Framing standard operating procedure for infection control and prevention during COVID pandemics

Haritha Madigubba; R Deepashree; Apurba Sankar Sastry

doi:10.4103/jcrsm.jcrsm_50_20

LETTER TO EDITOR

Year : 2022 | Volume : 8 | Issue : 1 | Page : 91-92

Framing standard operating procedure for infection control and prevention during COVID pandemics

Haritha Madigubba, R Deepashree, Apurba Sankar Sastry
Department of Microbiology, JIPMER, Puducherry, India

Date of Submission	17-Jul-2020
Date of Decision	21-Nov-2020
Date of Acceptance	30-Jun-2021
Date of Web Publication	8-Jul-2022

Correspondence Address:
Dr. Apurba Sankar Sastry
Department of Microbiology, JIPMER, Puducherry - 605 006
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jcrsm.jcrsm_50_20

How to cite this article:
Madigubba H, Deepashree R, Sastry AS. Framing standard operating procedure for infection control and prevention during COVID pandemics. J Curr Res Sci Med 2022;8:91-2

How to cite this URL:
Madigubba H, Deepashree R, Sastry AS. Framing standard operating procedure for infection control and prevention during COVID pandemics. J Curr Res Sci Med [serial online] 2022 [cited 2023 May 30];8:91-2. Available from: https://www.jcrsmed.org/text.asp?2022/8/1/91/350139

Dear Sir,

The coronavirus disease 2019 (COVID-19) pandemic is a catastrophic global pandemic of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was originated in Wuhan, China, in December 2019 and was declared as pandemic by the World Health Organization (WHO) on March 11.^[1],[2] As of June 26, 2020, more than 9.6 million cases of COVID-19 have been reported in more than 188 countries and territories, resulting in more than 4.8 lakh deaths.^[3] As no effective drug is available for treatment, the only way to control this pandemic is through a robust infection prevention and control (IPC) strategy. Therefore, healthcare facility (HCF) must put on immense effort to strengthen their infection control network. The first and foremost step toward strengthening and implementing IPC is to prepare an evidence-based, well-designed IPC standard operating procedure (SOP). Development of SOP is the prime responsibility of the hospital infection control committee (HICC).

Standard Operating Procedure Versus Guidelines

There are quite a number of standard and authenticated guidelines available on IPC of COVID-19, which include guidelines from Government of India such as Ministry of Health and Family Welfare (MoHFW) guidelines and international guidelines such as WHO and CDC. Therefore, the question which comes to the mind is what is the need of framing another SOP by the HCF.

The SOP is different than the guidelines; SOP is institute specific, whereas guidelines are more generalized, applied at a broader (national or global) level. Many a times, it is observed that guidelines cannot be directly practiced by the HCF. This may be because of several factors, such as unavailability of resources and workforce. Therefore, it is very important to develop institute-specific SOPs.

Development of Standard Operating Procedure

The guidelines should not be directly cut-copy pasted while preparing the SOP. HICC should work at the ground level and discuss with the stakeholders to find out the resources available. For example, before reproducing directly the “PPE indication table” given in MoHWF guideline, it is very important to determine whether the resources are available and, if available, then whether in adequate quantity. HICC should also make an attempt to understand the current knowledge, attitude, and practice of healthcare workers (HCWs) and accordingly should do the necessary changes in the SOP. For example, it is observed that hand hygiene compliance is improved considerably by providing pocket hand-rub to the HCWs. Therefore, although not given in any standard guideline, the HCF can incorporate this into the SOP if local resources are available.

It is to be noted that a well-designed SOP is the backbone of a good IPC setup in a HCF.

Components of Infection Prevention and Control Standard Operating Procedure

The IPC SOP comprises several components, each addressing different areas of infection control [Table 1].^{[4],[5],[6],[7],[8]} It should be available in both printed and electronic version.

Table 1: Components of standard operative procedure for prevention of COVID-19 pandemics in a healthcare facility^{[4],[5],[6],[7],[8]}

Click here to view

Being a new disease, the guidelines available for COVID keep evolving. Therefore, the SOP of the institute needs to be revised as on when new updates are available, preferably once in a fortnight.

Conclusion

Infection control is the single most important measure to prevent the cross-transmission of SARS-CoV-2 in the HCF. The HCF should develop their own IPC-SOP so that the HCWs can adapt during the patient care activity. HICC should take the lead role in framing the SOP through repeated discussion with the stakeholders. The implementation of SOP is only possible when it is structured well, which will also result in increased compliance of HCWs to SOP and thereby to prevent the spread of the infection.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health-The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis 2020;91:264-6.
2.	WHO Director-General's Opening Remarks at the Media Briefing on COVID-19. World Health Organization (WHO) (Press Release); 11 March, 2020.
3.	COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Baltimore, Maryland: ArcGIS Johns Hopkins University; 2020.
4.	World Health Organization. WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care is Safer Care. World Health Organization; 2009.
5.	World Health Organization. Glove use Information Leaflet. Geneva, Switzerland: World Health Organization; 2009.
6.	Centers for Disease Control and Prevention. Recommended Guidance for Extended use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings. The National Institute for Occupational Safety and Health (NIOSH); 2020.
7.	National Health Mission. Guidelines for Implementation of “KAYAKALP” Initiative; 2015.
8.	Guidelines for Handling, Treatment and Disposal of Waste Generated During Treatment/Diagnosis/Quarantine of COVID-19 Patients, Central Pollution Control Board, Ministry of Environment, Forest and Climate Change, Revision 3; 10 June, 2020.