Download files
Abstract
It has been suggested that when adherence to infection prevention control (IPC) protocols is in place, the risk of transmission of infectious diseases to patients and other healthcare workers (HCWs) appears low. Adherence to IPC recommendations and protocols depends on many factors including availability of resources, health priorities, staff ratios, workload allocation, and patient turnover. Lastly, HCWs may be unsure of how and when to adhere to local guidelines. Evidence to date has established that HCW feel there is a lack of training about infections, IPC and about how to use personal protective equipment.
While guidelines often stipulate that HCWs should be trained, there is currently a gap in our understanding about how IPC training programs are being designed and implemented across low, middle- and high-income settings. This research program aimed to examine how the topic of training is framed and discussed in policies, as well as critically analyse the current landscape of IPC training and the factors impacting on delivery.
Following a multi-method approach, four studies were undertaken to examine IPC training across a range of countries, with a focus on pandemic and non-pandemic recommendations. The first study, a scoping review of publicly available IPC guidelines, was conducted to examine recommendations around IPC training programs. This study highlighted that mode of delivery and IPC curriculum differed across guidelines. It also highlighted that there is a failure to acknowledge adult learning principles. The second study examined the current landscape around occupational IPC training of HCW, across six low/middle-income/high-income countries via in-depth interviews. This work identified policy variations, lack of dedicated funding, poor resource allocation and impact of COVID-19 as factors affecting the delivery of training. Focusing on pandemic relevant IPC training, the third study examined the discourse around IPC training from the pandemic plans and COVID-19 specific guidelines from countries across every WHO region. This study found omissions and inconsistencies in the way pandemic specific IPC training programs were considered within the documents. Based on an extensive literature review as well as the factors identified in the previous three studies, a modified Delphi approach was used in the final study, to develop best practice principles to optimize the provision of occupational IPC training programs for HCWs.
The thesis contributes new knowledge regarding the framing of the topic of training across guidelines and policy documents, as well as an absence to recognise the need for dedicated resources and trained personnel. The recommendations offered can potentially support policy development and improvement in the delivery of occupational IPC training programs for HCWs in low-, middle- and high-income countries.
