Achieving Zero-Leak Infection Prevention: A Theory of Continuous Protection (TCP) Based on Embedded Real-Time Protection
The Theory of Continuous Protection or Soojeede’s Theory; A New Paradigm for 100% IPC
DOI:
https://doi.org/10.55544/ijrah.6.2.18Keywords:
Theory of Continuous Protection (TCP), Soojeede’s Theory, Infection Prevention and Control (IPC), Zero-Leak, Embedded MentorshipAbstract
Background: Healthcare-Associated Infections (HAIs) continue to pose a serious challenge to global health, highlighting the need to move beyond traditional oversight toward stronger, system-wide interventions. Although Infection Prevention and Control (IPC) practices are well established, the greatest obstacle to achieving full compliance lies in the “implementation gap”—the disconnect between knowing the correct protocols and consistently applying them at the bedside. The objective: The study proposes the Theory of continuous protection (TCP), Also referred to as Soojeede’s Theory (ST) which is a transformative framework to bridge the global implementation gap in infection prevention and control (IPC). This theory challenges traditional punitive auditing models and introduces a new way of continuous collaboration oversight, to achieve a zero-leak standard by integrating national governance and facility-level embedded mentorship. Framework: The TCP framework works on two connected level, national level – establish the necessary system through legislation, curriculum development within national health institute at Ministry of health, standardized professional certification, and defined staffing ratio (1 IPC professional per 69-100 beds). Facility-level execution Implementation is guided by seven pillar, first pillar is embedded co-working mentorship, where IPC professional function as daily partners and mentors rather than inspector. The remaining pillars include zone bio-segregation, automated reminders and visual life cycle tagging system, continuous supply chain and promotion psychological safety and family engagement. Conclusion: by Theory of continuous protection provides a practical roadmap for elimination of Healthcare Associated infections. It emphasized the normalization of Infection Prevention and Control as an intrinsic component of clinical practice rather than a documentation task. Furthermore, it redefines the role IPC professional’s role from enforcement agents to collaborative enablers, reinforcing the idea that infection control is continuous, living reality in healthcare system.
Downloads
References
Kassa, G., Ogongo, I., Rabkin, M., Bancroft, E., Mitchell, R., Block, L., Dennison, C., Katwesigye, E., Paulos, M., Hokororo, J., Kamau, I., & Herzig, C. (2025). The East Africa Infection Prevention and Control (IPC) Learning Network: An Approach to Improving IPC Competencies and Practices During the COVID-19 Pandemic, 2020–2023. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 81, 41 - 48. https://doi.org/10.1093/cid/ciaf245.
Abbas, S. (2024). The challenges of implementing infection prevention and antimicrobial stewardship programs in resource-constrained settings. Antimicrobial Stewardship & Healthcare Epidemiology : ASHE, 4. https://doi.org/10.1017/ash.2024.35.
Ademi, A., Qyra, S., Dika-Haxhirexha, F., Dogjani, A., Biberaj, P., & Haxhirexha, K. (2025). Contemporary Guidelines for the Treatment and Prevention of Nosocomial Infections: Critical Analysis and Practical Perspectives.. Albanian Journal of Trauma and Emergency Surgery. https://doi.org/10.32391/ajtes.v9i2.483.
Agreli, H. L., Murphy, M., Connor, Y., & Ramos, A. (2019). Dissonance between guidelines and reality in Irish acute care: An ethnographic study of infection prevention. Journal of Hospital Infection, 104(3), 298–305. https://doi.org/10.1016/j.jhin.2019.11.015
Alhumaid, S., Mutair, A., Alawi, Z., Alsuliman, M., Ahmed, G., Rabaan, A., Al-Tawfiq, J., & Al-Omari, A. (2021). Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review. Antimicrobial Resistance and Infection Control, 10. https://doi.org/10.1186/s13756-021-00957-0.
Allegranzi, B., & Pittet, D. (2009). Role of hand hygiene in healthcare-associated infection prevention. Journal of Hospital Infection, 73(4), 305–315. https://doi.org/10.1016/j.jhin.2009.04.019.
Asgedom, A. (2024). Status of infection prevention and control (IPC) as per the WHO standardised Infection Prevention and Control Assessment Framework (IPCAF) tool: existing evidence and its implication. Infection Prevention in Practice, 6. https://doi.org/10.1016/j.infpip.2024.100351.
