Organizational Structure
Organizational Structure
Introduction
Infection control (IC) is a necessary component of safe, high quality patient care
and is essential for the well being of the patients and of the staff. The
fundamentals of infection control are applicable across all settings where health
care is being provided throughout the world. These fundamentals need to be
employed regardless of constraints in resources and support, as they are
designed to protect the patient and provider against exposure to infectious
microorganisms and against the morbidity and mortality associated with these
agents if infection occurs.
In order to achieve reduction in infection rates among patients and staff, an
infection control program has to develop a clear and firm organizational structure.
As a first step, the infection control program needs to establish the appropriate
organizational structure within each level of the health care system and to have
defined roles and responsibilities for key personnel. This organizational structure
is an essential component to the success of any public health program. Each
level of the infection control program, from the person(s) charged with
administrative support to the direct care provider at the patient bedside, should
share in the overall responsibility of preventing infection. The hierarchy of the
infection control program in Egypt is presenting all levels of health care e.g. the
national, governorate, district, and hospital facility levels.
National Level
There are two groups supervising the implementation of the infection control
program at the national level:
National Infection Control Advisory Committee (NIC-AC)
Central Infection Control Unit (ICD)
National Infection Control Advisory Committee (NIC-AC)
This is a generic committee that should advise all staff of infection control at
central level. It is headed by H.E. Minister of Health and Population.
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Organizational Structure
Personnel
Chairman
Minister of Health and Population
Members
 Director of Primary Health Care & Preventive Sector
Director of Preventive affairs
Director of Curative department
Director of Central Laboratory
Director of Dentistry
Director of Primary health care
Director of Family planning
Director of Pharmacy
Director of Nursing
Director of Free treatment (Private Sector )
Head of Central Infection Control Unit (MOHP)
Director of Medical supply
Representative from the Medical Syndicate
VACSERA
Representative from University Hospitals
Representative from GOTHI
Representative from Health Insurance Organization
Representative from Military hospitals
Representative from Police hospitals
Representative from Environmental Affairs
Representative from WHO
Terms of reference
Approve the national plan for the program of promotion of infection control
Approve standards for infection control practices
Approve annual plan submitted by representatives
Liaison to legislation
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Organizational Structure
Raise funds
Accreditation in cooperation with independent team
Collaboration (Coordination/Advocacy/Partnership with MOHP – (Internal
and External)
Meetings and Minutes
The national infection control advisory committee (NIC-AC) will meet at least
twice annually. Additional meetings of full or partial membership may be called by
the Chairman as indicated by current concerns, problems, or important issues.
Subcommittees or task forces will be scheduled to meet by the respective
chairperson. Establishment of the meeting schedules allow for routine review,
evaluation, and discussion of infection control issues and to provide support and
guidance to the Central Infection Control Unit (CICU) staff.
Infection Control Department(ICD)
The ICD is under the umbrella of the Preventive affairs department and will be
responsible for planning, supervision and monitoring of all activities related to
implementation of infection control program in all MOHP facilities in all
governorates in Egypt. The ICD reports to the head of preventive affairs.
Personnel
Chairman
An epidemiologist with a postgraduate degree of public health, epidemiology
or equivalent
Members
Medical epidemiologist (5)
Sanitarians (2)
Infection control nurse (1)
Microbiologist (if available)
Statistician
IT (if available)
Terms of reference:
Prepare national plan for the program of promotion of infection control
Supervise implementation of the plan and training in all governorates
Problem solving
Ensure availability of required supplies and equipment
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Organizational Structure
Develop a system for surveillance of nosocomial infections in all levels of
health care facilities and follow up this system
Inspection of facilities
Coordination/Advocacy between different partners interested in infection
control
Feed back to the governorate infection control units
Prepare bi-annual progress reports to the head of preventive affairs
Required resources for implementation
Office in the MOHP
Unit staff members
Staff training
Procure equipment (computers, printer, phone line, fax)
Meetings and minutes
The members of the ICD will meet on monthly basis. Minutes should be made
available and submitted to the NIC-AC upon request.
Governorate Level
Governorate Infection Control Advisory Committee (GICAC)
This is a committee that guides advise all staff of infection control at governorate
level. It has almost the same responsibilities as the NIC-AC but focuses on
implementation. This committee report to the ICD and has direct authority over
the Governorate Infection Control Unit (GIC-U).
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Organizational Structure
Personnel
Chairman
First Undersecretary or General director of health directorate at governorate
level
Members
Director of preventive affairs
Director of curative department
Director of primary health care
Director of child and maternal Health
Director of laboratories
Director of dentistry
Director of blood banks
Director of free treatment sector (Private sector)
Director of pharmacy
Director of medical supply
Director of nursing
Head of Governorate Infection Prevention Unit (GIC-U)
Terms of reference for GIC-AC:
Supervise all activities implemented by the GIC-U
Monitor progress of GIC-U
Mobilize resources at governorate level to support infection prevention.
Problem Solving
Approve standards for infection control practice
Approve annual plan submitted by the GIC-U
Collaboration Coordination Advocacy Partnership with other stakeholders
Approve annual reports submitted by GIC-U and submit them to the ICD
Support training of staff
Distribute Infection Control guidelines to Committees of HCF
Meetings and minutes
Meet at least twice annually and keep minutes for all meetings
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Organizational Structure
Governorate Infection Control Unit (GIC-U)
This unit is responsible for implementation of the infection control activities in the
whole governorate. It works with close collaboration and guidance of the CICU.
GIC-AC has direct authority over the District and Facility Infection Control
Advisory Committees (DIC-ACs and FIC-ACs).
Personnel
Chairman
Full time epidemiologist preferably with a postgraduate degree of public health,
epidemiology or equivalent
Members
Medical epidemiologist (1)
Sanitarian (1)
Infection control nurse (1)
Microbiologist (if available)
Statistician
IT (if available)
Terms of reference:
Develop-governorate level annual plan for infection control program based
on governorate needs.
Supervision, monitoring, and evaluation of infection control activities inside
health care facilities in the governorate.
Problem solving
Ensure availability of required supplies and equipment at governorate level
Request and assist in Outbreak investigations in health care facilities/
Follow-up and interpretation of surveillance data
Inspection of facilities (needs tools for inspection)
Submit request for resources
Develop annual training plans for infection control for governorate wide
expansion of the program.
Coordination /Advocacy
Feed back to the infection control committees and teams at facility level.
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Organizational Structure
Prepare bi-annual progress reports to be submitted to the GIC-AC and ICD
Report any problems or constraints to the GIC-AC and the ICD,
Needs to establish an GICU required resources for implementation
Office in the health directorate
Identifying staff for the unit
Training of staff
Purchasing equipment (computer, printer, phone line, fax)
Meetings and minutes
The members of the GICU will meet on monthly basis. Minutes should be made
available and submitted to the GIC-AC and ICD upon request.
District Level
District Infection Control Committee (DIC-C)
At the district level only an infection control committee will be formed. This
committee reports to the GIC-U and has supervision and implementation
responsibilities to infection control staff in facilities with no beds or with less than
30 beds.
Personnel
Chairman
Director of health district
Members
Deputy director of health district
Director of preventive affairs
Director of primary health care
Director of free treatment sector
Director of Dentistry
Director of Laboratory
Director of nursing
Health educator
Sanitarian supervisor
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Organizational Structure
Terms of reference
Implement recommendations of the GIC-U
Coordinate or implement training of Infection Control staff in primary health
care facilities and health care facilities with less than 30 beds or no beds.
Develop plan for supervision and monitoring of infection control practices in
all primary care facilities
Oversee, supervise and monitor all activities of infection control by
inspection of facilities (mainly primary care facilities)
Problem solving in primary health care facilities with less than thirty beds or
with no beds.
Ensure availability of supplies and equipment needed for infection control
Report to GIC-U every 3 months
Meetings and minutes
The DIC-AC will meet every 3 months. Minutes should be kept and sent regularly
to the GIC-U.
Health Facility Level
The hospital director should be responsible for ensuring that appropriate
arrangements (IC professionals and appropriate IC program infrastructure) are in
place for effective infection control.


