NABH 6th Edition IPC Chapter: Infection Prevention and Control Explained

What the IPC chapter is about

NABH's intent for IPC is a documented, hospital-wide programme that reduces infection risk for patients, visitors and staff, in clinical areas and support services alike. Management provides facilities and resources, the hospital runs an antimicrobial programme based on local data, surveillance is built in, and the programme includes disinfection, sterilisation and biomedical waste management.

Core elements are checked at every assessment and must each score at least 4 out of 5, so IPC carries a lot of weight for a small chapter. Our 6th Edition overview explains the scoring.

The 8 standards at a glance

The programme, committee and team (IPC.1)

The IPC programme must be documented (IPC.1.a, Core), identify high-risk activities with written guidance for each, and be reviewed at least once a year. Reviewing it against an IPC assessment tool is an Achievement element. The hospital needs a multidisciplinary IPC committee, an IPC team, a designated IPC officer and designated IPC nurse(s). It also runs community education and takes part in managing community outbreaks.

Evidence that works: an IPC manual with a high-risk activity list; committee terms of reference and monthly minutes; appointment letters for the IPC officer and nurse(s); the annual review record.

Resources (IPC.2)

Two Core elements: management makes resources available, including funds from its annual budget (IPC.2.a), and hand hygiene facilities are accessible in all patient-care areas (IPC.2.c). Personal protective equipment, soap and disinfectants must be available and used correctly, and isolation or barrier nursing facilities must exist.

Evidence that works: an IPC budget line; hand-wash stations and alcohol rub at every point of care; PPE stock records; a designated isolation room.

Clinical areas (IPC.3)

Four Core elements apply at every bedside: standard precautions (IPC.3.a), hand hygiene guidelines (IPC.3.b), safe injection and infusion practices (IPC.3.d) and an antimicrobial stewardship programme that monitors antimicrobial use (IPC.3.f). Transmission-based precautions and a documented antimicrobial policy complete the standard.

Evidence that works: an antibiotic policy built on your own culture and sensitivity data; stewardship meeting minutes with usage data; hand hygiene audit sheets; injection safety audits; isolation signage and practice on the ward.

Support services (IPC.4)

Housekeeping procedures (IPC.4.c) and safe biomedical waste handling (IPC.4.d) are Core. The standard also covers engineering controls, an infection-risk plan for construction and renovation, laundry and linen, and kitchen sanitation and food handling. Your biomedical waste authorisation must be in date; see biomedical waste authorisation.

Evidence that works: cleaning schedules and checklists by area; colour-coded waste segregation at source with records; linen and kitchen hygiene procedures; a construction risk assessment when you renovate.

Preventing patient infections (IPC.5)

The hospital takes action to prevent the four classic healthcare-associated infections: catheter-associated urinary tract infection, ventilator-associated pneumonia, central line-associated bloodstream infection and surgical site infection. In practice that means insertion and maintenance bundles with compliance checks.

Evidence that works: bundle checklists in ICU and wards; bundle compliance audits; device-day counts that feed the infection rates.

Surveillance (IPC.6)

Three Core elements: surveillance covers infection risks, rates and trends (IPC.6.a), hand hygiene compliance (IPC.6.d) and housekeeping effectiveness (IPC.6.f). The IPC team verifies the data, focuses on high-risk activities, gives clinicians regular feedback, controls outbreaks and acts on the analysis. Capturing multidrug-resistant organisms is an Achievement element.

The 6th Edition's KPI annexure turns this into numbers: device infections per 1,000 device days, surgical site infections per 100 procedures and hand hygiene compliance, defined by CDC/NHSN criteria and the WHO observation tool. See the NABH quality indicators list.

Sterilisation and disinfection (IPC.7)

Cleaning, packing, disinfection and sterilisation, storage and issue of items must follow written guidance (IPC.7.b, Core). The CSSD needs adequate space and zoning, reprocessing rules, documented validation tests and a recall procedure when sterilisation fails.

Evidence that works: CSSD zoning from dirty to clean to sterile; load records with physical, chemical and biological indicators; a reprocessing policy for single-use items; a recall log.

Staff health (IPC.8)

The hospital protects its staff with occupational health and safety practices, an immunisation policy, measures against blood and body fluid exposure, and post-exposure prophylaxis. Work restrictions for staff with transmissible infections are an Achievement element.

Evidence that works: staff hepatitis B vaccination records; a needlestick and exposure reporting procedure; post-exposure prophylaxis records.

How assessors test IPC

Assessors watch practice. They observe hand hygiene at the bedside, ask a nurse what she does after a needlestick injury, check how a cannula was inserted and labelled, follow a soiled instrument through CSSD, look at waste bins on the ward and read the IPC committee minutes for real infection data and actions. A surveillance report with no infections in a busy ICU invites closer questions.

Getting IPC ready

1. Map all 49 elements and fix the 13 Core elements first.
2. Appoint the IPC officer and nurse(s) and start monthly committee meetings with data.
3. Write an antibiotic policy from your own microbiology data and begin stewardship rounds.
4. Introduce device bundles and start counting device days.
5. Audit hand hygiene, housekeeping and CSSD every month and act on the results.

Our NABH documents checklist lists the IPC documents, and we run 6th Edition gap analyses scored the way assessors score. Hospitals up to 50 beds follow the equivalent chapter in the SHCO standards.

All ten NABH 6th Edition chapter guides: AAC · COP · MOM · PRE · IPC · PSQ · ROM · FMS · HRM · IMS