Asghar, S., Atif, M., & Masood, I. (2025a). An Intersectional Analysis of Infection Prevention and Control Practices in Pakistan: A Nationwide Survey Based on the Infection Prevention and Control Assessment Framework.. American journal of infection control. https://doi.org/10.1016/j.ajic.2025.04.006.
Asghar, S., Atif, M., Masood, I., & Khan, M. (2025b). A comprehensive review of current status of infection prevention and control program in low- and middle-income countries.. Infection, disease & health. https://doi.org/10.1016/j.idh.2025.03.005.
Asif, N., & Hassan, K. (2023). Challenges for Infection Prevention and Control Practices in Hospital. Journal of Islamabad Medical & Dental College. https://doi.org/10.35787/jimdc.v11i4.936.
Barrera-Cancedda, A., Riman, K., Shinnick, J., & Buttenheim, A. (2019). Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: a systematic review. Implementation Science : IS, 14. https://doi.org/10.1186/s13012-019-0958-3.
Borodova, A., Diallo, A., Songbono, C., Rocha, C., Nabé, I., Marcis, F., Chérif, M., & Müller, S. (2025). Context specific challenges of the WHO infection prevention and control core components in the Faranah region: a mixed methods approach. Frontiers in Public Health, 13. https://doi.org/10.3389/fpubh.2025.1605425.
Chassin, M. R., & Loeb, J. M. (2013). High-reliability health care: Getting there from here. The Milbank Quarterly, 91(3), 459–490. https://doi.org/10.1111/1468-0009.12023.
Cissé, D., Laure, E., Blaise, K., Paul, N., Gbonon, M., Mayaka, C., Eugénie, G., Simplice, D., Philippe, K., & Mamadou, S. (2023). Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the autonomous district of Abidjan (Cote d’Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF). BMC Health Services Research, 23. https://doi.org/10.1186/s12913-023-09853-2.
Cohen, R., Gesser-Edelsburg, A., Singhal, A., Benenson, S., & Moses, A. (2022). Translating a theory-based positive deviance approach into an applied tool: Mitigating barriers among health professionals (HPs) regarding infection prevention and control (IPC) guidelines. PLoS ONE, 17. https://doi.org/10.1371/journal.pone.0269124.
Fujimoto, K., Utsumi, M., Swa, T., Furuya, A., Ikuji, A., Nakanishi, A., & Harada, N. (2025). The Multiple Determinants of Infection Prevention and Control Practices in Nursing Homes: A Scoping Review.. Journal of the American Medical Directors Association, 105593 . https://doi.org/10.1016/j.jamda.2025.105593.
Gilbert, G., & Kerridge, I. (2019). The politics and ethics of hospital infection prevention and control: a qualitative case study of senior clinicians’ perceptions of professional and cultural factors that influence doctors’ attitudes and practices in a large Australian hospital. BMC Health Services Research, 19. https://doi.org/10.1186/s12913-019-4044-y.
Gomes, D., Hazim, C., Safstrom, J., Herzig, C., Luvsansharav, U., Dennison, C., Ahmed, Y., Wesangula, E., Hokororo, J., Amone, J., Tekle, B., Owiso, G., Mutayoba, R., Lamorde, M., Akello, E., Kassa, G., Feleke, B., Ndegwa, L., Kazaura, K., Musisi, D., Date, A., Park, B., & Bancroft, E. (2022). Infection Prevention and Control Initiatives to Prevent Healthcare-Associated Transmission of SARS-CoV-2, East Africa. Emerging Infectious Diseases, 28, S255 - S261. https://doi.org/10.3201/eid2813.212352.
Havers, S., Martin, E., Wilson, A., & Hall, L. (2020). A systematic review and meta-synthesis of policy intervention characteristics that influence the implementation of government-directed policy in the hospital setting: implications for infection prevention and control. Journal of Infection Prevention, 21, 84 - 96. https://doi.org/10.1177/1757177420907696.
Havers, S., Russo, P., Page, K., Wilson, A., & Hall, L. (2019). Clinician perspectives of policy implementation: A qualitative study of the implementation of a national infection prevention policy in Australian hospitals. AJIC (American Journal of Infection Control), 47, 366–370. https://doi.org/10.1016/j.ajic.2018.09.029.
Kabego, L., Balde, T., Barasa, D., Ndoye, B., Hilde, O., Makamure, T., Mulumeoderwa, G., Kanyowa, T., Kamara, R., Hamadou, B., Ogundiran, O., Okeibunor, J., Williams, G., Tusiime, J., Atuhebwe, P., Oyugi, B., Mawanda, E., Razakamanantsoa, A., Braka, F., Chamla, D., & Gueye, A. (2023). Analysing the implementation of infection prevention and control measures in health care facilities during the COVID-19 pandemic in the African Region. BMC Infectious Diseases, 23. https://doi.org/10.1186/s12879-023-08830-8.
