title: Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus.
abstract: Despite control efforts, the burden of health-care-associated infections in Europe is high and leads to around 37,000 deaths each year. We did a systematic review to identify crucial elements for the organisation of effective infection-prevention programmes in hospitals and key components for implementation of monitoring. 92 studies published from 1996 to 2012 were assessed and ten key components identified: organisation of infection control at the hospital level; bed occupancy, staffing, workload, and employment of pool or agency nurses; availability of and ease of access to materials and equipment and optimum ergonomics; appropriate use of guidelines; education and training; auditing; surveillance and feedback; multimodal and multidisciplinary prevention programmes that include behavioural change; engagement of champions; and positive organisational culture. These components comprise manageable and widely applicable ways to reduce health-care-associated infections and improve patients' safety.
authors.affiliation: Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Walter
authors.initials: W
authors.lastname: Zingg
authors.affiliation: Infection Control Programme, Imperial College London, London, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Holmes
authors.affiliation: Department of Environmental Health Science, University Hospital of Freiburg, Freiburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Dettenkofer
authors.affiliation: Department of Environmental Health Science, University Hospital of Freiburg, Freiburg, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Goetting
authors.affiliation: Infection Control Programme, Imperial College London, London, UK.
authors.forename: Federica
authors.initials: F
authors.lastname: Secci
authors.affiliation: Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Lauren
authors.initials: L
authors.lastname: Clack
authors.affiliation: Department of Environmental Health Science, WHO, Geneva, Switzerland.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Allegranzi
authors.affiliation: European Centre for Disease Prevention and Control, Stockholm, Sweden.
authors.forename: Anna-Pelagia
authors.initials: AP
authors.lastname: Magiorakos
authors.affiliation: Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland. Electronic address: didier.pittet@hcuge.ch.
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D005060:Europe / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*