This week, we continue to shine a light on IPC excellence beyond the acute setting. The featured posters showcase remarkable work across community and specialist environments — from care homes to rehabilitation units — highlighting how collaboration, education, and local champions are driving safer care across all healthcare contexts.
1. Acute infections are common and are a key driver of care of acute readmission in inpatient rehabilitation settings: A scoping review by Ladbrook, Bouchoucha, and Hutchinson.
The study provides a review of existing evidence on medical complications among adults in inpatient rehabilitation. The study included 47 studies published between 2000–2022 retrieved from MEDLINE and CINAHL, and the review followed the PRISMA-ScR guidelines.
The review showed that patients in subacute rehabilitation are at substantial risk of medical complications, with reported rates ranging from 3.4% to 96.8%, depending on diagnosis and setting. The most common complications were infections (notably urinary tract infections and pneumonia), neurological problems (such as seizures and cognitive changes), and cardiorespiratory issues. Patients recovering from stroke, traumatic brain injury, spinal cord injury, or cancer were especially vulnerable. Complications were associated with longer rehabilitation stays and higher rates of return to acute care (RTAC)—ranging from 2.9% to over 50%—often due to infection or respiratory distress.
Through this review, we underscore the need for multidisciplinary teams in rehabilitation units that include clinicians with expertise in acute medicine, infection control, and early recognition of clinical deterioration. Further, we highlight a significant gap in proactive prevention strategies, and we call for stronger clinical governance, better monitoring systems, and further multi-site research to reduce avoidable complications and improve patient outcomes.
Author: Prof Stéphane Bouchoucha (School of Nursing and Midwifery, Faculty of Health – Deaking University. President, Australasian College for Infection Prevention and Control (ACIPC)
2. What are the challenges associated with antimicrobial stewardship in nursing homes in the Republic of Ireland
This study explored the key challenges associated with implementing antimicrobial stewardship in nursing homes in the Republic of Ireland. A cross-sectional survey using a structured 30 item questionnaire was conducted across 12 nursing homes in the northeast region between April 2023 and May 2024, achieving a 93% response rate (n=145). Participants included Directors of Nursing, Assistant Directors, Clinical Nurse Managers, and nursing staff.
Findings demonstrated a high level of awareness of antimicrobial stewardship (96%), yet significant implementation barriers remain. Routine urine dipstick testing was reported by 67% of respondents, with private facilities more likely to use dipsticks routinely (72%) than public facilities (52%), P =0.023. Family influence contributed to unnecessary antibiotic prescribing in 40% of cases, while 86% reported reliance on out-of-hours general practitioner services for empirical prescribing. Although 83.5% reported having an infection prevention and control (IPC) lead or link practitioner, only 57% were allocated protected time to fulfil this role effectively.
The study highlights the need for enhanced antimicrobial stewardship training for staff and families, standardised policies and procedures, improved access to IPC specialists, and stronger leadership and governance. Addressing these barriers is essential to optimise antimicrobial use, minimise inappropriate prescribing, and strengthen antimicrobial stewardship practices within nursing home settings.
Author: Elaine Moloney (General Manager), Evergreen Care (Ireland)
3. Establishing a trust benchmark for the rate of Post-Ozurdex Implant Endophthalmitis Theme: IPC in specialist settings e.g. oncology, renal, community, adult social care, and prisons/places of detention
This review examined the incidence of post-Ozurdex endophthalmitis at Moorfields Eye Hospital over a ten-year period (2014–2023). Ozurdex, a biodegradable intravitreal dexamethasone implant, is used to treat macular oedema, retinal vein occlusion, and non-infectious uveitis. While highly effective, it carries a rare risk of endophthalmitis which is a severe intraocular infection typically caused by microbial contamination during or shortly after injection.
A literature review established international rates of endophthalmitis following Ozurdex implantation ranging from 0.34 to 1.53 per 1000 implants. Local data from Moorfields identified 4 confirmed cases among 5,064 implants, equating to a rate of 0.79 per 1000, consistent with international findings. The identified organisms were predominantly coagulase-negative Staphylococci, suggesting potential skin flora contamination.
The findings confirm that post-Ozurdex endophthalmitis is very rare, but its potential visual impact underscores the importance of maintaining strict aseptic technique. The review highlights the need for 5% povidone-iodine ocular preparation, proper draping, hand hygiene, environmental cleaning, and adherence to infection prevention protocols.
Ongoing surveillance and continued IPC training will help sustain low infection rates and establish a robust benchmark for evaluating future procedural safety and quality improvements within the Trust.
Author: Nadine Grant-McKenzie (Lead Infection Control Nurse), Moorfields Eye Hospital NHS Foundation Trust
4. Providing a service that trains staff to be responsible for infection prevention and control standards within their settings.
Aim: Providing a service that trains staff to be responsible for infection prevention and control standards within their settings. Training provides knowledge and skills to settings enabling them to become Infection Prevention and Control (IPC) Champions, working alongside their managers in the delivery of IPC standards. Benefits are improving the quality of care and aims to reduce infections by disseminating, educating, auditing and supporting their organisations when commissioning services. Ensuring they have the appropriate structure in place helps keep residents, staff, and visitors safe from healthcare associated infections.
