Implementation status of infection prevention and control measures in italian intensive care units

Abstract Background Implementing Infection, Prevention, and Control (IPC) measures is crucial in combating Healthcare-Associated Infections. The World Health Organization's Infection Prevention and Control Assessment Framework (IPCAF) tool enables facility-level self-assessment of eight key IPC components. Intensive Care Units (ICUs) participating in the SPIN-UTI Project 2022-23 edition were invited to evaluate their IPC implementation status. Methods An online IPCAF tool was developed within the SPIN-UTI platform. For each of the 43 participating ICUs, a score was calculated for each key component (range 0-100) to obtain an overall score (range 0-800). According to the overall score, implementation levels were evaluated as Inadequate (≤200), Basic (201-400), Intermediate (401-600) or Advanced (≥601). A survey was administered to identify barriers to IPC adoption. Results The highest-scoring components were Guidelines (median 95; range 37.5-100), Physical Environment (90; 75-100), HAI Surveillance (80; 32.5-100) and Workload (80; 15-100). The lowest-scoring areas were Training (60; 3-100), Monitoring/Audit and Feedback (67.5; 30-100), Multimodal Strategies (75; 0-100) and IPC Program (75; 15-100). Overall scores ranged from 350 to 782.5 (median 610). Implementation level was classified Advanced for 22 ICUs (51.2%), Intermediate for 15 (34.9%), and Basic for 6 (13.9%). Of all potential barriers, the most frequently reported were insufficient resources and staff (73.8%) and inadequate financial support (66.7%). 92.9% of ICUs reported at least one barrier, with an average of 5 barriers (range 0-10) and a negative correlation with the overall score (p < 0.001). Conclusions The analysis showed good IPC implementation, but training, monitoring, and multimodal strategy adoption need improvement. Among the main barriers reported, there is a lack of resources and personnel that underlines the need for targeted investments and greater organizational support. Key messages • Good IPC implementation in participating ICUs, with 51.2% classified as ‘Advanced.’ Improvements needed in training, monitoring, and multimodal strategies. • Main barriers include lack of resources and personnel and insufficient financial support, suggesting the need for targeted investments and greater organizational support.