Paper I — 2023 July (Supplementary) (2019 Scheme) — Q3
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Paper I
2023 July (Supplementary) (2019 Scheme) · 100 marks · 180 min
Question
Write the functions of HICC (Hospital Infection Control Committee). Add a note on
antimicrobial stewardship (5+3)
Q38 marksShort Essays
Answer
Functions of the Hospital Infection Control Committee (HICC):
Surveillance — monitoring rates of hospital-acquired infections (HAIs) across departments, identifying trends/outbreaks.
Policy formulation — developing and updating infection-control policies (hand hygiene, isolation precautions, device-care bundles, sterilization protocols) based on current evidence.
Outbreak investigation and management — identifying the source of any HAI cluster/outbreak and implementing control measures.
Education and training — regular training of healthcare staff in infection-control practices, hand hygiene, and safe injection practices.
Antimicrobial stewardship oversight — monitoring antibiotic use patterns and promoting rational prescribing (often via a linked antimicrobial stewardship subcommittee).
Monitoring compliance — auditing adherence to infection-control practices (e.g., hand hygiene compliance audits) across the facility.
Biomedical waste management oversight — ensuring proper segregation, treatment, and disposal of hospital waste.
Advising on healthcare facility design — providing input on isolation ward requirements, ventilation, and other infrastructure relevant to infection control.
Note on antimicrobial stewardship
Antimicrobial stewardship refers to a coordinated set of interventions designed to promote the appropriate use of antimicrobials, improving patient outcomes while reducing the emergence of antimicrobial resistance and adverse effects.
Key components:
Restriction/pre-authorization of certain broad-spectrum or reserve antibiotics, requiring specialist approval before use.
Prospective audit and feedback — reviewing ongoing antibiotic prescriptions and providing feedback to prescribers.
De-escalation — narrowing empirical broad-spectrum therapy once culture/susceptibility results are available.
Dose optimization — ensuring appropriate dosing based on pharmacokinetic/pharmacodynamic principles and organ function.
Selective/cascade reporting of susceptibility results (reporting only appropriate first-line agents unless resistance is present) to guide rational prescribing.
Education of prescribers on antibiotic guidelines and local resistance patterns.
Significance: antimicrobial stewardship is essential for combating the global rise of antimicrobial resistance, preserving the effectiveness of existing antibiotics, and reducing healthcare costs and adverse drug effects, and is a core, closely linked function of the HICC in most modern healthcare facilities.
