Infection control capacity survey

Abstract

BACKGROUND: In the post-SARS period, Hong Kong has devoted enormous resources to building the infection control (IC) infrastructure to be prepared for other emerging infectious diseases. A large number of IC nurses and officers have been recruited, but they have relatively little experience. There is a need to understand the existing IC capacity in public hospitals in order to conduct long-term strategic planning, e.g., to assess training needs. PROJECT: A cross-sectional survey was conducted among IC officers in 37 public hospitals between July and August 2004, using a modified self-administered questionnaire. Outcomes measures included types and intensity of surveillance activities, IC structure, and training needs. Statistical software SPSS v.12 was used for data analysis. The overall response rate was 99.46%. Over 50% of the hospitals monitored infectious disease outbreaks, sharps injuries and mucosal exposures, staff sick leave, immunization status of healthcare workers, laboratory-based surveillance, and use of disinfectants. Around half of surveyed hospitals did not monitor surgical site infections. In hospitals with adult intensive care unit (ICU) beds available, more than 60% did not conduct device-related surveillance. The majority (83.9%) of IC doctors had obtained specialist status and 25.8% were hospital consultants. All IC doctors were overseeing IC tasks in addition to their normal hospital duties and most were working in microbiology (41.9%) and internal medicine (32.3%) specialties. Regarding IC nurses (ICNs), 84.1% had obtained a bachelor's degree or above, and 71% of ICNs were working full-time. Overall, 64.5% of ICNs had less than 5 years' working experience in IC. They spent most time on surveillance and epidemiological investigation (27%), followed by education and training (20%). On average, one ICN serves 314 beds in public hospitals. CONCLUSIONS: There is a need to further extend the scope of surveillance on hospital-acquired infections with standardized reporting. Directed education and training should be provided to build up capacity in the field, to improve the ICN-to-bed ratio, and to empower existing staff in infection control.