J Islamabad Med Dental Coll 2022     194 
 

O p e n  A c c e s s   

 

Challenges for Infection Prevention and Control Practices in 

Hospital 
 

Naghmi Asif1, Khalid Hassan2 
1Head and Professor of Pathology, Islamabad Medical & Dental College. 

2Professor of Pathology and Editor-in-Chief, Journal of Islamabad Medical and Dental College. 
 

Infection prevention and control (IPC) is the 

foremost component in the delivery of patient care 

and safety in health care setting. Major impact of 

implementation of infection control practices is not 

only on the safety of patients, but also safety of 

health care providers and patients’ attendants. Due 

to ineffective implementation of IPC practices, 

patients may acquire nosocomial infections (also 

called Health Care Associated infections), resulting 

in increased morbidity and mortality, longer hospital 

stay, increased resistance to antimicrobial and high 

financial burden on health care system and patients’ 

families.  

With inadequate IPC practices in health care system, 

HAIs are the most frequent adverse event in hospital 

settings, affecting hundreds of millions of people 

globally. At least one in 10 patients acquire an 

infection whilst receiving care in health facilities in 

low-and-middle-income-countries. This is because in 

many health care settings, resources are limited and 

infrastructure and practices both are neglected. 

Among health care associated infections, (which 

include catheter associated infections, ventilator 

associated pneumonia, blood stream infections and  

surgical site infections) blood stream infections and 

Correspondence: Naghmi Asif 
Email: naheed.naghmi@imdcollege.edu.pk 
Cite this editorial: Asif N, Hassan K. Challenges for 
Infection Prevention and Control Practices in Hospital. J 
Islamabad Med Dental Coll. 2022; 11(4)194-195 DOI: 
https://doi.org/10.35787/jimdc.v11i4.936 
 

catheter related infections comprise the leading 

cause, particularly in intensive care units. Various 

factors such as adequate knowledge, development 

and stringent implementation of policies and 

guidelines, essential environmental health 

conditions, appropriate infrastructure, antibiotic 

stewardship, continuous surveillance and periodic 

audits etc. all play a vital role in implementation of 

IPC practices. Establishment of IPC committee with 

well-defined TORs, is an essential first step for 

successful IPC program.  

Many studies have proven that inadequate hospital 

infrastructure and resources, shortage of staff, 

inadequate knowledge and training of health care 

providers. ineffective surveillance, large number of 

visitors and overcrowding are the main barriers to 

IPC in any health care setting.  

Improperly built and poorly maintained buildings, 

such as damaged surfaces, walls and floors, 

improper doors and windows, lack of isolation 

rooms and cohorting areas, and non-availability of 

space and facilities in case of disease outbreaks, 

non-availability of proper waste segregation and 

incineration facilities have been identified as barrier 

to effective IPC practices. Moreover, non-availability 

of HANDWASH stations is a critical factor for IPC 

practice especially in critical areas like ICUs, where 

patients are under care for multiple problems and 

most of them are critically ill. Continuous education, 

training, behavior change and monitoring are crucial 

to IPC practices. This is especially important in

E D I T O R I A L  
 

mailto:naheed.naghmi@imdcollege.edu.pk


 

          J Islamabad Med Dental Coll 2022     195 
 

relevance to Hand washing practices, good hand 

hygiene practices and use of PPEs.  

Waste management, disinfection and regular 

monitoring of culture reports are some additional 

areas that need continuous surveillance and 

monitoring. Role of microbiologist and IPC 

committee in this regard are of vital importance. 

Housekeeping staff should always be included in IPC 

training programs. Continuous education, training 

plus availability of relevant printed material in local 

language as well as in English should be available for 

house-keeping staff.   

Lack of implementation and compliance to the 

visitor’s policy and large number of visitors 

(especially in critical areas) is another challenge to 

IPC. Overcrowding is recognized as a risk factor for 

HAIs. With large number of visitors, it is difficult to 

clean the environment and provide proper care to 

the patients, since visitors do not understand the 

importance of hand hygiene practices, waste 

disposal and factors affecting transmission of 

diseases.  

Lack of knowledge and training of hospital staff 

stands a major challenge to IPC. Moreover, there is 

a lack of understanding and motivation to 

implement recommended IPC practices. Shortage of 

PPEs and disinfectants in resource limited setting is 

another challenge to IPC. However, in resource 

limited arears rational use of PPEs should be 

monitored and policies should be devised 

accordingly. 

Keeping under consideration all these factors, the 

following recommendations are made: 

a. Every hospital must have an active IPC committee. 

b. IPC policies, its TORs and SOPs must be properly 

displayed and strictly followed; these may be 

periodically revised according to need. 

c. Hospital must have stringent waste management 

program.Regular refreshment programs should be 

in place for training on hand hygiene, good hand 

hygiene practices, use of PPEs, prevention of needle 

stick injuries, etc.