Biosafety Management Practices Among Clinical Laboratory Professionals in Debre Berhan Town Governmental Hospitals, Ethiopia: A Cross-Sectional Study

Background and Aims

Clinical laboratories play a vital role in modern healthcare, where laboratory test results significantly influence medical decisions. However, laboratory professionals are often exposed to hazardous biological materials, underscoring the importance of biosafety management. This study aimed to assess biosafety practices among clinical laboratory professionals in Debre Berhan town, Ethiopia.

Methods

A cross-sectional study involving 81 participants was conducted using a standard questionnaire covering work habits, protective barriers, safety equipment, and biosafety policy perception. Descriptive data was summarized using a table and graph. Logistic regression was employed to determine factors affecting adherence to biosafety protocols. Statistically significant value was identified using p value ≤ 0.05, 95% CI, and OR.

Results

The results revealed high compliance with essential work habits, such as the use of mechanical pipettes 77 (95.1%) and proper handwashing after handling biohazardous material 78 (96.3%) and after removing gloves 80 (98.8%). However, adherence to the use of protective barriers 50 (61.7%), biosafety training 15 (18.5%), and emergency preparedness 28 (34.6%) were notably low. Only 35 (43.2%) of participants received appropriate immunizations, and access to biosafety equipment like biological safety cabinets was limited 15 (18.5%). Experience and training were significant predictors of biosafety compliance, highlighting the need for continuous education and institutional support.

Conclusion

The findings underscore the importance of enhancing training programs, improving access to safety equipment, and ensuring the consistent application of biosafety protocols to protect laboratory personnel from hazardous biological materials and maintain public health.

Hand hygiene compliance and improvement interventions in the Eastern Mediterranean Region: a systematic review and meta-analysis

Hand hygiene compliance among healthcare workers is crucial for preventing infections in healthcare settings. This systematic review and meta-analysis aimed to assess the compliance of healthcare workers in the Eastern Mediterranean region with hand hygiene guidelines and synthesize evidence on the success rate of strategies to improve hand hygiene. Five electronic databases (PubMed, CINAHL, Cochrane, Web of Science, and Scopus) were searched up to August 2020. Articles were included if they were conducted in the Eastern Mediterranean Region. A manual search was conducted for reference lists of included papers, and relevant additional references were reviewed. Two reviewers independently screened articles for inclusion, performed data extraction, and assessed quality. A meta-analysis was conducted to synthesize findings and determine the prevalence of hand hygiene compliance interventions. The search yielded 6678 articles. After removing duplicates and applying inclusion/exclusion criteria, 42 articles were included, of which 24 were meta-analyzed. The meta-analysis showed a compliance prevalence of 32% with significant heterogeneity (I2= 99.7% p <0.001). Interventions using the World Health Organization (WHO) guidelines were over two times more likely to improve compliance rates (OR= 2.26, [95% CI:(2.09 - 2.44)], I2= 95%, p<0.001) compared to no intervention. Other interventions were close to two times more likely to improve compliance rates (OR= 1.84, [95% CI:(1.66 - 2.04)], I2= 98% p= 0.001). Approximately two-thirds of healthcare providers in the Eastern Mediterranean region were non-compliant with standard hand hygiene practices, highlighting the need for increased efforts, awareness, observation, and control policies.

Hand Hygiene Compliance and Associated Factors among Healthcare Workers in Ethiopia: A Systematic Review and Meta-Analysis

Background

Promoting hand hygiene compliance should be a priority for health authorities and all healthcare facilities at all levels. Therefore, this systematic review and meta-analysis aimed to provide a pooled estimate of hand hygiene compliance and associated factors among healthcare professionals in Ethiopia.

Methods

PubMed, Science Direct, EMBASE, the Google search engine, and Google Scholar were used to retrieve studies that were eligible for the study. The searches included all studies published in English prior to July 2021. Using a structured data extraction format, two authors independently extracted the required data. STATA Version 16 software has been used for statistical analysis. To measure the heterogeneity of the studies, the Cochrane Q-test statistics and I2 test were used. Because of the significant heterogeneity, a random-effects model was used.

