1. There is a lack of high quality studies addressing the effectiveness of hospital-based IPC programmes, including the impact, cost-effectiveness, and ideal composition of IPC programmes.
2. Many best practice IPC recommendations are based upon weak evidence. For example, the World Health Organization identified, in its Global Guidelines for the Prevention of Surgical Site Infection, 20 recommendations with a “low” quality of evidence such as, for example, for the optimal timing for preoperative surgical antibiotic prophylaxis. The evidence base supporting IPC guidelines needs to be strengthened.
3. Situational analyses in different settings (high, medium or low-incomes countries) but also different healthcare settings (ICU, short or long stay, medico-social facilities) are needed to better understand potential adaptations of IPC guidelines.
4. A better understanding of the different patient screening strategies is needed for risk management. This includes who should be screened, when (including start and stop of screening), and how movement between healthcare institutions should trigger screening. Research should include both clinical impact and cost-effectiveness.
5. Additional tools are needed to evaluate ICP training programmes and implement them.
6. New innovative ways of training should be evaluated such as e-learning, simulation, self-directed training modules or mentorship for ICP education. There is a lack of study on the impact of these innovative training tools on the practice change and HAI rate in healthcare facilities.
7. Minimal standard requirements for the recruitment and training of ICP professional should also be investigated.
8. Research is needed to assess and validate the reliability of surveillance based on available patient clinical information (syndromic-based surveillance) rather than microbiological data or prescription databases, i.e., data gathered for other primary purposes.
9. There is a lack of published standards to monitor IPC practices beyond hand hygiene. Evidence-based standardized audit protocols need to be created addressing, for example, catheter related bloodstream/urinary tract infections or ventilator associated pneumonia.
10. There are a number of innovative, new methods to monitor compliance to IPC practices, including electronic and infrared approaches for example. These need to be tested in multiple settings to assess their value for IPC programmes.
11. Insufficient data are available on the impact of infrastructural changes at the facility level on the reduction of HCAI and AMR (accessibility to specific equipment, density of hand washing points, single room, facilitation of care circuits, and more).
12. Research is needed to explore the impact of patient-to-bed ratio on the spread of HCAI and AMR, including instances of overcrowding. This should include analyses of staff workload, available staffing (including presence of infection control professionals), bed occupancy, and visitor frequency. Ideally, studies would be performed in high, medium, and low-resource settings but also in different healthcare settings (ICU, short or long stay, medico-social facilities).
13. Studies are needed to assess the demographic, organizational, economic, sociological, and behavioral factors facilitating success but also the barriers and challenges to implement effective IPC programmes.
14. Patients and their family are key elements in the chain of transmission in the healthcare facilities. Studies addressing the impact of patient and family-oriented education and communication campaign (involving patients associations) on the rate of HCAI are lacking.
15. Research is needed to assess the impact of IPC measures in different operational contexts including small farms, industrial farms, feedlots, slaughterhouses, fish farms, and more. IPC measures may include the density of the animal populations as well as the infection control measures of the workers (vaccination, hand hygiene, antibiotic use and more).