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Daba C, Atamo A, Gebretsadik Weldehanna D, Oli A, Debela SA, Luke AO, Gebrehiwot M. Infection prevention and control compliance of healthcare workers towards COVID-19 in conflict-affected public hospitals of Ethiopia. BMJ Open 2023; 13:e074492. [PMID: 38159945 PMCID: PMC10759124 DOI: 10.1136/bmjopen-2023-074492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Non-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19 IPC compliance among healthcare workers in conflict-affected settings. The objective of this research was to assess compliance with COVID-19 IPC measures and determine the factors associated with it among healthcare providers in Ethiopian governmental hospitals affected by conflict. DESIGN A cross-sectional study was carried out within institutional settings. STUDY SETTING AND PERIOD The study was conducted in three public hospitals located in northeastern Ethiopia during the period of March to April 2022. PARTICIPANTS Simple random sampling technique was used to select 325 healthcare workers after proportional allocation was made to each public hospital. PRIMARY OUTCOME MEASURES The primary outcome was non-compliance with COVID-19 IPC. A multivariable logistic regression analysis was employed to identify factors associated with the lack of adherence to the COVID-19 IPC protocol. RESULTS Nearly half (150, 46.2%) of the healthcare workers had non-compliance with COVID-19 IPC protocol. Absence of hand washing soap (adjusted OR (AOR)=2.99; 95% CI 2.46 to 5.76), workload (AOR=2.25; 95% CI 1.33 to 3.84), disruption in the supply of piped water (AOR=1.82; 95% CI 1.11 to 2.99), did not undergo training in COVID-19 IPC (AOR=2.85; 95% CI 1.85 to 4.84), absence of COVID-19 IPC guidelines (AOR=2.14; 95% CI 1.11 to 4.13) and chewing khat (AOR=2.3; 95% CI 1.32 to 3.72) were determinant factors for non-compliance. CONCLUSIONS The magnitude of non-compliance with COVID-19 IPC was high. Hospital managers and federal ministry of health should provide regular training on COVID-19 IPC, continuous piped water and personal protective facilities for healthcare workers. Ultimately, improving the security situation in the area would help improve COVID-19 IPC compliance among healthcare workers in these and other similar conflict-affected settings.
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Affiliation(s)
- Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amanuel Atamo
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Gebretsadik Weldehanna
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abdi Oli
- Department of Mathemathics, College of Natural and Computational Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Abebe Debela
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Amana Ogeto Luke
- Department of Public Health, Lancha Campus, Rift Valley University, Addis Ababa, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Liu Y, Yuan S, Wang LY, Chen S, Li Y, Ma W. Factors Affecting the Qualification Rate of Hand Disinfection Among Physicians: A Cross-Sectional Survey. J Multidiscip Healthc 2023; 16:4091-4097. [PMID: 38111827 PMCID: PMC10726755 DOI: 10.2147/jmdh.s430604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/01/2023] [Indexed: 12/20/2023] Open
Abstract
Objective The objective of this study is to examine the qualification rate of hand disinfection in the surgical department wards and analyze the influencing factors. Methods A surprise assessment was carried out to evaluate the daily adherence to hand hygiene protocols in the surgical department wards. We aimed to investigate the factors that impact the qualification rate of hand disinfection. Results In this study, the qualification rate of hand disinfection was determined to be 64.38%. Notably, this rate exhibited significant variations based on gender, age, surgical site, and department category. Specifically, the qualification rate of hand disinfection among female participants stood at 82.35%, surpassing the qualification rate observed among male counterparts of 52.83%. Furthermore, doctors in the age group of 41-50 years demonstrated the highest qualification rate, and the abdominal surgical site exhibited the most noteworthy qualification rate, reaching 79.49%. The outcomes of the multiple logistic regression analysis highlighted the significance of age and gender as influential factors impacting the qualification rate. Specifically, doctors aged 51 years or older exhibited the lowest hand hygiene compliance, whereas female doctors demonstrated a notably higher qualification rate compared to their male counterparts. Conclusion The disheartening qualification rate of hand disinfection highlights a concerning lack of awareness regarding hand hygiene among surgeons in their professional duties. Consequently, targeted interventions are imperative, focusing on intensified training, educational initiatives, enhanced supervision, and internal performance evaluations for key groups. The findings not only serve as a valuable database but also offer a viable roadmap for similar hospitals to reinforce the management of nosocomial infections.
