The Weaponising of IPC and Its Heartbreaking Consequences

This chapter is concerned with compassion, quality and infection preventions and control (IPC). Using the example of the restrictions imposed across health and social care during the COVID-19 pandemic, it explores the adverse consequences associated with the restrictions and outlines the case for compassionate implementation of IPC guidance explaining how the two are not mutually exclusive. Whenever IPC is cited as a justification for practices that could be considered to be inhumane, this should be critically examined with consideration of proportionality, evidence base and duration. A new compassionate, people-centred IPC can become a reality and will be a powerful force for good across all of health and social care in all countries. It will require strengthened IPC leadership and a new movement that takes account of the day-to-day realities of health and social care so that frontline practitioners are supported in their IPC-related decision-making and communication. More research is also called for. © 2023 Taylor & Francis Group, LLC.

"Connected" conversations in TESOL education: A retrospective on virtual esl service learning during the Covid-19 pandemic

This chapter details strategies for integrating university methods coursework with ESL-focused service learning and focuses on lessons learned from university coursework and service-learning experiences. TESOL educators participated in service learning as part of training in ESL methods, internship, and practicum courses. Service-learning supported content focused on ESL teaching through distance learning. Students were provided with training and resources in the use of technology necessary to take advantage of the opportunities afforded by virtual service learning. Implications address both the importance of maintaining program stability during a time of crisis and responding to broader and short-term trends towards online learning. The authors reflect on the various partnerships that were developed during the pandemic that continue to be of use now that the crisis part of the pandemic has diminished. Broader goals, beyond the pandemic, of preparing TESOL students for preparation to teach in a virtual setting are described. © 2023, IGI Global. All rights reserved.

Applying workflow analysis techniques in care homes in the context of IPC and COVID-19

Introduction: The unprecedented COVID-19 pandemic saw a plethora of infection prevention and control (IPC) recommendations. However, implementing these within a compassionate milieu appeared to present a universal challenge. We highlighted the need for action in an open letter (https:// www. nursi ngtim es. net/ opini on/ open- letter- infec tion- preve ntion- and- contr ol- should- never- be- at- the- expen se- ofcompa ssion ate- care- 16- 10- 2020/) and identified real life scenarios as one solution to address the perceived IPC-induced compassion catastrophe reported to be taking place in many long term care (LTC) facilities. Objectives: To apply workflow analysis techniques in LTC in order to present IPC measures in the context of COVID-19. Methods: First hand narrative descriptions of carer/relative journeys in a LTC facility were obtained. Individuals were asked to recall a recent scenario, breaking it down into its smallest unit of activity, as outlined by WHO in a 2012 document on hand hygiene and long term care. The findings were reviewed and modified by a sample of people working in LTC, relatives/carers and IPC experts, with the experts applying IPC recommendations within the flow of activities. Results: Simulation of the flow of activity for two commonly encountered LTC scenarios, uniquely from the perspective of carers/relatives, was created. A table and a visual outlining the two scenarios were developed (figure 1 illustrates an example scenario: Spending time with a loved one outside/on a car journey) and launched on a unique website with site traffic monitored. At each step, the relevant IPC measures and their rationale were described with the aim of empowering those in LTCs to act with both compassion and safety. Conclusion: We used a robust, evidence-based approach to develop a data bank of workflow information related to activities within LTC, as well as visual representations. These constitute a de novo implementation resource designed to promote safe access to LTC in the context of a global pandemic. The end products and website (www. enabl esafe care. org) go some way to redress the imbalance between IPC and compassion and have been made freely available for universal adaptation and use. (Figure Presented).

Development of a training resource focused on those who clean health care facilities

Introduction: The workforce who clean health care facilities are overlooked and undervalued. Strengthening the training of this important cadre of staff in all countries will support infection prevention and control (IPC), water, sanitation and hygiene and antimicrobial resistance (AMR). Objectives: To explore existing materials and develop a new World Health Organization (WHO) training resource aimed at those who clean, initially in maternity wards. Methods: Electronic databases were searched using mesh terms for cleaners/cleaning, IPC and AMR, low and middle income countries, maternal and newborn health, training and development. Relevant web portals were also searched. After an initial assessment of all sourced publications, four scientific publications and 44 resources were further reviewed against a list of criteria. Results: An existing product entitled TEACH CLEAN was identified as suitable for modification. Permission was granted and adaptations and updates were made. A consultation was performed and a twopart WHO prototype was created. Other publications featuring the latest standards on IPC and environmental cleaning were also identified and informed the content. The components of the package stayed true to the original educational concept, which has been tested in a range of countries. An outline of the contents of the WHO resource is in Figure 1. Conclusion: This resource is the first WHO-developed training curriculum aimed at those who clean, a priority that has assumed greater significance in recent years including due to COVID-19. Further validation of the prototype is planned in a sample of WHO regions.

