Union Health Secretary, in his letter to chief secretaries and administrators of states and UTs, has urged them to undertake activities/practices to ensure that there are robust infection prevention and control practices in COVID hospitals and other healthcare facilities
Taking note of the mucormycosis becoming a cause of concern, the Ministry of Health and Family Welfare (MoH&FW) has advised all the states and Union Territories (UTs) to review their preparedness for infection prevention and control, as well as hygiene and sanitation in hospitals.
Rajesh Bhushan, Union Health Secretary, in his letter to chief secretaries and administrators of all states and UTs, has urged them to undertake the following activities/practices to ensure that there are robust infection prevention and control practices in COVID hospitals and other healthcare facilities:
- Establish/activate the hospital infection control committee with the head of the institution or an administrator as the chairperson.
- Designate an infection prevention and control nodal officer – preferably a microbiologist or senior infection control nurse.
- Prepare and implement the Infection Prevention Control (IPC) programme in the hospital/health facilities, as per the guidance given in the national guidelines for infection and control in healthcare facilities including infection prevention and control manual, guidelines on anti-microbial use and management, educational programmes and strategies, risk assessment and risk management, planning, monitoring, audit and feedback and implementation strategies.
It also asked the states to emphasise and strengthen procedures and practices for IPC. “In the context of COVID-19, standard precautions are to be applied all across the hospital/health facility. Transmission-based precautions need heightened focus on the droplet, airborne and contact precautions from the perspective of protecting healthcare workers and ensuring patient safety.”
It further advised to improve the environment and facilitate ventilation with focus on fresh air and natural ventilation wherever control systems with requisite air changes are not available. Cleaning, disinfection and sanitation of the hospital environment and frequently-touched surfaces, with recommended disinfectants like one per cent sodium hypochlorite or 70 per cent alcohol was also mentioned in the letter.
“Biomedical waste needs to be managed as per the Central Polution Control Board (CPCB) guidelines available at https://cpcb.nic.in/uploads/Projects/Bio-Medical-Waste/BMW-GUIDELINES-COVID_1.pdf,” it added.
Mentioning about taking care of the Intensive Care Unites (ICUs), it said that infection prevention and control practices need to be enhanced in ICUs using a bundle-approach to prevent device-associated infections such as ventilator-associated pneumonia or catheter-associated blood stream, urinary infections, etc.
The letter also said, “Infection prevention and control practice in the clinical laboratories, and those attached to hospitals are crucial for the safety of laboratory/hospital staff and health security of the community.
“Meticulous adherence to infection prevention and control, while managing immunocompromised patients such as COVID-19 patients on steroid treatment, with co-morbidities (such as diabetes where good glycemic control needs to be established; the guidelines for which are available at https://www.mohfw.gov.in/pdf/ClinicalGuidanceonDiabetesManagementatCOVID19PatientManagementFacility.pdf),” it stated.
Putting an emphasis on the training of the healthcare staff, it also said, “Train all hospital staff to develop their skills in IPC, irrespective of their individual routine duties, in implementing procedures and protocols described in the hospital infection control manual.”
Further, a state nodal officer needs to be identified to monitor the implementation of infection prevention and control to provide evaluation and feedback of the IPC programme in the state, according to the letter.