Clean and Confident: Impact of Sterile Instrument Processing Workshops on Knowledge and Confidence in Five Low- and Middle-Income Countries

Shreckengost, Constance S Harrell; Starr, Nichole; Mammo, Tihitena Negussie; Gebeyehu, Natnael Atnafu; Tesfaye, Yonas; Belayneh, Kinfemichael; Tara, Mansi; Lima, Isabela Dantas de Araujo; Jenkin, Kitty; Fast, Christina; Weiser, Thomas

doi:10.1089/sur.2021.187

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…For the fourth modification, which involved instituting supplementary education to reinforce infection prevention standards, supplementary training on infection prevention standards was a critical part of improving practice in Ethiopia, where many IPC processes are nursing driven and fit with recommendations for other LMIC’s IPC programs . The available workshops on IPC standards, SSC adaptation and uptake, and surgical instrument reprocessing can now be delivered in a standardized fashion to all Clean Cut sites to close these knowledge and training gaps …”

Section: Discussionmentioning

confidence: 99%

Scalability and Sustainability of a Surgical Infection Prevention Program in Low-Income Environments

Starr,

Gebeyehu,

Nofal

et al. 2024

JAMA Surg

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ImportanceSurgical infections are a major cause of perioperative morbidity and mortality, particularly in low-resource settings. Clean Cut, a 6-month quality improvement program developed by the global nonprofit organization Lifebox, has demonstrated improvements in postoperative infectious complications. However, the pilot program required intense external programmatic and resource support.ObjectiveTo examine the improvement in adherence to infection prevention and control standards and rates of postoperative infections in hospitals in the Clean Cut program after implementation strategies were updated and program execution was refined.Design, Setting, and ParticipantsThis cohort study evaluated and refined the Clean Cut implementation strategy to enhance scalability based on a qualitative study of its pilot phase, including formalizing programmatic and educational materials, building an automated data entry and analysis platform, and reorganizing hospital-based team composition. Clean Cut was introduced from January 1, 2019, to February 28, 2022, in 7 Ethiopian hospitals that had not previously participated in the program. Prospective data initiated on arrival in the operating room were collected, and patients were followed up through hospital discharge and with 30-day follow-up telephone calls.ExposureImplementation of the refined Clean Cut program.Main Outcomes and MeasuresThe primary outcome was surgical site infection (SSI); secondary outcomes were adherence to 6 infection prevention standards, mortality, hospital length of stay, and other infectious complications.ResultsA total of 3364 patients (mean [SD] age, 26.5 [38.0] years; 2196 [65.3%] female) from 7 Ethiopian hospitals were studied (1575 at baseline and 1789 after intervention). After controlling for confounders, the relative risk of SSIs was reduced by 34.0% after program implementation (relative risk, 0.66; 95% CI, 0.54-0.81; P &lt; .001). Appropriate Surgical Safety Checklist use increased from 16.3% to 43.0% (P &lt; .001), surgeon hand and patient skin antisepsis improved from 46.0% to 66.0% (P &lt; .001), and timely antibiotic administration improved from 17.8% to 39.0% (P &lt; .001). Surgical instrument (38.7% vs 10.2%), linen sterility (35.5% vs 12.8%), and gauze counting (89.2% vs 82.5%; P &lt; .001 for all comparisons) also improved significantly.Conclusions and RelevanceA modified implementation strategy for the Clean Cut program focusing on reduced external resource and programmatic input from Lifebox, structured education and training materials, and wider hospital engagement resulted in outcomes that matched our pilot study, with improved adherence to recognized infection prevention standards resulting in a reduction in SSIs. The demonstration of scalability reinforces the value of this SSI prevention program.

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Section: Discussionmentioning

confidence: 99%

Scalability and Sustainability of a Surgical Infection Prevention Program in Low-Income Environments

Starr,

Gebeyehu,

Nofal

et al. 2024

JAMA Surg

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“…O Centro de Materiais e Esterilização (CME) é uma unidade responsável pelo suporte indireto aos pacientes, que realiza o processamento de produtos para saúde (PPS) utilizados em procedimentos cirúrgicos, ambulatoriais e assistenciais. Esse processo compreende diversas etapas, que incluem a pré-limpeza, a limpeza, a inspeção, o preparo, a desinfecção ou esterilização, o armazenamento e a distribuição 1,2 .…”

Section: Introductionunclassified

“…Ao considerar que prover materiais livres de contaminação no momento do uso é uma das medidas cruciais na prevenção de infecções, a etapa do preparo ganha destaque no processamento de PPS. Essa fase é responsável pela inspeção criteriosa da limpeza, pelos testes de funcionalidade dos instrumentais cirúrgicos e pela preparação dos itens, incluindo a escolha adequada da embalagem para garantir a manutenção da esterilidade [1][2][3][4] .…”

Section: Introductionunclassified

Construção e validação de cartilha educativa para o preparo de produtos para saúde

Santos,

Paiva,

De Faria

et al. 2024

Rev SOBECC

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Objetivo: Construir e validar uma cartilha educativa para o preparo de produtos para saúde pela equipe de Enfermagem no Centro de Materiais e Esterilização. Método: Estudo metodológico realizado em quatro etapas: diagnóstico situacional, revisão da literatura, construção da cartilha educativa e validação do conteúdo por seis juízes especialistas e 13 representantes do público-alvo. A análise de dados considerou o índice de validade de conteúdo acima de 0,80 e o teste exato de distribuição binomial com nível de significância de 5%. Resultados: O Índice de Validade de Conteúdo apresentou uma média de 0,99. Em relação ao público-alvo, a validação da cartilha educativa obteve pontuação que variou de 92,3 a 100% entre as seis categorias de avaliação. Conclusão: A cartilha foi validada e mostrou-se confiável para ser utilizada pela Enfermagem como uma ferramenta de educação voltada ao preparo de produtos para saúde.

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Improving mastery and retention of knowledge and complex skills among sterile processing professionals: A pilot study on borescope training and competency testing

Ofstead¹,

Smart²,

Hopkins³

et al. 2023

American Journal of Infection Control

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Clean and Confident: Impact of Sterile Instrument Processing Workshops on Knowledge and Confidence in Five Low- and Middle-Income Countries

Cited by 5 publications

References 14 publications

Scalability and Sustainability of a Surgical Infection Prevention Program in Low-Income Environments

Scalability and Sustainability of a Surgical Infection Prevention Program in Low-Income Environments

Construção e validação de cartilha educativa para o preparo de produtos para saúde

Improving mastery and retention of knowledge and complex skills among sterile processing professionals: A pilot study on borescope training and competency testing

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