Knowledge, Attitude, and Practices of Healthcare Personnel Regarding the Transmission of Pathogens via Fomites at a Tertiary Care Hospital in Karachi, Pakistan

Diwan

et al. 2018

IJERPH

Background: Health care-associated infections (HAIs) result in treatment delays as well as failures and financial losses not only to patients but also to the treating hospital and overall health-care delivery system. Due to hospital-acquired infections, there are problems of increase in morbidity and mortality, additional diagnostic and therapeutic interventions and ultimately antimicrobial resistance. Proper understanding among health-care workers about the ill effects of HAIs is very important to address this issue. The present study is a qualitative exploration aimed at understanding various aspects of hospital environmental hygiene and Infection prevention control program, by exploring the staff perception regarding the challenges, facilitators and barriers as well as feasible measures towards improvement in a rural tertiary teaching hospital in central India. Method: A qualitative study was conducted using 10 focus group discussions (FGDs) among five different professional groups, which included hospital administrators, doctors, nurses, environmental cleaning staff, and undergraduate medical students. The FGD guide included the following topics: (1) opinion about the status of cleanliness, (2) concepts and actual practices prevailing of hospital environmental hygiene, (3) Barriers, constraints, and problems in maintaining hospital environmental hygiene, (4) Suggestions for improvements. The data were analyzed manually using the content (thematic) analysis method. Results: Two themes were identified: Theme 1: “Prevailing practices and problems related to hospital surface/object contamination and hospital infection control”. Theme 2: “Measures suggested for improving hospital cleanliness within the existing constraints”. The participants emphasized the influence of resource constraints and needed inputs. They brought up the consequent prevailing practices and problems related, on one hand, to various stakeholders (service consumers, hospital personnel including the management), on the other, to specific infection prevention and control processes. They also suggested various measures for improvement. Conclusions: The study has revealed prevailing practices, problems, and suggested measures related to hospital environmental hygiene, particularly hospital cleanliness and HAI prevention and control processes. These insights and assertions are important for developing future behavioral and structural interventions in resource-limited settings. This study recommends a nationwide reliable HAI surveillance system and a robust infection prevention and control program in each health-care institution.

Section: Discussionsupporting

confidence: 90%

“…Several earlier studies conducted in the resource-limited institutions mostly belonging to the LMICs have reported practices similar to our findings [ 34 , 35 , 36 , 37 , 38 ], which are in sharp contrast to a study from a resource-rich institution in north India [ 27 ].…”

Section: Discussionsupporting

confidence: 76%

“How Can the Patients Remain Safe, If We Are Not Safe and Protected from the Infections”? A Qualitative Exploration among Health-Care Workers about Challenges of Maintaining Hospital Cleanliness in a Resource Limited Tertiary Setting in Rural India

Diwan

et al. 2018

IJERPH

“…Similar microorganisms were encountered by health professionals in other studies. 2,13,14 The mode of transmission of Nosocomial Infections cited by medical professionals was direct contact with patients and staff, aerosols from patients, unsterile instruments and fomites. All doctors were aware of universal safety precautions and believed that Nosocomial Infections are a major concern to them in their respective practice and also agreed for its inclusion in Medical education syllabus.…”

Section: Discussionmentioning

confidence: 99%

Knowledge and Practices of Health Care Professionals With Regard to Nosocomial Infections at a Medical College at Goa, India- A Cross-Sectional Study

Dhupdale¹,

Singh²,

Cacodcar³

2019

jemds

BACKGROUND Nosocomial infections (NI) are acquired during hospitalization which are not present at the time of admission to a hospital. Present study is aimed at bridging this knowledge gap which will benefit the policy makers to safeguard health of professionals and patients. MATERIALS AND METHODS A cross-sectional study was conducted on a purposive sample of 100 doctors. The data was obtained in the form of selfadministered questionnaire. RESULTS All participants were familiar with NI. UTI (28%) was reported as commonest NI. Pseudomonas (28%) was identified as commonest causative agent of NI. 94% medical professionals believed that they need training in NI. 78% of medical professiona ls reported regular hand washing before and after examination of patient. CONCLUSION Doctors who participated in study had excellent knowledge about the NI. Some deficiencies in the practices such as not ensuri ng sterile conditions, exiting operation room along with sterile footwear were of concern.

“…In this regard, the stethoscope, which is universally used as a medical device by healthcare workers, is more likely to be contaminated by microorganisms, if it is not disinfected and may transmit pathogens from one patient to another [14–19]. For this reason, regular cleaning with a suitable disinfectant is decisive and part of a multi-barrier strategy to prevent HCAIs; since failure to properly disinfect or sterilize equipment carries not the only risk associated with breach of host barriers but also risk for person-to-person transmission and transmission of environmental pathogens (e.g., Pseudomonas aeruginosa ) [14, 20].…”

Section: Introductionmentioning

confidence: 99%

Stethoscope disinfection is rarely done in Ethiopia: What are the associated factors?

Sahiledengle

2019

PLoS ONE

Introduction The stethoscope, which is non-critical medical devices and a symbol of healthcare, is likely to be contaminated by pathogenic microorganisms and can play a contributory role in the transmission of hospital-acquired infection. And regular cleaning of the diaphragm of the stethoscope with a suitable disinfectant is decisive. However, in the resource-constrained setting like many healthcare facilities in Ethiopia healthcare provider’s stethoscope disinfection practice and its associated factors have not been well studied so far. Therefore, this study sought to determine stethoscope disinfection practice and associated factors among the healthcare providers in Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study was carried out between April and May 2016. For this study, 576 healthcare providers (physicians, health officers, nurses, midwives, and anesthesiologist) were included from 21 healthcare facilities in Addis Ababa. A pre-tested structured questionnaire was used for data collection. Descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were used to identify factors that were significantly associated with stethoscope disinfection after every use. Results A total of 546 healthcare providers participated in this study, for a response rate of 94.7%. Two-fifths, 39.7% (95%CI: 35.9, 44.0%) of healthcare providers disinfecting their stethoscope after every use. And a significant number of participants 34.6% (95%CI: 30.8, 38.5%) never disinfect their stethoscope. Three out of four (76.0%) healthcare providers believe that stethoscope contamination can contribute to the transmission of infections. Safe infection prevention practice (AOR = 3.79, 95%CI: 2.45–5.84), awareness on infection prevention guideline (AOR = 1.93; 95%CI: 1.31, 2.82), and favorable attitude towards infection prevention (AOR = 1.73, 95%CI: 1.02, 2.93) were significantly associated with stethoscope disinfection after every use. The study also found that the odds of stethoscope disinfection were likely to be reduced by 79% among physicians than nurses (AOR = 0.21; 95%CI: 0.09, 0.49). Conclusions Only a small proportion of healthcare providers disinfect their stethoscopes after every use. Factors such as safe infection prevention practice, awareness on infection prevention guidelines, and favorable attitude towards infection prevention were the independent predictors of stethoscopes disinfection after every use. Hence, promotion of stethoscope hygiene along with an educational program to enhance disinfection compliance in healthcare facilities may have a positive effect.