Infection Prevention Bundles Essay
Infection bundles refer to a collection of evidence-based practices that upon execution reliably prevent infection and enhance patient outcomes (Molina García et al., 2022). Bundled interventions are broadly classified as primordial, primary, secondary, and tertiary. However, these bundles are highly variable depending on the distinct nature of the infection and include but are not limited to judicious use of antimicrobials, hand hygiene, disinfection procedures, early screening, patient education, isolation, and social distancing.
The effectiveness of infection prevention bundles cannot be overstated and has well been established. For instance, a study by Wee et al. (2020) demonstrated a significant reduction in healthcare-associated respiratory viral infection during COVID 19 (from 1.25 to 0.29 cases per 1000, 95% confidence interval, 0.19–0.44; p < 0.001) following the implementation of infection prevention bundle that consisted of segregation of symptomatic patients, droplet precautions, strict mask-wearing, and visitor screening. Similarly, Agarwal et al. (2018) in their study demonstrated that the postoperative spine surgery infection rate decreased by 45% from 3.8% to 2.1% (risk ratio 0.55; 95% CI 0.32–0.93; p = 0.03) following implementation of postoperative surgical dressing infection control measures and physician awareness.
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The effectiveness of an infection prevention bundle can be assessed in various ways. These include reviewing outcomes both pre-and post-implementation, data analysis, surveys and inspections, observations, and interviewing the caregivers to obtain the relevant information. Likewise, infection prevention and control assessment tools developed by CDC and WHO such as the infection prevention and control assessment and response (ICAR) tools and the infection prevention and control assessment framework (IPCAF) respectively can be deployed to assess the effectiveness of infection bundle in healthcare facilities (Tomczyk et al., 2020). In conclusion, infection bundles are effective in preventing infection although they should be customized and assessed.
References
Agarwal, N., Agarwal, P., Querry, A., Mazurkiewicz, A., Tempel, Z. J., Friedlander, R. M., Gerszten, P. C., Hamilton, D. K., Okonkwo, D. O., & Kanter, A. S. (2018). Implementation of an infection prevention bundle and increased physician awareness improves surgical outcomes and reduces costs associated with spine surgery. Journal of Neurosurgery. Spine, 29(1), 108–114. https://doi.org/10.3171/2017.11.spine17436
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Molina García, A., Cross, J. H., Fitchett, E. J. A., Kawaza, K., Okomo, U., Spotswood, N. E., Chiume, M., Ezeaka, V. C., Irimu, G., Salim, N., Molyneux, E. M., Lawn, J. E., & with the NEST360 Infection Prevention, Detection and Care Collaborative Group. (2022). Infection prevention and care bundles addressing health care-associated infections in neonatal care in low-middle income countries: a scoping review. EClinicalMedicine, 44(101259), 101259. https://doi.org/10.1016/j.eclinm.2021.101259
Tomczyk, S., Aghdassi, S., Storr, J., Hansen, S., Stewardson, A. J., Bischoff, P., Gastmeier, P., & Allegranzi, B. (2020). Testing of the WHO Infection Prevention and Control Assessment Framework at acute healthcare facility level. The Journal of Hospital Infection, 105(1), 83–90. https://doi.org/10.1016/j.jhin.2019.12.016
Wee, L. E., Conceicao, E. P., Sim, X. Y. J., Ko, K. K. K., Ling, M. L., & Venkatachalam, I. (2020). Reduction in healthcare-associated respiratory viral infections during a COVID-19 outbreak. Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 26(11), 1579–1581. https://doi.org/10.1016/j.cmi.2020.06.027
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How effective is the use of infection bundles to prevent infection compared to not using a bundle? How can one measure effective of an infection bundle?