International Journal of Infection Control

Stakeholders’ perceptions about a surgical site infection master training plan for a low-middle income country

Thu, 13 Apr 2023 00:00:00 -0400

Background: Training is a critical component for improving the practice of surgical site infections (SSI). We have designed a master training plan characterized by a task-based, interprofessional and reflective approach consisting of initial training of employees and subsequent refresher training. It aims to improve the practice of SSI in hospitals. The research question was: How do policymakers, teachers and managers/leaders of health care institutions perceive the outline of a master training plan for SSI?

Methods: Semi-structured interviews were conducted with a purposive sample of 28 stakeholders from three categories.

Results: Four key themes emerged from the interviews: 1) Discussion of authentic tasks fosters the transfer of knowledge to the workplace; 2) interprofessional reflective learning comes with challenges; 3) the master training plan help to change behavior, and 4) it is feasible with limited resources. However, the stakeholders pointed that interprofessional training creates friction among health care professionals (HCPs) who work together and participate in the interprofessional training sessions. To disseminate the training across healthcare facilities, stakeholders suggested developing a train-the-trainer plan. Furthermore, stakeholders suggested making HCPs accountable for actual behavior changes in the workplace.

Conclusion: The stakeholders agreed with the approach that the master plan is based on. Implementing this master training plan was expected to encourage knowledge and skills to practice. Participants indicated that arranging training might be feasible in different institutions and it should be part of undergraduate, postgraduate, and continuing medical education. The stakeholders perceived the outline of the master training plan to be well-suited for implementation in low- and middle-income countries (LMICs).

Factors associated with knowledge about ‘Undetectable HIV viral load is Untransmittable’ among Zambian adults on antiretroviral therapy: a mixed method approach

Fredrick Ngwenya, Mpundu Makasa — Thu, 06 Apr 2023 10:38:01 -0400

Background: Knowledge of ‘Undetectable HIV viral load (VL) is Untransmittable’ (U=U) motivates optimal adherence to antiretroviral therapy (ART).

Objective: This study assessed factors associated with knowledge about U=U among Zambian people living with HIV on ART.

Design: The study used questionnaires and in-depth interviews (IDIs) concurrently between December 2018 and January 2019. Three high volume health facilities, Chilenje, Chipata, and Kalingalinga, were selected. A single proportion of 63.4% of HIV VL suppression (VLS) in Lusaka Province was used to calculate a sample size of 362 respondents. Probability proportional to size procedure was used to apportion the sample to the study sites while a simple random technique was employed in selecting respondents aged 18–59 years and on ART for over 9 months. Stata 14 was used to run descriptive and chi-square statistical analyses. Fifty-five respondents were drawn from 362 respondents for IDIs. The selection was based on varied VL levels. Interviews were audio-recorded, transcribed and analysed thematically, and the findings merged in the discussion.

Results: Approximately, 34.5% of the 362 respondents (n = 125) had knowledge about U=U. The VLS status was significantly associated with U=U knowledge (P = 0.01).

Discussion: Diverse information sources, symbiotic understanding of VL, and treatment-as-prevention benefits were enablers of acquiring more knowledge about U=U, while inadequate health discussion about VL and congestion and waiting time were barriers.

Conclusions: The findings suggest that increased information sharing on the implication of suppressed VL being able to prevent HIV transmission could motivate people living with HIV to adhere to ART, thus sustaining VLS.

Midwives’ experiences of utilising personal protective equipment during the COVID-19 pandemic: a qualitative descriptive study

Angela O'Farrell, Anna V. Chatzi, Owen Doody — Mon, 03 Apr 2023 09:43:02 -0400

Background: Coronavirus has placed a lot of strain on the healthcare system. As a result, major changes have occurred in the way healthcare is delivered, including pregnancy care delivery. Within the Irish healthcare system, the response to the COVID-19 pandemic has demanded frequent and ongoing adjustments to midwifery practice and the provision of personal protective equipment (PPE) and its usage have come under serious scrutiny during the COVID-19 pandemic.

Aim: To explore midwives experiences of utilising PPE during the COVID-19 pandemic.

Methods: A qualitative descriptive study utilising a purposive sampling of 10 midwives who participated in in-depth semi-structured interviews, highlighting their experiences of utilising PPE during the COVID-19 pandemic. Data obtained was analysed using the Braun and Clarkes framework and reported in line with the consolidated criteria for qualitative research reporting (COREQ).

Results: Analysed data resulted in five themes, eight subthemes and 18 codes. The themes identified represent the participants experiences and highlight the; importance of effective communication, fear and anxiety of contracting and spreading the virus, value of peer support as a coping strategy, impact of lack of resources in the midwifery practice, and education and training effectiveness.

Conclusion: The introduced strict mandatory infection prevention and control measures, predominantly the wearing of PPE, took effect with concurrent increased stress and anxiety, while caring for pregnant women.

Self-reported adherence of healthcare workers to infection prevention and control practices during the early waves of the COVID-19 pandemic in Egypt

Thu, 16 Mar 2023 00:00:00 -0400

Introduction: Considering the absence of effective treatment, the World Health Organization had recommended stringent infection prevention and control (IPC) measures against coronavirus disease 2019 (COVID-19) to reduce its transmission. The non-adherence of healthcare workers (HCWs) to these measures had been reported as a major cause of infection.

Aim: To assess the level of self-reported adherence of HCWs to IPC measures during their social life and work time.

Methods: This cross-sectional study included 559 HCWs (411 females and 148 males) working at 39 hospitals across different Egyptian governorates. A predesigned structured questionnaire about COVID-19 IPC measures was completed by trained interviewers.

Results: Washing hands before eating (98.2%), using soap for hand wash (97.9%), washing hands after returning home (96.6%), and wearing a face mask when going outside in public places (83.7%) were the commonest daily-life practices among the 559 studied HCWs, while the least common was social distancing (46.0%). Less than half of the studied HCWs were adherent to the proper duration of handwashing (P < 0.01). Only 5.9% of the studied HCWs usually wore full personal protective equipment (PPE) at work (P = 0.051). The highest percentages of HCWs working at outpatient clinics and laboratories (98.1% each) ‘sometimes’ used PPE (P = 0.017). There was a significant difference in self-reported adherence to wearing face masks at hospitals according to specialties (P < 0.01). HCWs working at intensive care units (ICUs) recorded the highest attendance rates at IPC training (53.8%, P = 0.012). A relatively higher percentage of HCWs at COVID-19 isolation hospitals wore PPE (15.7%) versus 2.2–4.7% in other hospitals (P = 0.015).

Conclusion: The majority of HCWs sometimes complied with wearing PPE (93.6%). HCWs were more adherent to wearing masks at hospitals (94.6%) compared to community settings (42.9%). Older age and female gender were significantly associated with self-reported adherence to some IPC measures. Hand hygiene training session emphasizing the proper duration of hand wash is mandatory.

Elimination of routine screening and contact precautions for endemic methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus bacteremia: a retrospective study in intensive care units in Brazil

Fri, 10 Mar 2023 15:25:54 -0500