Development of three aide-memoires to improve standard, droplet/contact and airborne transmission practices and behaviours

Introduction: The World Health Organization (WHO) recommends the use of multimodal improvement strategies (MMIS) to implement IPC interventions. These include each item of standard and transmission- based precautions according to national guidelines or standard operating procedures and under the coordination of the national IPC focal point (or team, if existing). In 2020, a rapid review of WHO IPC guidance, including for COVID-19, was undertaken to address WHO European region country needs with regards to implementation and improvement tools. Objectives: To develop targeted improvement tools to support IPC guidance into action (GTA) in WHO European region countries. Methods: The topics for new improvement tools were decided upon and text drafted. A first online consultation (29 June-13 July 2020) included WHO and country experts. The questions took account of theory of change concepts, resource use, values and preferences (figure 1). Feedback informed significant changes to the tools. The second consultation, November 2020, involved WHO headquarters and regional office experts. It comprised an interactive 90-min virtual discussion, with materials shared in advance and by asking three key questions, iteratively seeking final validation. A final follow up exercise in 2021 verified accuracies in the final products. Results: A new WHO Europe document consisting of three focused, improvement tools called aide-memoires was launched in May 2021, targeted at IPC focal points. The three aide-memoires are;1) respiratory and hand hygiene, 2) personal protective equipment and 3) environmental cleaning, waste and linen management. Each consists of action checks structured around the five elements of the MMIS Conclusion: These are the first GTA tools to focus on the detail of 'how' to improve standard and transmission-based precaution practices and behaviours by describing actions that comprise the five elements of the WHO MMIS. The action checks included in each are informed by WHO IPC guidance, as well as input from experts, and are importantly rooted in a proven improvement approach acting as reminders of things to do in the real world.

The effectiveness of hand hygiene interventions for preventing transmission or acquisition of viral infections in the community: Findings from a systematic review

Introduction: The World Health Organization recommends improving hand hygiene (HH) practices of the general public as one aspect of controlling the transmission of novel coronaviruses and influenza virus epidemics or pandemics. Objectives: To systematically review the evidence on the effectiveness of HH interventions for preventing transmission or acquisition of viral infections in the community. Methods: PubMed, MEDLINE, CINAHL and Web of Science databases were searched for empirical studies published between 2002-May 2020, on HH in the general public and acquisition or transmission of novel coronavirus infections or influenza. Study selection, data extraction and quality assessment were conducted by one reviewer, with all decisions checked by another. We conducted a sub-set analysis of intervention studies included in this review, by calculating the effect estimates. Results: The review identified four intervention studies, all of which used cluster randomised designs evaluating the effectiveness of HH education paired with provision of HH products or hand washing with soap and water (HW) against influenza transmission or acquisition amongst the populations of schoolchildren (n = 2) or the general public (n = 2). Three indicated a protective effect of HH interventions (Figure);yet, this effect was significant for only one school-based intervention, which consisted of the provision of HH education and performing HW twice a day (OR: 0.64;95% CI 0.51, 0.80). However, the risk of bias of this study was assessed as unclear;whereas the remaining three studies were assessed as high risk. Conclusion: There is some limited evidence demonstrating that hand hygiene interventions were effective in preventing influenza in school children. Thus, whilst provision of HH education to school children will be beneficial from a public health perspective, it's impact on influenza transmission is unclear. Research is needed to evaluate the effectiveness of HH interventions for prevention of respiratory infections, including SARS-CoV-2, amongst more diverse groups of the general public populations.

Preserve a Voucher Specimen! The Critical Need for Integrating Natural History Collections in Infectious Disease Studies.

Despite being nearly 10 months into the COVID-19 (coronavirus disease 2019) pandemic, the definitive animal host for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the causal agent of COVID-19, remains unknown. Unfortunately, similar problems exist for other betacoronaviruses, and no vouchered specimens exist to corroborate host species identification for most of these pathogens. This most basic information is critical to the full understanding and mitigation of emerging zoonotic diseases. To overcome this hurdle, we recommend that host-pathogen researchers adopt vouchering practices and collaborate with natural history collections to permanently archive microbiological samples and host specimens. Vouchered specimens and associated samples provide both repeatability and extension to host-pathogen studies, and using them mobilizes a large workforce (i.e., biodiversity scientists) to assist in pandemic preparedness. We review several well-known examples that successfully integrate host-pathogen research with natural history collections (e.g., yellow fever, hantaviruses, helminths). However, vouchering remains an underutilized practice in such studies. Using an online survey, we assessed vouchering practices used by microbiologists (e.g., bacteriologists, parasitologists, virologists) in host-pathogen research. A much greater number of respondents permanently archive microbiological samples than archive host specimens, and less than half of respondents voucher host specimens from which microbiological samples were lethally collected. To foster collaborations between microbiologists and natural history collections, we provide recommendations for integrating vouchering techniques and archiving of microbiological samples into host-pathogen studies. This integrative approach exemplifies the premise underlying One Health initiatives, providing critical infrastructure for addressing related issues ranging from public health to global climate change and the biodiversity crisis.