Kalule, A., Currie, K., & Price, L. (2025). Barriers and enablers to the implementation of infection prevention and control guidance in a Ugandan healthcare facility – a theory-informed qualitative study to guide intervention design. International Journal of Infection Control. https://doi.org/10.3396/ijic.v21.23768.
Khubrani, I. (2025). The Intersection of Public Health and Infection Control: An Integrated Review of Emerging Threats, Prevention Strategies, and Policy Responses in Global Health Systems. International Journal of Medical Toxicology and Legal Medicine. https://doi.org/10.47059/ijmtlm/v28i2s1/016.
Kirwan, M., Egan, E., & Matthews, A. (2025). Missed Nursing Care Infection Prevention and Control Practices in Acute Hospitals in Ireland During the COVID‐19 Pandemic. International Journal of Nursing Practice, 31. https://doi.org/10.1111/ijn.70062.
Lutkam, D., Konduri, N., Hokororo, J., Eliakimu, E., Alombah, F., Simba, S., Muiva, C., Ngowi, R., Bahegwa, R., Msigwa, Y., Schwarz, D., Lusaya, E., & Joshi, M. (2025). Multi-pronged system strengthening approach to improving infection prevention and control practices in Tanzania. Infection Prevention in Practice, 7. https://doi.org/10.1016/j.infpip.2025.100477.
Michie, S., Van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(1), 42. https://doi.org/10.1186/1748-5908-6-42
Nanyondo, S., Nakato, S., Franklin, J., Kwiringira, A., Malikisi, M., Kesande, M., Wailagala, A., Suubi, R., Byonanebye, D., Katwesigye, E., Katongole, P., Kasule, J., Bayo, L., Kasendwa, M., Musisi, D., Hunter, J., Oakley, L., Dennison, C., Ndegwa, L., Tompkins, L., Gupta, N., Bahatungire, R., Willet, V., Kolwaite, A., Zalwango, S., Bancroft, E., Mearns, S., & Lamorde, M. (2025). Implementation of an infection prevention and control response strategy to combat the Sudan Virus Disease outbreak in an urban setting, the Kampala Metropolitan area, Uganda, 2022. BMC Infectious Diseases, 25. https://doi.org/10.1186/s12879-025-10720-0.
Nasim, A. (2025). Infection prevention and control assessment by the Government: A crucial step. Infectious Diseases Journal of Pakistan. https://doi.org/10.61529/idjp.v34i2.421.
Ng'ambi, D., O’byrne, T., Jingini, E., Chadwala, H., Musopole, O., Kamchedzera, W., Tancred, T., & Feasey, N. (2024). An assessment of infection prevention and control implementation in Malawian hospitals using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool. Infection Prevention in Practice, 6. https://doi.org/10.1016/j.infpip.2024.100388.
Nyantakyi, E., Baenziger, J., Caci, L., Blum, K., Wolfensberger, A., Dramowski, A., Albers, B., Castro, M., Schultes, M., & Clack, L. (2025). Investigating the implementation of infection prevention and control practices in neonatal care across country income levels: a systematic review. Antimicrobial Resistance and Infection Control, 14. https://doi.org/10.1186/s13756-025-01516-7.
Pronovost, P. (2008). Interventions to decrease catheter-related bloodstream infections in the ICU: the Keystone Intensive Care Unit Project. American journal of infection control, 36(10), S171-e1.
Puro, V., Coppola, N., Frasca, A., Gentile, I., Luzzaro, F., Peghetti, A., & Sganga, G. (2022). Pillars for prevention and control of healthcare-associated infections: an Italian expert opinion statement. Antimicrobial Resistance and Infection Control, 11. https://doi.org/10.1186/s13756-022-01125-8.
Rezaee, N., Sartipi, M., Jahantigh, M., Pezaro, S., & Mardani-Hamooleh, M. (2025). Barriers to the prevention and control of healthcare-associated infections in public hospitals: a qualitative study of Sistan and Baluchistan province, Iran. BMC Nursing, 24. https://doi.org/10.1186/s12912-025-03650-4.