Methods: Online Programme Delivery. Benefits to the current online programme delivery continue to be evidenced; access to the course is easier as there are no travel requirements. Whilst the cost to providing venue hire is not required, there are limitations on the content that mean practical training cannot be delivered such as hand hygiene demonstrations using light boxes. Results: Significant increase in the demand for IPC Champions training.
25% increase in the number of champions trained. Evaluation evidence shows 76% increase in positive feedback. The increase has come largely from care settings who have not previously engaged with us, or as the evidence shows, during last winter, infectious outbreaks, has seen some homes experiencing difficulties in managing IPC, which increased more frequent support visits. An increase in loaning of equipment for hand hygiene monitoring and more audits being carried out. Reports produced by the IPC advisor have been well received with recommendations being put in place, reflecting the improvements and this has enabled the setting to use the audit finding as part of their CQC evidence submission.
Conclusion: Priority for returning to face-to-face training from the Health Protection team, moving to an in-house delivery programme for care homes and work is underway with support from ESCC training team.
Author: Sharon Champion Infection Control Advisor Care Homes (Public Health), East Sussex.
5. An exploration of perceived achievement of learning outcomes for the National Infection Prevention and Control Link Practitioner Programme in older persons services in Ireland. A descriptive qualitative study.
While working in older persons services, the author undertook the IPC Link Practitioner Programme when it was launched in Ireland in 2021. It is a one-week training programme, four days virtual and one day in person, and has eight learning outcomes. The benefits of the programme quickly became evident at ward level, starting with small incremental changes that built upon embedding robust and consistent IPC practices. The author was keen to explore if other Link Practitioners shared this experience. Five main themes emerged from the study;
1) Enhanced daily practices: Contributors to success
2) Innovations in Antimicrobial Stewardship
3) Scale of the Link Practitioner Role
4) Leading by example: Changing the IPC culture
5) Challenges to Success
The study identified that the learning outcomes are being achieved, and the Link Practitioner programme promotes change, improves practice and positively impacts patient care and safety measures. It gave remarkable insights into the experiences of the Link Practitioners and the positive outcomes they achieved. Innovations in AMS were highlighted as a notable accomplishment for many participants. The study challenged the scale of the Link Practitioner role profile as executing the role was arduous at times. The study confirmed that participants shared the experience, and the IPC link Practitioner programme has a positive impact with older persons services in Ireland.
Authors: Pamela Landers, Senior Enhanced Nurse & IPC Link Practitioner (HSE Dublin and South), and Sinéad Creedon, Lecturer (School of Public Health, University College Cork)
6. Infection Prevention and Control (IPC) Care Home Education Programme
The Somerset IPC Education Programme for Care Homes is a six-month rolling initiative designed to strengthen infection prevention and control across the care sector. Delivered by the NHS Somerset IPC Team, the programme trains nominated staff to become IPC Champions – confident role models equipped to lead safe practice, conduct audits, and support colleagues within their settings.
Each cohort completes six focused sessions covering topics such as standard precautions, waste and environmental cleanliness, respiratory and isolation practice, and the management of specific pathogens. The blended learning model combines in-person workshops, virtual sessions, and practical resources aligned with national standards and CQC Key Lines of Enquiry. The programme fosters a sustainable peer network through ongoing mentorship, drop-in advice clinics, and refresher training opportunities.
The first cohort is due to complete in October 2025, with early feedback highlighting improved confidence, strengthened compliance, and an emerging culture of safety and collaboration across Somerset’s care homes.
Author: Lucy Champion (Infection Prevention and Control Nurse Specialist), NHS Somerset
7. Improving Awareness, Understanding, and Confidence in Infection Prevention and Control Legislation and Guidance Through a Primary Care-Specific IPC Board Assurance Framework: A Quality Improvement Study
Background: Primary care delivers the majority of patient contacts within the NHS but has historically lacked practical, accessible tools to support Infection Prevention and Control (IPC) and Antimicrobial Stewardship (AMS). In Bath and North East Somerset, Swindon and Wiltshire (BSW), approximately 80% of healthcare-associated infections (HCAIs) originate in the community. Existing IPC guidance, largely designed for acute care, often fails to translate effectively into general practice settings.
Aim: To improve awareness, understanding, and confidence in the application of IPC legislation and guidance among primary care staff through the implementation of a Primary Care–Specific IPC Board Assurance Framework (BAF). Methods: A revised IPC BAF, adapted from the National IPC Manual, was co-developed for primary care and relaunched in May 2025. The initiative included pre- and post-implementation surveys and three educational webinars. Surveys assessed awareness, understanding, and confidence in applying IPC and AMS/AMR guidance. Approximately 150 primary care staff were invited to participate; 38 responded to each survey. Responses were anonymous and therefore unpaired.
Results: Following implementation, staff reporting high awareness (rating ≥4) of IPC legislation increased by 26%, awareness of setting-level compliance increased by 17%, and understanding of compliance increased by 31%. The consistent gains across all domains indicate a meaningful positive effect despite the inability to pair responses.
Authors: Jennifer Bennett-Britton and Connie Timmings, IPC team, (NHS Bath & North East Somerset, Swindon and Wiltshire ICB)