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Affiliation(s)
- Yan Liu
- Department of Infection Control, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Song Yuan
- Department of Infection Control, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Li-Yi Wang
- Department of Infection Control, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Si Chen
- Department of Infection Control, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Yang Li
- Department of Infection Control, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Wei Ma
- Department of Infection Control, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
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Moiwo MM, Kamara GN, Kamara D, Kamara IF, Sevalie S, Koroma Z, Kamara KN, Kamara MN, Kamara RZ, Kpagoi SSTK, Konteh SA, Margao S, Fofanah BD, Thomas F, Kanu JS, Tweya HM, Shewade HD, Harries AD. Have Hand Hygiene Practices in Two Tertiary Care Hospitals, Freetown, Sierra Leone, Improved in 2023 following Operational Research in 2021? Trop Med Infect Dis 2023; 8:431. [PMID: 37755893 PMCID: PMC10538178 DOI: 10.3390/tropicalmed8090431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023] Open
Abstract
In 2021, an operational research study in two tertiary hospitals in Freetown showed poor hand hygiene compliance. Recommended actions were taken to improve the situation. Between February-April 2023, a cross-sectional study was conducted in the same two hospitals using the World Health Organization hand hygiene tool to assess and compare hand hygiene compliance with that observed between June-August 2021. In Connaught hospital, overall hand hygiene compliance improved from 51% to 60% (p < 0.001), and this applied to both handwash actions with soap and water and alcohol-based hand rub. Significant improvements were found in all hospital departments and amongst all healthcare worker cadres. In 34 Military Hospital (34MH), overall hand hygiene compliance decreased from 40% to 32% (p < 0.001), with significant decreases observed in all departments and amongst nurses and nursing students. The improvements in Connaught Hospital were probably because of more hand hygiene reminders, better handwash infrastructure and more frequent supervision assessments, compared with 34MH where interventions were less well applied, possibly due to the extensive hospital reconstruction at the time. In conclusion, recommendations from operational research in 2021 contributed towards the improved distribution of hand hygiene reminders, better handwash infrastructure and frequent supervision assessments, which possibly led to improved hand hygiene compliance in one of the two hospitals. These actions need to be strengthened, scaled-up and guided by ongoing operational research to promote good hand hygiene practices elsewhere in the country.
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Affiliation(s)
- Matilda Mattu Moiwo
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Joint Medical Unit, Freetown 00232, Sierra Leone; (G.N.K.); (S.S.)
| | - Gladys Nanilla Kamara
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Joint Medical Unit, Freetown 00232, Sierra Leone; (G.N.K.); (S.S.)
- Department of Clinical Research, Sustainable Health Systems, 34 Military Hospital Research Center, Freetown 00232, Sierra Leone
| | - Dauda Kamara
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | | | - Stephen Sevalie
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Joint Medical Unit, Freetown 00232, Sierra Leone; (G.N.K.); (S.S.)
- Department of Clinical Research, Sustainable Health Systems, 34 Military Hospital Research Center, Freetown 00232, Sierra Leone
| | - Zikan Koroma
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | - Kadijatu Nabie Kamara
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | - Matilda N. Kamara
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (M.N.K.); (F.T.)
| | - Rugiatu Z. Kamara
- United States Centres for Diseases Control and Prevention, Freetown 00232, Sierra Leone;
| | | | | | - Senesie Margao
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | - Bobson Derrick Fofanah
- World Health Organization Country Office, Freetown 00232, Sierra Leone; (I.F.K.); (B.D.F.)
| | - Fawzi Thomas
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (M.N.K.); (F.T.)
- Pharmacy Board of Sierra Leone, National Pharmacovigilance Centre, Freetown 00232, Sierra Leone
| | - Joseph Sam Kanu
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (M.N.K.); (F.T.)
| | - Hannock M. Tweya
- International Training and Education Centre for Health, Lilongwe P.O. Box 30369, Malawi;
| | - Hemant Deepak Shewade
- Division of Health Systems Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India;
| | - Anthony David Harries
- International Union Against Tuberculosis and Lung Disease (The Union), 2 Rue Lantier, 75001 Paris, France;
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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