Feasibility of the WHO Infection Prevention and Control Assessment Framework in long-term care facilities: a pilot...

The World Health Organization's Infection Prevention and Control Assessment Framework (IPCAF) is widely used to evaluate infection prevention and control (IPC) quality in hospitals, but IPC standards in long-term care facilities (LTCFs) are less studied and standardized. The IPCAF has not previously been used in LTCFs. This study aimed to pilot an adapted version of the IPCAF in Dutch LTCFs to assess its usability, perceived feasibility and acceptability in this context.

First, the IPCAF was translated and adapted to the Dutch LTCF context through expert consultation for relevance. In this pilot, the adapted IPCAF was then completed during face-to-face interviews together with a multidisciplinary team in fourteen healthcare groups between May and September 2024. Second, LTCF characteristics were collected in advance through a separate questionnaire on LTCF level. Finally, after receiving feedback reports, LTCFs completed a separate web-based survey about their experiences with the process. Data were summarized descriptively and group differences were tested using the Kruskal-Wallis test.

Most participants found the adapted IPCAF clear and informative, appreciating its ability to highlight areas needing attention and identify priorities for improvement. About a quarter of LTCFs expressed willingness to use the adapted IPCAF in the future, while over half were hesitant. IPC standards were generally high, with the highest scores for 'Workload, staffing and bed occupancy' and 'Environments, materials and equipment for IPC'. The lowest scores were for 'HAI surveillance' and 'IPC education', with only five LTCFs including HAI surveillance in their IPC programs.

This is the first study to adapt the WHO IPCAF as a tool for measuring IPC in LTCFs and to evaluate its usability, perceived feasibility, and acceptability in this context. The adapted IPCAF can be implemented in LTCFs and may help identify IPC priorities and areas for improvement. However, greater familiarity and support may be needed to enable wider adoption. While IPC standards were relatively high in the LTCFs included in this pilot, ongoing attention to surveillance and education remains essential. Further research may be needed to validate our findings in larger and more diverse LTCF populations and to explore its impact on IPC outcomes.