Journal of infection prevention · 2026
Changes in self-assessed infection prevention and control standards compliance following accreditation in palliative care services: A mixed-methods pre-post evaluation.
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Theologia Tsitsi, Polychronis Giannis, Nikitara Monika, Papoui Elena
Аннотация
AIM/OBJECTIVE: To evaluate changes in self-assessed infection prevention and control (IPC) standards compliance associated with an organizational accreditation process in an independent nonprofit palliative care provider.
METHODS AND RESULTS: A single-site mixed-methods pre-post evaluation was conducted in a 21-bed inpatient hospice. Baseline assessment occurred from May to July 2024, post-implementation assessment in October 2025, and the external survey on 24-27 November 2025. The accreditation intervention included standards review and gap analysis, creation or revision of 64 IPC procedures and criterion-related implementation elements, one comprehensive and one brief staff-training session, a pre-audit, committee oversight, and introduction of healthcare-associated infection surveillance. Six health professionals contributed baseline data and five contributed post-implementation data across 13 IPC dimensions. The overall mean score increased from 3.54 to 4.16 out of 5; the descriptive dimension-level standardized change index was 2.37. External surveyors recorded full IPC compliance. Service-user and loved-one evaluation scores increased from 1.60 to 2.00 out of 2.0. A focus group with six health professionals reported clearer procedures, improved hand hygiene, and increased perceived safety, alongside time and documentation burden. Infection-rate data were reported only as descriptive post-implementation trends because no comparable baseline existed.
DISCUSSION: Accreditation was associated with improved self-assessed IPC standards compliance, supported by external post-implementation findings. Causal inference is limited by the single-site design, small samples, and lack of a control group.
SIGNIFICANCE AND IMPACT: Accreditation can provide a structured approach to IPC improvement in palliative care, but it sustainability requires reduced documentation burden and workflow integration.
METHODS AND RESULTS: A single-site mixed-methods pre-post evaluation was conducted in a 21-bed inpatient hospice. Baseline assessment occurred from May to July 2024, post-implementation assessment in October 2025, and the external survey on 24-27 November 2025. The accreditation intervention included standards review and gap analysis, creation or revision of 64 IPC procedures and criterion-related implementation elements, one comprehensive and one brief staff-training session, a pre-audit, committee oversight, and introduction of healthcare-associated infection surveillance. Six health professionals contributed baseline data and five contributed post-implementation data across 13 IPC dimensions. The overall mean score increased from 3.54 to 4.16 out of 5; the descriptive dimension-level standardized change index was 2.37. External surveyors recorded full IPC compliance. Service-user and loved-one evaluation scores increased from 1.60 to 2.00 out of 2.0. A focus group with six health professionals reported clearer procedures, improved hand hygiene, and increased perceived safety, alongside time and documentation burden. Infection-rate data were reported only as descriptive post-implementation trends because no comparable baseline existed.
DISCUSSION: Accreditation was associated with improved self-assessed IPC standards compliance, supported by external post-implementation findings. Causal inference is limited by the single-site design, small samples, and lack of a control group.
SIGNIFICANCE AND IMPACT: Accreditation can provide a structured approach to IPC improvement in palliative care, but it sustainability requires reduced documentation burden and workflow integration.