of infection control, was also developed and distributed. This global perspective on IPC involved twenty-four countries who submitted data from more than 300 hospitals, revealing detailed information about their facilities and HAI practices. European hospitals were invited to participate in a trial, testing either the promotion of hand hygiene or a strategy to improve insertion and care of central venous catheters. Throughout 14 hospitals in 11 countries, over 2 000 catheter insertions were observed and more than 4 000 hand hygiene observations were documented. The study confirmed that multimodal infection prevention interventions are feasible and effective in culturally-different European countries if room is left for local adaptation. Finally, a screening questionnaire relating to the adoption, implementation and sustainability of HAI prevention programmes was sent to the hospitals participating in the trial. Several key themes emerged, including resources, networks and communication, staff issues, education and training commitments, and safety culture. PROHIBIT has outlined a comprehensive list of recommendations for the European Commission. These include a European IPC strategy encompassing surveillance, creation of a platform and an authoritative body to produce guidelines, training and adoption of evidence-based strategies. For funding, PROHIBIT proposes a budget for IPC activities to ensure that high-quality research is geared to emphasise implementation and behaviour change where appropriate.
Keywords
Hospital infections, guidelines, best practices, multimodal infection prevention interventions, recommendations
