in_the_evidence

The panel recommends that the following elements should be adhered to in order to reduce
the risk of HAIs and the spread of AMR: bed occupancy should not exceed the standard
capacity of the facility; and healthcare worker staffing levels should be adequately assigned
according to patient workload.

National level: The panel recommends that a national IPC monitoring and evaluation programme should be
established to assess the extent to which standards are being met and activities are being
performed, according to the programme’s goals and objectives. Hand hygiene monitoring
with feedback should be considered as a key performance indicator at the national level.

Healthcare facility level: The panel recommends that regular monitoring/audit and timely feedback of healthcare practices,
according to IPC standards, should be performed to prevent and control HAIs and AMR at the
healthcare facility level. Feedback should be provided to all audited persons and relevant staff.

National level: The panel recommends that national IPC programmes should coordinate and facilitate the
implementation of IPC activities through multimodal strategies on a nationwide or subnational level.

Health care facility level: The panel recommends that IPC activities using multimodal strategies should be
implemented to improve practices and reduce HAIs and AMR.

National level: The panel recommends that national HAI surveillance programmes and networks that include
mechanisms for timely data feedback, with the potential to be used for benchmarking
purposes, should be established to reduce HAIs and AMR.

Health care facility level: The panel recommends that facility-based HAI surveillance should be performed to guide IPC
interventions and detect outbreaks, including AMR. Surveillance with timely feedback of results to healthcare workers and stakeholders is essential and should be carried out through national networks.

Health care facility level: The panel recommends that IPC education should be in place for all healthcare workers
by utilizing team- and task-based strategies that are participatory and include bedside and
simulation training to reduce the risk of HAIs and AMR.

Triage of people with TB signs and
symptoms, or with TB disease, is
recommended to reduce M. tuberculosis
transmission to health workers, persons
attending health care facilities or other
persons in settings with a high risk
of transmission.

Xpert MTB/RIF may be used as a replacement test for usual practice (including conventional
microscopy, culture or histopathology) for testing specific non-respiratory specimens (lymph
nodes and other tissues) from patients suspected of having extrapulmonary TB.