In large health facilities (more than 30 beds) two groups should be formed:

Infection Control committees (IC-committees)

Infection Control teams (IC-team)
In hospitals of less than 30 beds and in primary care facilities with no
beds:

Infection Control committees (IC-committees)

Infection Control nurse
Hospital Infection Control Committees (IC-Committees)
Hospital Infection Control committees should be developed in any health care
facility in Egypt. The IC-committee should be made up of key personnel from the
various health facility departments. It should act as a liaison between
departments that are responsible for patient care and departments responsible
for support (nursing, medicine, pharmacy, central store, engineering, etc).
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Organizational Structure
Infection Control Committees In Primary Health Care
Facilities
They should be developed in all primary health care facilities that have no beds
or less than 30 beds. It will be limited in number according to available staff.
Personnel
Chairman

The director of the facility or his Deputy
Members

Three directors of clinical departments

The head nurse

All members of the infection control team in facilities that have more
than 30 beds

Director of the pharmacy

Director of the medical supply unit

The financial and administrative director of the hospital

Others as appropriate, e.g., occupational health
microbiology laboratory professional, surgeon, etc.
specialist,
Note:
All infection control committees at all levels should consist of the staff available
from those listed above. The committee has the right to invite any other eligible
members.
Roles and Responsibilities of the IC-com
 To approve the annual plan for infection control at the level of the facility.

