A Delphi Survey on the Validity and Feasibility of a Healthcare-Associated Infection Surveillance System for Traditional Korean Medicine Hospitals in South Korea

<b>Background:</b> Current research on healthcare-associated infection (HAI) surveillance in traditional Korean medicine (TKM) institutions is limited. <b>Methods:</b> We utilized the Delphi method to evaluate the validity and feasibility of implementing an HAI surveillance system in TKM hospitals. This involved conducting a systematic literature review and focus group interviews with three infection control experts and five TKM doctors experienced in infection control within TKM hospitals. Based on these findings, we developed a Delphi questionnaire. The survey included a total of fifteen participants: ten TKM doctors and TKM-related policy researchers with infection control expertise, two infection control nurses, and three infectious disease doctors. <b>Results:</b> The survey results indicated strong consensus on the necessity of introducing an HAI surveillance system tailored to TKM hospitals, as well as their integration into the Korean National Healthcare-associated Infections Surveillance (KONIS) system. Since infectious diseases do not differentiate between acute care hospitals and TKM hospitals, it is reasonable for TKM hospitals to participate in infection surveillance systems. However, the feasibility of implementing HAI surveillance in TKM hospitals remains low due to a lack of awareness regarding infection surveillance, insufficient surveillance personnel, inadequate diagnostic and surveillance infrastructure, and limited policy support for infection control. Therefore, this study proposes a phased approach in which hand hygiene surveillance and safe injection practice monitoring, which received relatively higher consensus on feasibility, should be prioritized to establish the necessary surveillance infrastructure. Subsequently, a stepwise implementation of HAI surveillance can be introduced. <b>Conclusions:</b> Although TKM hospitals generally have a lower risk of HAIs compared to acute care facilities, they lack robust infection control systems and support. To address this gap, TKM hospitals should join the KONIS system. Appointing and training dedicated infection control personnel will enable their participation and enhance overall infection management.