Results

The pooled hand hygiene compliance among healthcare workers in Ethiopia was 38% (95% CI: 0.16-0.59). According to the study's subgroup analysis, Addis Ababa City administration health workers had the highest hand hygiene compliance, at 73% (95% CI: 0.50-0.96), while SNNP regional state had the lowest, at 9% (95% CI: 0.05-0.13). Presence of hand hygiene promotion (OR: 2.14, 95% CI: 1.04-3.24), towel/tissue paper availability (OR: 3.97, 95% CI: 2.09-5.86), having a positive attitude toward hand hygiene (OR: 1.79, 95% CI: 1.28-2.30), having good knowledge about hand hygiene (OR: 3.45, 95% CI: 1.26-5.64), and being trained for hand hygiene (OR:4.97, 95% CI:1.81-8.14) were significantly associated with hand hygiene compliance.

Conclusion

In this analysis, hand hygiene compliance among healthcare workers in Ethiopia was less than half. Providing hand hygiene promotion, towel/tissue paper presence, having a positive attitude toward hand hygiene, having good knowledge about hand hygiene, and being trained for hand hygiene were important variables for the increment of hand hygiene compliance.

An investigation into nursing students' application of infection prevention and control precautions

BACKGROUND

Undergraduate education of Health Care Workers is pivotal to ensuring that frontline clinicians have appropriate knowledge and skills in Infection Prevention and Control (IPC).

OBJECTIVES

The aim of this study was to describe undergraduate nursing students' self-reported compliance with Standard Precautions and to explore the psychosocial factors that influence adherence in clinical practice.

DESIGN

A cross-sectional survey design was used.

SETTING

The study was conducted in the School of Nursing and Midwifery at an Australian University.

PARTICIPANTS

All undergraduate nursing students were invited to participate in an online survey; 321 participated, mean age 25.7 years (SD = 8.4). The majority, 196 (61%), had no healthcare work experience, 54 (17%) were patient-care assistants, 40 (13%) enrolled nurses, and 31 (9%) were nurses registered overseas.

METHODS

Two validated instruments were used: the Compliance with Standard Precautions Scale (CSPS) and the Factors Influencing Adherence to Standard Precautions Scale- Student version (FIASPS-SV). Linear regression was used to measure the impact of psychosocial factors on self-reported compliance.

RESULTS

Overall self-reported compliance with prevention of cross-infection was 83%, use of Personal Protective Equipment (81%), correct disposal of sharps (83%) and general waste (75%), and equipment decontamination (69%). The predominant factors endorsed on the FIASPS-SV were 'Leadership' (M = 15.21 SD = 5.28) and 'Contextual cues' (M = 19.09 SD = 6.37). Multivariate linear regression demonstrated that after adjusting for age, gender and years of nursing study, the Leadership factor predicted participants' self-reported compliance on the 'prevention of cross-infection' (p < .001), 'use of PPE' (p < .001), 'waste disposal' (p = .021), and 'decontamination of equipment' (p < .001) sub-domains of the CSPS.

CONCLUSIONS

These findings highlight that strong clinical leadership and role modelling are essential to ensure all healthcare students prioritise rigorous adherence with infection prevention and control guidelines.

Hand washing practice among health care workers in Ethiopia: systemic review and meta-analysis, 2020

Objective

Hand washing with soap and water is the single most weapon against infectious agents. Proper hand washing is not only reduces nosocomial infection, but also prevents the spread of current global concern Novel Corona viruses (COVID-19) and other viral illnesses like cold and flu. Therefore, the aim of this study is to assess hand washing practice among health care workers in Ethiopia.

Methods

In the current meta-analysis, the target variables search from different databases, like Google Scholar, African Journals OnLine, PubMed, and Scopus. All necessary data extracted by using a standardized data extraction format. Heterogeneity across the studies was evaluated using the I² index and Cochran's Q test. A random effect model computes to estimate the pooled proportion of hand washing practice among health care workers.

Results

In this meta-analysis, we included fifteen observational studies summarize the proportional of hand washing practice among health care workers. In the current study, the pooled hand washing practices among Ethiopian was 57.87% (95% CI: 44.14–71.61). Subgroup analysis conduct to identifying the sources of heterogeneity.

Conclusion

The overall pooled proportion of hand washing practice among health care workers was low. Hand washing with water and soap is recommended at least for 20 s to prevent contagious disease like Corona viruses.

Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia

Background

Poor hand hygiene compliance is one in all the leading contributory factors to healthcare-associated infections. This is an important source of complications across the continuum of care and poses a serious threat to people admitted to hospitals. However, the magnitude and associated factors of hand hygiene compliance in public primary hospitals were not well investigated in Ethiopia. Therefore, this study was conducted to assess hand hygiene compliance and associated factors among health care providers in Central Gondar Zone public primary hospitals, Northwest Ethiopia.

Methods

An Institutional based cross-sectional study was conducted from March to April 2019 among health care providers. The data were collected using self-administered questionnaires and observational checklists. Using Epi Info 3.1, data was entered and analyzed using SPSS version 23. The data were analyzed using descriptive statistics and logistic regression models. A p-value less than 0.05 with 95% confidence interval was used to declare statistical significance.

Results

Of 335 study participants, 50 (14.9%), had good hand hygiene compliance. Training on hand hygiene (AOR = 8.07, 95%CI: 2.91, 22.39), availability of adequate soap and water for hand hygiene (AOR = 5.10, 95%CI: 1.93, 13.52), availability of alcohol-based hand rub (AOR = 3.23, 95%CI: 1.32, 7.92), knowledge about hand hygiene (AOR = 6.74, 95%CI: 2.96, 15.34) and attitude towards hand hygiene (AOR = 2.15, 95%CI: 1.04, 4.46) were factors associated with hand hygiene compliance.

Conclusion

The overall level of hand hygiene compliance among health care providers was poor. Training, availability of adequate soap and water, availability of alcohol-based hand rub, knowledge on hand hygiene, and attitude of health care providers were significantly associated with hand hygiene compliance.

Evidence-based guidelines for prevention of ventilator-associated pneumonia: Evaluation of intensive care unit nurses' adherence

Using self-reported questionnaires, this descriptive study assessed nurses' adherence to ventilator-associated pneumonia (VAP) guidelines, which was found to be 81.3%. Although items concerning infection control achieved the highest scores, items concerning the suctioning process achieved the lowest scores. Participants' score of VAP care knowledge had a significant positive correlation with their score of VAP guidelines adherence. Addressing the strength and weakness domains that affect nurses' adherence is crucial for health care administrators at different managerial levels, which may help in executing different strategies to improve nurses' adherence to VAP strategies.

Factors influencing compliance to the infection control precautions among nurses and physicians in Jordan: A cross-sectional study

BACKGROUND

Adherence to infection control precautions (ICP) is important to reduce the transmission of healthcare-associated infections (HAIs).

AIMS

To determine nurses and physician's knowledge, attitude and compliance to ICPs and factors associated with reported compliance.

METHODS

A cross-sectional survey of nurses and physicians recruited from three hospitals at three different healthcare sectors in Jordan. Three instruments were used to assess knowledge, attitudes and compliance to ICPs.

FINDINGS

A total of 211 professionals completed the survey: 155 nurses and 56 physicians. Both groups had low knowledge scores for ICP but a high positive attitude. Although both groups had high reported compliance scores, nurses scores were higher (P = 0.04). Participants from the private hospital had higher knowledge and compliance scores. Length of experience, knowledge and attitude were significant predictors of reported compliance to ICPs.

DISCUSSION

Despite poor knowledge, Jordanian healthcare professionals reported high scores for positive attitudes and compliance with IPCs. Clinical training programmes are required to enhance knowledge and understanding of IPCs.

Identification of low, high, and super gelers and barriers to hand hygiene among intensive care unit nurses

BACKGROUND

The purpose of this article was to provide information identified during hand hygiene (HH) surveillance periods at 5 intensive care units (ICUs) (4 hospitals) in Texas.

METHODS

Using room entry and room exit, overt observation periods were 8 consecutive hours for 3-5 days on 64 ICU nurses.

RESULTS

A total of 3,620 HH opportunities were recorded during 18 days of observation (144 hours). The average hand hygiene compliance (HHC) rate was 64%, with 19% of the nurses participating in HH in the 60%-69% range. Male nurses had a rate of 67%, whereas female nurses had a rate of 62%. Having a HHC rate of <29%, 6% of the nurses were identified as low gelers, whereas 14% were identified as high gelers (HHC rate 80%-89%), and 13% were classified as super gelers (HHC rate 90%-100%). Four barriers to HHC were identified: carrying something in their hands, talking on mobile phones, donning gloves or personal protective equipment, and pushing or pulling the workstation on wheels; all were statistically significant. Accounting for 18% noncompliance, barriers identified present teaching opportunities to increase compliance.

