Administrative Controls to Guarantee Implementation of Infection Prevention and Control Measures in the Context of COVID-19

What this guideline says

GMJ summary

This interim guidance from the Pan American Health Organization presents administrative controls—the first tier in the hierarchy of infection prevention and control (IPC) measures—necessary to reduce COVID-19 transmission in health facilities. Administrative controls include human resource planning, triage processes, environmental management, and monitoring systems that enable effective implementation of other IPC measures.

The document specifies staffing ratios, workflow organisation, and surveillance requirements. It recommends one full-time IPC professional per 100–250 beds (with higher ratios for COVID-19 areas), dedicated clinical teams for confirmed cases, active surveillance of health workers for acute respiratory infection, and well-equipped triage stations at facility entrances. The guidance emphasises maintaining at least 1 metre patient separation, ensuring adequate PPE supply, and establishing monitoring indicators across outcome, process, organisational, and structural domains.

The core message is that administrative controls form the foundation of a successful IPC programme: without proper planning of human resources, environmental standards, and monitoring systems, other infection control measures such as PPE use and environmental controls cannot be effectively implemented or sustained.

Key points

For clinicians — doses and thresholds as stated in the guideline

1. Assign one full-time IPC professional (nurse or physician) for every 100–250 beds, with higher ratios for areas caring for suspected or confirmed COVID-19 cases
2. Establish a well-equipped triage station with trained staff at the health facility entrance using screening questionnaires based on current case definitions
3. Assign dedicated teams of health workers exclusively to care for suspected or confirmed COVID-19 cases to reduce transmission risk
4. Maintain at least 1 metre separation between all patients and do not exceed standard bed occupancy capacity
5. Conduct active surveillance for acute respiratory infection among health workers, maintain rosters of all workers and their shifts, and record all unprotected occupational exposures
6. Ensure availability of hand hygiene products at points of care and working sinks with supplies at entrances to care and drug preparation areas
7. Guarantee safe drinking water availability for at least 8 hours per day
8. Monitor adherence to IPC standards through regular audits with outcome indicators (health professional and patient COVID-19 infections), process indicators (isolation procedure compliance), organisational indicators (presence of IPC team), and structural indicators (ventilation, bed spacing)

Management Indicators for COVID-19 Infection Prevention and Control

Table extracted from the guideline

Source: Pan American Health Organization, Administrative Controls to Guarantee Implementation of Infection Prevention and Control Measures in the Context of COVID-19. Reproduced in summary form.

From the guideline

Verbatim

“The WHO recommendation on the ratio of IPC professionals required to handle the workload in an acute care health facility is one full-time IPC professional (nurse or physician) for every 100-250 beds or fraction thereof, depending on the demand.”

Editor’s perspective

Why this matters for Georgia and the region

Applicability

Georgia and the South Caucasus

Questions this guideline answers

Quick answers

Related on GMJ

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