Impact of a quality improvement project to strengthen infection prevention and control training at rural healthcare facilities

Background: South Africa (SA) has a dire shortage of skilled infection prevention and control (IPC) practitioners with limited opportunities for IPC training, especially in rural areas.Methods: This quality improvement research-based case study surveyed healthcare workers’ IPC training needs and measured the impact of a targeted IPC training intervention at four healthcare facilities in a rural sub-district in the Western Cape Province of SA. Transfer and implementation of IPC knowledge and best practice were evaluated at the participating facilities, both pre and post intervention.Results: Most survey respondents (239/271; 88.2%) practised in rural districts and reportedly received infrequent (either annual or no) in-service training in IPC (138/271; 51%). The IPC education intervention (five short courses) was attended by almost one-third of clinical staff (129/422; 30.6%) at the four rural healthcare facilities. The pre-intervention IPC assessment identified the following: poor knowledge and implementation of tuberculosis-IPC measures; limited knowledge of medical device decontamination; high rates of needle-stick injuries; low hand-hygiene compliance rates and poor compliance with personal protective equipment use. At the post-intervention assessment, IPC knowledge scores and hand-hygiene compliance rates improved significantly but some IPC practices were unchanged.Conclusion: A structured IPC training programme in rural healthcare facilities can improve healthcare workers’ IPC knowledge, but has limited impact on clinical practice