Adherence to infection control practices in relation to neonatal care in major hospitals in a district of Sri Lanka

Abstract

Introduction: Adherence to infection control practices are crucial for neonatal care.Objectives: To describe the adherence to clean birth and postnatal care practices by healthcare workers in selected procedures in major hospitals in a district of Sri Lanka Methods:This was a qualitative observational study. The study sample comprised healthcare workers (doctors, nurses and midwives) attached to the labour room (LR), postnatal ward (PNW), neonatal intensive care unit (NICU) and operating theatre (OT). A total of 70 healthcare workers from the LR, 90 from the PNW, 50 from the NICU and 60 from the OT were assessed in relation to each procedure they carried out. Four checklists were used to record the observations on infection control standards. The performance of each healthcare worker for each specific procedure was observed only once. Results:Hand washing practices among the healthcare workers in LR, NICU, PNW and OT varied, with better practices seen in NICU and PNW. Recapping of the needles was done by 18.6%, 18.0% and 31.2% in LR, NICU and PNW, respectively. Disposal of sharps to the bin was done by almost all healthcare workers in the LR, NICU and PNW, respectively. All the healthcare workers used 70% alcohol to disinfect the skin, of whom the majority used povidone iodine when drawing blood samples for blood culture in the NICU. Changing or washing gloves before cutting the umbilical cord was observed in the majority of healthcare workers in LR and the minority in OT. Conclusions:Adherence to infection control standards by healthcare workers in observed procedures was not up to the standard.

The use of gloves by the nursing team in a hospital environment

“…It was observed in this study that in view of 396 opportunities to use gloves, only one (0.25%) of them occurred in agreement with all the necessary steps, including the correct hand hygiene. This low adherence to HH by nursing professionals is corroborated by the literature in several countries (8,(12)(13) .…”

“…In Sri Lanka, a research (13) that aimed to describe adherence to infection control practices in relation to neonatal care by nursing team and physicians, found that HH before the use of gloves was performed by 33.3% of professionals in the operating room (before handling neonates) and 57.1% in the delivery room, unlike those working in the Neonatal Intensive Care Unit, in which the percentage was quite satisfactory, 96%. Despite the knowledge about the stages and the importance of HH seem to be something well established for the nursing team, other factors can influence, such as an intensive care environment, which can give the professionals who work in it the false impression that HH is more necessary as it is an imminent risk sector.…”