Tuberculosis (TB) transmission in health care settings is a concern, particularly nosocomial TB due to exposure to unsuspected cases of TB. Therefore, risk assessments are undertaken to identify potential risk areas for infection transmission so that proper IPC measures can be introduced. Every type of health-care setting should conduct initial and ongoing evaluations of the risk for transmission of M. tuberculosis regardless of whether patients with suspected or confirmed TB disease will be encountered in the setting. Risk assessments serve as a tool for ongoing evaluation of the quality of TB infection control measures and the need to strengthen them. The findings from the required risk assessments form the basis for decisions about the level of administrative, environmental, and respiratory protective measures needed to ensure a safe environment for HCWs, patients, and others. To complete the assessment, direct observation of infection control practices is necessary. The risk assessment should be repeated at least annually as per guidance from the National IPC guidelines for TB, MDR-TB and XDR-TB, so that areas of increased risk can be identified, and corrective action taken to prevent TB transmission.
Case Study in the Western Cape
In Cape Winelands district, due to the implementation of IPConnect in 2018, the number of facilities with IPC plans increased by 24% and those with guidelines by 18% over the course of a year.
Unstructured interviews with IPC personnel concerning the use of IPConnect showed enthusiasm to conduct annual risk assessments. This is evident in the increase of risk assessments conducted in each district in 2018 vs 2019, from one to at least three per month.
Facility Managers are also optimistic about IPConnect since it provides them with real-time risk assessment and CO2 data as well as historical trends. These assist them to develop operational plans and targeted interventions for problematic facilities.