Epidemiology, Prevention & Control of Infection

The role of Prevention and Control of Infection (PCI) at Aspetar is to monitor and maintain the highest level of health and safety for our staff, patients and visitors by applying the principles and practices of infection prevention and control.

By creating Aspetar’s comprehensive, sustainable system for the prevention and control of infection, the department utilises evidence based best practice to ensure protocols, guidelines and the correct infection control policies are in place, and oversees their implementation within every department and facility at Aspetar. The collation of this information allows PCI to consult with health care providers and assess communicable diseases, offer surveillance for healthcare-associated infections, maintain educational infection control programmes for all hospital employees, and create evidence-based interventions to prevent infections.

Aspetar‘s PCI programme follows the standard definition of Surgical Site Infections (SSI) from the Centre For Disease Control and Prevention (CDC). All surgical cases are reviewed on a daily basis and SSI rates monitored, which are then reported as the number of infections per total number of surgeries to the Supreme Council of Health on a monthly basis. A daily SSI Surveillance Form and a monthly SSI Prevention Audit are also generated by the PCI.

The SSI Prevention Programme includes pre-operative screening for MRSA, MRSE and S.Aureus, as well as decolonization therapy for all patients undergoing surgical procedures in Aspetar, whilst clinical staff are screened bi-annually.

Methicillin-Resistant Staphylococcus Aureus (MRSA) is a transmission prevention programme that includes hand hygiene promotion, isolation (contact) precautions, environmental cleaning and disinfection, staff and patient education, and the monitoring and sustainable evidence-based best practices for Multi-drug resistant organisms (MDRO) prevention.

The viral respiratory infections prevention programme also includes education and reinforcement of respiratory etiquette; programmes to promote, monitor and sustain evidence-based best practices for respiratory virus prevention; and influenza vaccinations for all Aspetar staff and visiting athletes.

Hand hygiene is a priority focus within Aspetar, as it is the single most important interventional method in preventing healthcare-associated infections. Hand hygiene training is mandatory and is included within the general orientation of each staff member. PCI perform surveillance for hand hygiene compliance using direct observations through our Link Personnel team members, during which observers monitor hand hygiene practices in all of our departments using standardised definitions and data collection procedures. Hand hygiene compliance is monitored upon each entry to and exit from a patient care room or area, and before and after any interventions or contact with the patient or patient environment. Team members from clinical and support staff members are also observed.

PCI also promote educational hand hygiene sessions for athletes in club and federations within Qatar as part of Aspetar’s National Sports Medicine Programme (NSMP).

Importance of IPAC during the COVID-19 Pandemic

In an era of emerging and re-emerging communicable disease health threats, the importance of infection prevention and control measures in health-care settings can never be underestimated. Transmission of a communicable disease/pathogen is an ever-evolving subject, and transmission of pathogens that cause acute respiratory diseases (ARD) such as the SARS-CoV2, which causes the COVID-19 are no exception.

The importance of administrative and environmental controls for decreasing transmission of acute respiratory infections have been well-illustrated by SARS outbreaks in the past. Administrative and infection controls, including early detection, isolation and reporting, and establishment of infection control infrastructure, are key components for containment and mitigation of the impact of pathogens that may constitute a major public health threat. This is facilitated by the Infection Prevention and Control Team (IPAC), which is governed by the Infection Control Committee and includes the Infection Control Practitioner, Infection Control Physicians, and key members from across clinical and support departments at Aspetar. For this crisis, support at AZF level has included direction from the Crisis Management Team (CMT) and participation of like minded professionals from the Return to Office Task Force.

The COVID-19 pandemic situation was and still is a challenge for IPAC as there has been a critical need to be flexible in times of heightened stress for staff and the community at large. IPAC is accustomed to having to critically think in high-stress environments. The requirement to train other healthcare workers about how to do things not in the manual is both an opportunity to learn about the disease at hand but also about how to work well within a healthcare team. Maintaining trust and transparency is a critical goal.

During a continuous stream of information overload and new evidence-based information becoming available about COVID-19, IPAC has worked to disseminate accurate information and dispel information that is not evidence based that is available to the community that often leads to fear. This not only includes creating guidelines based on the infectious disease state at hand but also to ensure communication, training and education on those guidelines occurs.

Our staff have been concerned with our patient’s safety and the safety of their families first and foremost and it has been a pleasure working with so many likewise committed individuals across Aspetar and AZF whose concern is the benefit of all in our community during these extraordinary times.

Experiences, like Ebola in 2014 and SARS-CoV in 2003, have demonstrated the ability for hospitals to amplify the spread of disease and the critical role IPAC programs plays in response. COVID-19 has been a wake-up call for public health and healthcare alike. We must stay diligent going forward, if we are so committed, we at AZF/Aspetar will come out of this even stronger!