Prevalence of Nosocomial Infections and Prevention and Control Strategies in Iranian Hospitals: A Mixed-Methods Study

Background: Hospital-acquired infections (HAIs) remain a major threat to patient safety and healthcare efficiency in Iran, contributing to increased morbidity, mortality, and healthcare costs.Aim: This study aimed to estimate the overall prevalence of HAIs in Iranian hospitals and identify the most effective strategies for their prevention and control.Method: A sequential explanatory mixed-methods design was employed. In Phase One, a systematic review and meta-analysis were conducted [on studies] published up to May ۲۰, ۲۰۲۴, following Gough's nine-step framework, PRISMA ۲۰۲۰, and the PIO framework. In Phase Two, a two-round Delphi technique was used to develop and prioritize evidence-based strategies for reducing HAIs, informed by the findings of Phase One.Results: A total of ۲۲ studies conducted between ۱۹۹۹ and ۲۰۲۰ reported hospital-acquired infection (HAI) prevalence ranging from ۰.۰۴۶% to ۲۶.۵%. In the second phase, the Delphi process initially identified ۸۲ potential strategies, which were refined through expert consensus (agreement >۷۰%) during a face-to-face meeting. Ultimately, ۵۶ context-specific strategies were finalized, with an emphasis on feasibility within Iranian clinical settings. These strategies focused on improving hand hygiene compliance, appropriate ventilation in high-risk units, strengthening infection control training, proper reprocessing of linens and medical equipment, establishment of infection prevention and control (IPC) committees, implementation of locally adapted evidence-based IPC guidelines informed by national surveillance and hospital data, timely and safe patient discharge, and effective hospital accreditation programs. Implications for Practice: Although published studies suggest a low prevalence of HAIs in Iranian hospitals, effective prevention and control remain essential. Prioritizing locally adapted infection prevention guidelines, staff training, hand hygiene, appropriate ventilation, and safe discharge practices can address key challenges in Iranian clinical settings.

کلیدواژه ها:

Iran ، Meta-analysis ، Nosocomial infections ، Prevalence ، Systematic review