Sonpar, A., Hundal, C., Totté, J., Wang, J., Klein, S., Twyman, A., Allegranzi, B., & Zingg, W. (2025). Multimodal strategies for the implementation of infection prevention and control (IPC) interventions - update of a systematic review for the WHO guidelines on core components of IPC programmes at the facility level.. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. https://doi.org/10.1016/j.cmi.2025.01.011.
Steinecker, H. W. (2025). Challenges and Strategies of Implementing the World Health Organization Infection Control Protocols in Rural Ugandan Hospitals (Doctoral dissertation, The Medical College of Wisconsin).
Storr, J., et al. (2017). Core components of infection prevention and control programmes: A WHO evidence-based recommendations. Antimicrobial Resistance & Infection Control, 6(1), 6. https://doi.org/10.1186/s13756-016-0161-9
Tartari, E., Tomczyk, S., Pires, D., Zayed, B., Rehse, A., Kariyo, P., Stempliuk, V., Zingg, W., Pittet, D., & Allegranzi, B. (2020). Implementation of the infection prevention and control core components at the national level: a global situational analysis. The Journal of Hospital Infection, 108, 94 - 103. https://doi.org/10.1016/j.jhin.2020.11.025.
Tomczyk, S., Twyman, A., de Kraker, M. E., Rehse, A. P. C., Tartari, E., Toledo, J. P., ... & Allegranzi, B. (2022). The first WHO global survey on infection prevention and control in health-care facilities. The Lancet Infectious Diseases, 22(6), 845-856.
Tomczyk, S., Storr, J., Kilpatrick, C., & Allegranzi, B. (2021). Infection prevention and control (IPC) implementation in low-resource settings: a qualitative analysis. Antimicrobial Resistance and Infection Control, 10. https://doi.org/10.1186/s13756-021-00962-3.
Trivedi, K., Schaffzin, J., Deloney, V., Aureden, K., Carrico, R., Garcia-Houchins, S., Garrett, J., Glowicz, J., Lee, G., Maragakis, L., Moody, J., Pettis, A., Saint, S., Schweizer, M., Yokoe, D., & Berenholtz, S. (2023). Implementing strategies to prevent infections in acute-care settings. Infection control and hospital epidemiology, 44, 1232 - 1246. https://doi.org/10.1017/ice.2023.103.
Wang, J., Liu, F., Tan, J., Harbarth, S., Pittet, D., & Zingg, W. (2019). Implementation of infection prevention and control in acute care hospitals in Mainland China – a systematic review. Antimicrobial Resistance and Infection Control, 8. https://doi.org/10.1186/s13756-019-0481-y.
Weir, L., Chandonnet, C., Ormsby, J., & Vaughan-Malloy, A. (2022A). Determining Infection Prevention Staffing for Pediatric Ambulatory and Procedural Setting. American Journal of Infection Control. https://doi.org/10.1016/j.ajic.2022.03.115.
Wood, R., Tembele, W., Hema, A., Somé, A., Kinganda-Lusamaki, E., Basilubo, C., Lumembe, R., Alama, N., Mbunsu, G., Zongo, A., Ahuka, S., Muyembe, J., Leendertz, F., Eckmanns, T., Schubert, G., Kagoné, T., Makiala, S., & Tomczyk, S. (2024). Implementation of the WHO core components of an infection prevention and control programme in two sub-saharan African acute health-care facilities: a mixed methods study. Antimicrobial Resistance and Infection Control, 13. https://doi.org/10.1186/s13756-023-01358-1.
World Health Organization. (2016). Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. https://doi.org/10.1016/S1473-3099(16)30513-3
Yilma, M., Taye, G., Tefera, M., Tassew, B., Fentie, A., & Abebe, W. (2024). Exploring barriers to and facilitators of infection prevention and control practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital, Ethiopia. Antimicrobial Resistance and Infection Control, 13. https://doi.org/10.1186/s13756-024-01475-5.
Zimba, M., Dorothy, C., Mulubwa, C., & Ngoma-Hazemba, A. (2022). Infection Prevention and Control practices; an exploratory qualitative study of experiences of health care providers and support staff at the University Teaching Hospital, Lusaka, Zambia. . https://doi.org/10.1101/2022.03.23.22269760.
Zimmerman, P., & Mason, M. (2025). A scoping review of published reports of the infection prevention and control assessment framework: a comparison to the findings of the global report on infection prevention and control. International Journal of Infection Control. https://doi.org/10.3396/ijic.v21.23806.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Mohamed Ibrahim Abdi - Soojeede
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
10.55544/ijrah
editor@ijrah.com | 
+91-8874396939
This work is licensed under a 