Table 1 Implementation timeline and intensity of infection prevention and control (IPC) interventions across study periods
|  | Period-1 (23 September 2018 to 20 March 2019) | Period-2 (21 March 2019 to 22 September 2019) | Period-3 (23 September 2019 to 20 March 2020) | †Period-4 (21 March 2020 to 21 September 2020) | Period-5 (22 September 2020 to 19 March 2021) | Period- 6 (21 March 2021 to 22 September 2020) | Period- 7 (23 September 2021 to 20 March 2022) |
|---|---|---|---|---|---|---|---|
Contact precautions (i.e. at least use of disposable gowns and gloves) education/monitoring | √ | √ | √ | - | √ | √ | √√ |
Active surveillance using urine, wound and respiratory samples of high-risk patients on admission in ICU (colonization/infection) | -/√√ | √√/√√ | √√/√√ | -/√ | √√/√√ | √√√/√√√ | √√√/√√√ |
Patient isolation | √ | √√ | √√√ | - | √√ | √√√ | √√√ |
Patient and staff cohorting | √ | √√ | √√√ | - | √√√ | √√√ | √√√ |
Daily prevalence reporting to management | - | √√√ | √√√ | - | √√√ | √√√ | √√√ |
Immediate laboratory notification of cases | - | √√√ | √√√ | - | √√√ | √√√ | √√√ |
Healthcare worker education and adherence monitoring including a focus on hand hygiene | √√ | √√ | √√√ | √ | √√√ | √√√ | √√√ |
Healthcare worker education and adherence monitoring (on MDR organisms) | - | √ | √√√ | - | √√√ | √√√ | √√√ |
Distribution of guidelines for active CRO surveillance | - | √√√ | √√√ | - | √√√ | √√√ | √√√ |
Environmental cleaning education to nursing assistants |  | √ | √√√ |  | √√√ | √√√ | √√√ |
Daily Chlorhexidine gluconate mouth (three times) | - | √√√ | √√√ | - | √√√ | √√√ | √√√ |
Enhanced environmental cleaning/decontamination | - | - | - | - | √√√ | √√√ | √√√ |
Bedside cleaning with hypochlorite three time a day | √ | √√ | √√√ | √ | √√√ | √√√ | √√√ |
Environmental surveillance cultures in the event of an outbreak | - | - | √√√ | - | √√√ | √√√ | √√√ |
Enhanced antimicrobial stewardship and restriction of carbapenem use | - | √√ | √√√ | - | √√√ | √√√ | √√√ |
Audit and feedback (on hand hygiene, contact precautions, environmental cleaning) | √ | √ | √√ | - | √√√ | √√√ | √√√ |
Encouraging personnel in the field of infection control by the management team | - | - | √√√ | - | √√√ | - | √√√ |
Designing special cards to mark patients with MDR bacteria | - | - | √√√ | √√√ | √√√ | √√√ | √√√ |
Sterile oral suction using sterile gas or sterile gloves | - | - | - | - | √√√ | √√√ | √√√ |
Cohort ward for positive cases with dedicated staff | - | - | √√√ | - | √√√ | √√√ | √√√ |