In conflict-affected areas, health-care facilities provide life-saving services with very limited resources. Combined with poor infection prevention and control (IPC) measures, inadequate water supply and sanitation, and weak hygiene infrastructure, this can often result in disease amplification among staff and patients, and in some situations in the community itself. On the first-ever World Patient Safety Day, the WHO Regional Office for Europe draws attention to patient safety and safer health care in various settings, including in the conflict-affected areas of eastern Ukraine and north-western Syria that the Regional Office is supporting.
“No one should be harmed while seeking or providing health care. However, too many patients are unnecessarily put at risk by avoidable health care-associated infections that threaten the safe functioning of health systems and adversely impact on the quality of health services. This is even more true in conflict-affected zones,” says Dr Dorit Nitzan, Acting Regional Emergency Director, WHO/Europe. “Through our emergency response activities, we at WHO work with partners to ensure that infection prevention and control measures exist and are used in health-care facilities in these especially vulnerable settings.”
Building health-care workers’ skills in eastern Ukraine and north-western Syria
In eastern Ukraine, improvement of patient safety is an integral part of health system strengthening. The WHO Health Emergencies Programme boosts health professionals’ capacity in this area in line with WHO guidelines, with a specific focus on preventing health care-associated infections. To date, WHO has trained over 250 health-care professionals in IPC.
“For us, infection prevention and control are essential for the prevention of health care-associated infections and vital to ensure the safety of patients, health-care workers and visitors to health-care facilities,” said Ludmila Khomyakova, Head of the Kramatorsk branch of the Donetsk Regional Laboratory Centre, Ministry of Healthcare, Ukraine.
However, patient safety needs go beyond training, and lack of equipment is an additional challenge. To this end, WHO has contributed to the modernization of sterilization units in selected hospitals, providing 3 pressure chambers for sterilization and decontamination to Luhansk Regional Children’s Hospital and to the trauma care department of Luhansk Regional Hospital.
In north-western Syria, WHO and partners are piloting a programme assessing 30 health-care facilities on compliance with WHO guidelines on IPC, to identify areas for improvement. Progress against recommendations is monitored by a taskforce including WHO experts and 2 focal points per facility, providing further guidance. To date, over 100 health personnel working in these facilities have been trained by WHO to improve their knowledge and skills on patient safety. For many, this is the first time they have received specialized training.
“It may be a commonplace saying that prevention is the best medicine, but it is so often true. Core measures, such as hand washing and proper waste management, will ensure patients receive better care,” says Annette Heinzelmann, WHO Health Emergencies Programme lead in Gaziantep, Turkey for the north-western Syria response. “We are proud of the work we are doing with partners, not only to improve skills but also to establish a culture where proper infection prevention and control measures are deeply embedded into health-care delivery.”
The 8 core components of IPC
Every day, 1 in 10 hospitalized patients develops a health care-associated infection. IPC is a unique feature of patient safety and quality of care, universally relevant to every health worker and patient, at every health-care interaction. It requires constant action at all levels of the health system, from policy-makers to facility managers, and from health workers to those who access health services.
Eight core components of IPC are essential to ensuring patient safety and improving quality of care:
- a dedicated team with adequate levels of staffing
- knowledge of and adherence to global guidelines and standards
- systematic training for health-care staff
- a reliable surveillance system to monitor health care-associated infections
- integrated strategies for successful implementation
- monitoring and evaluation mechanisms
- a suitable number of health-care workers per patient
- essential supplies and a safe environment.
“Patients and health-care workers need to be safe and protected at all times, no matter where and the context. The 8 core components of infection prevention and control are the wheels to the cart that will ensure each patient has a safe journey while in hospital,” concludes Ana Paula Coutinho Rehse, expert on IPC at WHO/Europe.