Mr. Savneel Shivam Kumar1, Miss Alvina Lata1, Mrs. Ashlyn Datt1, Miss Sisilia Genaro1, Mrs. Timaima Ditukana1, Ms. Ilisapeci Nabose1, Dr Ravi Naidu1, Dr Ana Suka1, Dr Tracey Young- Sharma1, Mrs. Shammi Prasad1, Mrs. Prinika Prasad1, Mrs. Sanjeshni Autar1, Mrs. Antonette David1, Miss Anisi Kavoa1, Mr. Alipate Vakamocea1, Mr. Matthew Richards1, Professor Kirsty Buising1, Professor Benjamin Howden1, Miss Donna Cameron1, Mrs. Aneley Strobel1
1Ministry of Health and Medical Services, Suva, Fiji
Biography:
Name: Savneel Shivam Kumar; Country: Fiji Islands; Organization: Ministry of Health and Medical Services, CWM Hospital
Work History:
Position: Team Leader, Infection Prevention Control Department, CWM Hospital
2020- 2022: Admission/ Bed Manager- CWM Hospital; 2016- 2020: Registered Nurse, Surgical Unit; 2012- 2015: Registered Nurse, Stress Management/ Medical Unit.
Qualifications: 2024: Foundation in Infection Prevention and Control, International – Australasian College of Infection Prevention and Control; 2019: Bachelor In Nursing, Lateral Entry – Fiji National University; 2012: Diploma in Nursing – Fiji National University
Membership: Infection Control Committee Secretariat- CWM Hospital; – Quality Improvement Committee
Abstract:
Background
The emergence of carbapenem resistant organisms (CRO) pose a great risk in low- and middle-income countries. The aim of this case study is to describe the steps taken to establish CRO surveillance, prevention, and control interventions in the Colonial War Memorial Hospital in Fiji and share the results that can be beneficial to other countries in the Pacific and globally.
Method
An observational survey, walkthrough and tabletop exercise were conducted to assess infection prevention and control (IPC) and laboratory preparedness capacity. Standard operating procedures (SOP) were developed. A train-the-trainer approach was used for healthcare worker (HCW) education and capacity building. Regular audits were conducted to monitor compliance.
Results
During the 12-month implementation period (January to December 2023), training and education sessions were conducted and attended by over 700 HCW. Communication among HCW was improved with prompt sharing of laboratory results accompanied by formal CRO case notification. Active surveillance of CRO colonisation among high-risk patients commenced in January 2023. The overall compliance with ICU admission screening was 70.3%. Majority (96%) of screening samples were collected within 72 hours as per the SOP. Audits of contact precautions and hand hygiene compliance showed gaps that required additional training.
Conclusion
The development of standardised procedures, reporting and audit tools, coupled with a series of capacity building initiatives led to increased awareness of CRO, improvement in CRO case notification and implementation of IPC measures. Fiji’s experience and lessons learned can guide other countries in establishing or further strengthening CRO surveillance, prevention and control programs.