Six Strategies by Liu Qian, President of the Chinese Hospital Association, to Address Recurrent Nosocomial Infections

Infection prevention and control in healthcare institutions are critical components of ensuring medical quality. Recently, two consecutive outbreaks of hospital-acquired infections in China have exposed problems and weaknesses in infection control practices within healthcare facilities, drawing widespread public attention.

Recently, the National Health Commission issued the "Notice on Further Strengthening Infection Prevention and Control in Medical Institutions," explicitly calling for heightened political awareness, a strong sense of responsibility and vigilance, adherence to baseline standards, and prioritization and effective implementation of infection prevention and control measures.

Liu Qian, President of the Chinese Hospital Association, emphasized at the 2019 China Hospital Quality Conference that these incidents also reveal a weakening of the “patient-centered” philosophy in some regions and medical institutions, as well as inadequate hospital quality and safety control systems, poor implementation, non-standardized management, lack of quality and safety awareness, and insufficient education in medical ethics and professional conduct.

To this end, at the opening ceremony of the 2019 China Hospital Quality Conference on May 31, the Chinese Hospital Association solemnly issued the “Proposal on Strengthening Infection Prevention and Control in Healthcare Institutions” to the entire industry, calling on domestic healthcare institutions to strengthen self-discipline and attach great importance to and actively engage in infection prevention and control work.

The Chinese Hospital Association has put forward six initiatives, calling on medical institutions across China:

1. We must raise our political stance and attach great importance to infection prevention and control work with a strong sense of responsibility and sensitivity, ensuring its effective implementation.Healthcare institutions shall implement robust and effective measures to enhance their capacity for the diagnosis, treatment, prevention, and control of infectious diseases; prevent and curb the transmission of infectious diseases; eliminate healthcare-associated infections; and mitigate the risk of infection outbreaks. Upholding a baseline awareness and demonstrating a high degree of responsibility for public health, they shall strengthen infection prevention and control management to provide the public with safe, high-quality medical services.

2. Strengthen the awareness of responsibility and focus on enhancing the whole-process management of infection prevention and control in medical institutions.Healthcare institutions shall fulfill their primary responsibility, effectively leverage the role of their infection prevention and control (IPC) committees, clearly define the responsibilities and division of labor among the IPC management department, medical affairs, pharmacy, nursing, clinical laboratory, and all clinical departments, reinforce departmental accountability, and strengthen whole-process management. Specific IPC measures shall be formulated and implemented in light of the characteristics of each department and clinical unit to ensure thorough implementation of all IPC measures. A multidisciplinary and multi-departmental collaboration mechanism shall be established to foster synergy in jointly carrying out IPC work.

Third, effectively reduce risks by actively implementing infection surveillance, reporting, and control protocols.Healthcare institutions shall establish infection surveillance and reporting management systems with clear processes, well-defined responsibilities, and practical feasibility. Meanwhile, they shall strictly implement regulations, operational procedures, and contingency plans for the reporting, investigation, and management of healthcare-associated infection outbreaks, and conduct regular drills. In the event of a suspected or confirmed infection outbreak, timely reporting shall be made in accordance with relevant regulations. Furthermore, proactive surveillance should be strengthened in key departments, ensuring full coverage of invasive procedural steps. Healthcare institutions should actively leverage information technology to conduct infection surveillance and assessment, regularly perform scientific evaluations of infection control risk factors, adopt evidence-based interventions, implement scientifically grounded prevention and control measures, and continuously improve infection control objectives and strategies.

Fourth, advocate for full staff participation to promote the scientific, systematic, and standardized management of infection prevention and control.Medical institutions shall strictly implement relevant laws, regulations, rules, and technical standards, such as the Basic System for Infection Prevention and Control in Medical Institutions. Targeted strengthening of monitoring and control measures shall be applied to high-risk infection links, high-risk populations, major sites of infection, and key departments involved in infection management. Standard Precautions can achieve bidirectional protection, ensuring the safety of both healthcare providers and patients. Healthcare personnel shall strictly adhere to Standard Precautions during diagnosis and treatment, encompassing hand hygiene, disinfection and isolation, respiratory hygiene, occupational protection, safe injection practices, standardized use of single-use diagnostic and therapeutic supplies, and medical waste management. Meanwhile, based on the routes of disease transmission, airborne isolation, droplet isolation, and contact isolation shall be implemented in addition to Standard Precautions.

5. Conduct comprehensive training for all staff, with a focus on strengthening infection prevention and control capabilities in healthcare institutions and among medical personnel.Establish a comprehensive training system for infection prevention and control (IPC) in accordance with national requirements, conducting at least one specialized annual training session on IPC-related laws, regulations, knowledge, and skills. Uphold the principle that “everyone is an IPC practitioner,” focus on enhancing healthcare workers’ capacity for infection prevention and control, and encourage them to consciously integrate IPC concepts and requirements into their clinical diagnosis and treatment activities.

Conduct assessments of training effectiveness, and incorporate training participation and assessment results into the periodic evaluation of physicians, nurse practice registration, and related personnel file management. These outcomes shall be linked to professional title promotion, performance-based compensation distribution, and awards for excellence.

6. Strengthen self-discipline and supervision, and focus on addressing the problems and weaknesses in infection prevention and control work at medical institutions.Core infection prevention and control measures for specific diseases, procedures, and techniques should be incorporated into the clinical pathway management of key diseases and into medical quality and safety management. Regular self-inspections and supervisory checks should be conducted, with timely rectification of identified weaknesses and potential risks. The roles of professional organizations, such as academic associations and infection control quality improvement centers, should be fully leveraged to assist administrative authorities in carrying out personnel training, guidance and evaluation, and supervision and assessment, thereby promoting the continuous improvement of infection prevention and control standards.