CONCLUSIONS

Average HHC rates recorded during 10- to 20-minute periods with random sampling may not show the complete picture of HHC. Barriers to HHC were identified that can be used as teaching interventions.

Knowledge and attitude of healthcare workers and patients on healthcare associated infections in a regional hospital in Ghana

Objective

To assess knowledge and attitude of healthcare workers (HCWs) and patients on healthcare associated infections (HAIs) in the central regional hospital in Ghana.

Methods

The purposive random sampling method was used to administer questionnaires over a period of 6 months to HCWs and patients visiting the hospital.

Results

A total of 210 patients and 71 HCWs were sampled. One hundred and three (53.8%) patients had some knowledge of HAIs with 52 (28.4%) being informed by a HCW compared with 63 (88.7%) of HCWs who were well informed about HAIs. Ninety-seven (46.2%) responding patient always washed their hands while 65 (31%) and 48 (22.9%) respectively sometimes or never washed their hands within or after leaving the hospital. Out of those who washed their hands, 64 (39.5%) always washed with soap while 46 (28.4%) did sometimes. This positively and significantly correlated (r=0.440, P<0.001) with knowledge on HAIs which was however insignificant in HCWs (r=0.025, P=0.835). As many as 48 (67.6%) of HCWs believed that authorities in the hospital had done little to prevent HAIs with the main reason being that the hospital was unclean. Whereas, 112 (53.3%) of patients considered the hospital clean. Twenty-seven (38%) of HCWs had had confirmed HAIs of which cholera made up 12 (16.9%) while 94 (44.8%) of patients believed they had had unconfirmed HAIs.

Conclusions

Although knowledge on HAIs is adequate, low compliance on preventive techniques resulting in high HAIs indicates attitudinal change is the best means of prevention.

Compliance of nursing students with infection prevention precautions: effectiveness of a teaching program

BACKGROUND

In Jordan's nursing schools, infection prevention precautions are not taught in special courses. Instead, most nursing schools include the topic as a 1-hour lecture within the clinical courses, which is believed to be insufficient. This study aimed to test the effectiveness of a nursing infection prevention educational program presented to nursing students before graduation, to promote their knowledge of infection prevention precautions.

METHODS

A true experimental design was used to examine the effects of the infection prevention educational program on students' educational knowledge. This study involved a random assignment of subjects to experimental and control groups, and administration of the pretest and the posttest to all subjects in both groups separately.

RESULTS

Participants in the experimental group demonstrated significantly better knowledge (t = 19.15; df = 95; P = .000) and attitude scores (t = 2.29; df = 46; P = .04) than participants in the control group after particpating in the infection prevention educational program. However, compliance scores were not significantly differernt between the 2 groups (t = 1.92; df = 95; P = .067); indeed, compliance was found to be significant within the experimental group (t = 10.65; df = 46; P = .000).

CONCLUSIONS

It is important that nursing students be competent in infection prevention precautions; however, there may be deficits in their education in this area. The nursing curriculum should include additional emphasis on practice as a means to help translate theory into clinical behavior.

Investigating Jordanian nurses' handwashing beliefs, attitudes, and compliance

BACKGROUND

Low rates of handwashing compliance among nurses are still reported in literature. Handwashing beliefs and attitudes were found to correlate and predict handwashing practices. However, such an important field is not fully explored in Jordan.

OBJECTIVES

This study aims at exploring Jordanian nurses' handwashing beliefs, attitudes, and compliance and examining the predictors of their handwashing compliance.

METHODS

A cross-sectional multicenter survey design was used to collect data from registered nurses and nursing assistants (N = 198) who were providing care to patients in governmental hospitals in Jordan. Data collection took place over 3 months during the period of February 2011 to April 2011 using the Handwashing Assessment Inventory.

RESULTS

Participants' mean score of handwashing compliance was 74.29%. They showed positive attitudes but seemed to lack knowledge concerning handwashing. Analysis revealed a 5-predictor model, which accounted for 37.5% of the variance in nurses' handwashing compliance. Nurses' beliefs relatively had the highest prediction effects (β = .309, P < .01), followed by skin assessment (β = .290, P < .01).

CONCLUSION

Jordanian nurses reported moderate handwashing compliance and were found to lack knowledge concerning handwashing protocols, for which education programs are recommended. This study raised the awareness regarding the importance of complying with handwashing protocols.