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UBC Theses and Dissertations

Infection prevention and control effectiveness and safety : validation of a survey for long term care facilities Schall, Valerie


Objectives: To develop and validate a survey that can be used to measure key infection prevention and control (IP&C) structures and processes in LTC facilities. Methods: This study was designed using a three-phase methodology. In Phase I, six structural and process composite indices were developed based on the 2004 PHAC recommendations for IP&C in LTC and other literature. During the second phase of the study, a group of 7 experts in LTC IP&C used the Delphi methodology to validate and further develop the survey based on group consensus. Five Safety Principles published by the Institute of Medicine were also provided to the experts so they could be used to complement and further develop the concepts covered by the survey. The Delphi phase began in April and ended in October 2007; 114 worksheets were sent to experts to support the consensus-reaching process. Once the validity of a survey draft had been established based on expert-group consensus, it was pilot-tested in Phase III using 20 randomly selected LTC facilities in Fraser Health. Findings: The three-phase methodology used in this study was very useful and innovative way to further develop and validate the literature-based survey developed in Phase I for IP&C in long term care. In addition, by merging two bodies of knowledge and thought into the process, concepts and components that are not explicitly described in IP&C literature yet were felt to be key in program success, were incorporated into the measurement tool. Using Delphi, the experts expressed a need for IP&C professionals working in LTC to increase their knowledge, understanding and use of safety theory and strategies. They also felt that interdisciplinary work, the development of a culture of safety, and the development clear and simple IP&C systems are key ways in which infections can be prevented and outbreaks quickly controlled. In Phase III, the pilot-study analysis demonstrated the utility, validity and reliability of the survey. In addition, the analysis showed that there is a tendency for facilities to have lower levels of components within the Leadership Index and the ICP Index.

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