To approve the infection control policies in the facility.

To support the IC-teams and to direct resources to address problems as
identified.

To ensure availability of appropriate supplies needed for IC at the facility
level.

To facilitate and to support the training of the staff.

To encourage communication among the involved disciplines and among the
different departments in the facility.
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Organizational Structure

To report outbreaks of nosocomial infections in the facility to the governorate
IC-unit.

Participate in outbreak investigations of nosocomial infections.

To submit monthly reports to the governorate IC-unit.
Meetings and minutes:
Meetings should occur once every 3 months and minutes should be widely
distributed to staff, with a request for feedback to the committee.
Hospital infection control committees should report to the GIC-U
PHC infection control committees should report to the DIP-U
Health Care Facility Infection Control Team
Infection Control team should be established in each health care facility that have
more than 30 beds. The Infection Control team should have the authority to
manage an effective infection control program and should have full support from
the director of the health facility. While in PHC facilities with no beds or with less
than 30 beds an infection control nurse should be assigned to be responsible for
implementation of infection control activities within the facility.
IC-team Personnel
The IC team should include a doctor and a nurse for the facility with 150 beds (or
less). In facilities with more than 150 beds, the team is formed of a doctor and
two nurses. All members of the team should be full-time employees dedicated to
infection control activities. Some nurses, called “link nurses” or “representatives”
affiliated with various departments should be assigned to the IC teams. The
infection control nurse in PHC facilities may not be a full timer for infection
control.
Team Leader

Infection control doctor ( a clinician, epidemiologist or a microbiologist )
Members
 Infection control nurses
Roles and responsibilities of the Infection Control team

To prepare an annual action plan for implementation of the Infection Control
Program and to get approval from the IC-committee.

To implement a plan to ensure safety of practices.

To advise the staff on all aspects of infection control needed to maintain a
safe environment for patients and for staff.
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Organizational Structure

To supervise and to monitor daily practices of patient care designed to
prevent infection.

To formulate infection control policies within the health facility.

To develop surveillance program for nosocomial infection.

To identify problems in the implementation of infection control activities which
need to be solved or transferred to the hospital IC-committee.

To develop an annual training plan for the health care workers and to submit
this plan to the hospital IC-committee for approval.

To implement the infection control training activities within the health facility.

To ensure availability of supplies and equipment needed for infection control.

To report outbreaks to the IC-committee and to investigate outbreaks with the
health care facility.

To submit reports on activities to the IC-committee every 3 months.
Meetings and minutes:
The team should meet regularly on daily basis to discuss relevant issues. A
standing agenda may include updates on surveillance, including clusters of
infections or outbreaks, observations of IC practice, policy review or revisions
status of educational efforts, and follow-up on any problems identified, e.g.,
supply/equipment issues. Minutes should be prepared for all meetings. Also, any
regulations or rules that are discussed that will facilitate the monitoring of the
activities of the wards and the departments should be widely distributed.
Feedback from the ward staff should be encouraged.
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Organizational Structure
Nursing Representatives or “Link Nurses”
Nursing representatives work in the different wards of the hospital and act as a
liaison between the Infection Control team and all of the staff of the department
or ward. Preferably, this nurse should be the head nurse of the department.
Examples of link nurse role or liaisons for the IC program have been published. 14
Responsibilities of the nursing representative:
 To convey the recommendations of the Infection Control team to the staff of
the ward and to send feedback to the Infection Control team.

To ensure implementation of infection control activities in the Link Nurses’
department.

To be responsible for reporting any infections in the department.
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Organizational Structure
Fig. 4: Organizational Structure
NIC-AC :
ICD
:
National Infection Control Advisory Committee
Infection Control Department
GIC-AC:
Governorate Infection Control Advisory Committee
GIC-U :
Governorate Infection Control Unit
DIC-C :
District Infection Control Committee
HIC-AC:
Hospital Infection Control Advisory Committee
ICT:
Infection Control Team
PHC IC-AC:
Primary Health Care Infection Control Advisory Committee
ICO
Infection Control Officer
:
Direct authority
Reporting
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