Infection control is everyone’s business

Weaving, Paul; Cooper, Tracey

doi:10.7748/nm.12.10.18.s14

Cited by 7 publications

(4 citation statements)

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“…Adherence and consistency in use of infection prevention strategies have been shown to minimize healthcare associated infection risks by 27% to 81% based on the country’s TB incidence [ 14 ] and reduce the frequency of pseudo-outbreaks [ 15 ]. According to internationally agreed standards, IPC practices should include: rapid clinical evaluation (TB-triage) of all persons (staff, patients and visitors) with symptoms suggestive of TB, segregation of patients with known or suspected pulmonary TB, use of effective local exhaust ventilation in connection with high-risk procedures, staff training, and ongoing risk assessment [ 16 ]. These measures emphasize the need for the implementation and adherence to infection control strategies which could reduce the number of staff and other patients who come into contact with aerosolized Mycobacterium tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis infection among health care workers: a case series in two district hospitals, Kenya, August 2013

Kanyina¹,

Boru²,

Mucheru³

et al. 2017

Pan Afr Med J

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Introductionhealth care workers (HCWs) have an increased risk of M. tuberculosis infection and tuberculosis (TB) disease compared to the general population. We evaluated the magnitude of TB disease among HCWs in two District Hospitals in Kenya.Methodsretrospective review of TB laboratory registers was performed at Makindu and Kiambu district hospitals. Cases were HCWs with confirmed TB diagnosis working at either hospital from 2010 to 2013. Cases were interviewed using structured questionnaire to collect clinical and epidemiologic information. Infection prevention (IP) practices were observed and recorded.ResultsMakindu and Kiambu had 91 and 450 HCWs respectively. As from the registers, 6,275 sputum smears were examined with 1,122 (18%) acid alcohol fast bacilli smear positive. Kiambu and Makindu reported 11 and five cases of TB among HCWs respectively. Of the 16, 57% were male; mean age was 45 (SD 5.32) years. HCWs affected were: four (25%) laboratory technicians, four (25%) nurses, two (13%) occupation therapists, two (13%) clinical officers and one pharmacist, telephone operator, driver and casual worker. Mean working time lost recuperating was 14 (range: 0-28) weeks. Both facilities lacked high-efficiency particulate air filters and Kiambu hospital lacked a biosafety cabinet too. Windows at both facilities were often closed and suspected TB patients shared common crowded outpatient waiting area where sputum was also collected. No standard reporting tool for TB disease among HCWs was in place at both facilities.ConclusionTB disease was distributed across professional cadres with long working time lost recuperating. Inadequate IP measures exposed HCWs to occupational risk of acquiring TB disease.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis infection among health care workers: a case series in two district hospitals, Kenya, August 2013

Kanyina¹,

Boru²,

Mucheru³

et al. 2017

Pan Afr Med J

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“…Healthcare workers cannot be blamed for applying inconsistent TB-IPC measures when appropriate, accessible and clear guidelines are not implemented, monitored and evaluated. According to our experiences, and in line with internationally agreed standards, IPC practices should include: rapid clinical evaluation (TB-triage) of all persons (staff, patients and visitors) with symptoms suggestive of TB, segregation of patients with known or suspected pulmonary TB, use of effective local exhaust ventilation in connection with high-risk procedures, employee training, and ongoing risk assessment [28]. Especially participants from wards without TB-routine complained that patients were managed inadequately with regard to TB.…”

Section: Discussionmentioning

confidence: 99%

TB infection prevention and control experiences of South African nurses - a phenomenological study

2011

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BackgroundThe tuberculosis (TB) epidemic in South Africa is characterised by one of the highest levels of TB/HIV co-infection and growing multidrug-resistant TB worldwide. Hospitals play a central role in the management of TB. We investigated nurses' experiences of factors influencing TB infection prevention and control (IPC) practices to identify risks associated with potential nosocomial transmission.MethodsThe qualitative study employed a phenomenological approach, using semi-structured interviews with a quota sample of 20 nurses in a large tertiary academic hospital in Cape Town, South Africa. The data was subjected to thematic analysis.ResultsNurses expressed concerns about the possible risk of TB transmission to both patients and staff. Factors influencing TB-IPC, and increasing the potential risk of nosocomial transmission, emerged in interconnected overarching themes. Influences related to the healthcare system included suboptimal IPC provision such as the lack of isolation facilities and personal protective equipment, and the lack of a TB-IPC policy. Further influences included inadequate TB training for staff and patients, communication barriers owing to cultural and linguistic differences between staff and patients, the excessive workload of nurses, and a sense of duty of care. Influences related to wider contextual conditions included TB concerns and stigma, and the role of traditional healers. Influences related to patient behaviour included late uptake of hospital care owing to poverty and the use of traditional medicine, and poor adherence to IPC measures by patients, family members and carers.ConclusionsSeveral interconnected influences related to the healthcare system, wider contextual conditions and patient behavior could increase the potential risk of nosocomial TB transmission at hospital level. There is an urgent need for the implementation and evaluation of a comprehensive contextually appropriate TB IPC policy with the setting and auditing of standards for IPC provision and practice, adequate TB training for both staff and patients, and the establishment of a cross-cultural communication strategy, including rapid access to interpreters.

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“…The much‐repeated mantra that infection prevention and control (IPC) is “everyone's business” is frequently understood to include not only staff of all roles and grades, but also patients and their relatives, all of whom are seen as stakeholders with a part to play in achieving IPC goals. There is limited evidence, however, about how staff feel about working together with patients and relatives to co‐produce that environment, or the specific challenges that staff perceive in relation to involving patients in IPC.…”

Section: Introductionmentioning

confidence: 99%

Making infection prevention and control everyone's business? Hospital staff views on patient involvement

Sutton

Brewster

Tarrant

2019

Health Expectations

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Context Ensuring an infection‐free environment is increasingly seen as requiring the contribution of staff, patients and visitors. There is limited evidence, however, about how staff feel about collaborating with patients and relatives to co‐produce that environment. Aims This study aims to understand how hospital staff perceive the involvement of patients and relatives in infection prevention and control (IPC) and the main challenges for staff in working together with patients and relatives to reduce the threat of infection. Methods Qualitative semi‐structured interviews were conducted with 35 frontline health‐care professionals and four executive staff, from two hospital trusts. Findings We found that staff were more supportive of approaches that encourage co‐operation from patients and relatives, than of interventions that invoked confrontation. We identified challenges to involvement arising from staff concerns about shifting responsibility for IPC onto patients. Staff were not always able to work with patients to control infection risks as some patients themselves created and perpetuated those risks. Conclusions Our work highlights that IPC has particular features that impact on the possibilities for involving patients and relatives at the point of care. Staff acknowledge tensions between the drive to involve patients and respect their autonomy, and their duty to protect patients from risk of unseen harm. The role that patients and relatives can play in IPC is fluctuating and context dependent. Staff responsibility for protecting patients from the risk of infection may sometimes need to take priority over prerogatives to involve patients and relatives in the co‐production of IPC.

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Infection control is everyone’s business

Cited by 7 publications

References 0 publications

Tuberculosis infection among health care workers: a case series in two district hospitals, Kenya, August 2013

Tuberculosis infection among health care workers: a case series in two district hospitals, Kenya, August 2013

TB infection prevention and control experiences of South African nurses - a phenomenological study

Making infection prevention and control everyone's business? Hospital staff views on patient involvement

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