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Yehouenou CL, Abedinzadeh A, Houngnihin R, Baxerres C, Dossou FM, Simon A, Dalleur O. Understanding Hand Hygiene Behavior in a Public Hospital in Benin Using the Theoretical Domain Frameworks: The First Step for Designing Appropriate Interventions. Healthcare (Basel) 2022; 10:healthcare10101924. [PMID: 36292370 PMCID: PMC9602033 DOI: 10.3390/healthcare10101924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/28/2022] [Indexed: 11/04/2022] Open
Abstract
Background: Hand Hygiene (HH) is widely recognized to be one of the most successful and cost-effective measures for reducing the incidence of healthcare-associated infections (HAIs). The hand hygiene behavior of hospital healthcare workers (HCWs) is not well-documented in Benin. Therefore, Theoretical Domains Framework (TDF) was used to identify the behavioral determinants that may impact HCWs’ hand-hygiene compliance in a public hospital. Methods: A qualitative design comprising face-to-face semi-structured interviews with nine HCWs. The interviews included questions on transmission of infections, hand-hygiene practices, problems with their implementation; and ways to improve hand hygiene compliance. Two pharmacists independently coded interviews into behavioral domains using the TDF and then subdivided them into several themes. Interview transcripts were analyzed following 3-steps approach: coding, generation of specific beliefs, and identification of relevant domains. Results: Almost all interviewees have cited the environmental context and resources (such as lack of water) as a barrier to HH practice. They also believed that role models had a significant impact on the good practices of others HCWs. Fortunately, they were confident of their capabilities to perform appropriate HH behaviors. The majority (7/9) reported having the necessary knowledge and skills and believed they could carry out appropriate HH behavior. In all cases, the participants were motivated to carry out HH behavior, and it was recognized that HH remains the cornerstone to reduce health care associated infections. Conclusion: This study identified several behavioral constructs aligned with the TDF that can be targeted and help for the development of new hand-hygiene interventions. These may increase the likelihood of a successful intervention, thereby improving HH compliance and patient safety, especially in hospitals.
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Affiliation(s)
- Carine Laurence Yehouenou
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain, 1200 Brussels, Belgium
- Laboratoire de Référence des Mycobactéries (LRM), Cotonou BP 817, Benin
- Faculté des Sciences de la Santé (FSS), Université d’Abomey Calavi (UAC), Cotonou 01 BP 526, Benin
- Correspondence: or
| | - Aynaz Abedinzadeh
- Service de Pharmacie Clinique, Clinique Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium
| | - Roch Houngnihin
- Laboratoire d’Anthropologie Médicale Appliquée (LAMA), Université d’Abomey-Calavi, Cotonou 01 BP 188, Benin
| | - Carine Baxerres
- UMR261-MERIT, French National Research Institute for Sustainable Development (IRD), University of Paris, 75006 Paris, France
- UMR151-LPED, IRD, Aix Marseille Université, 13005 Marseille, France
| | - Francis M. Dossou
- Department of Surgery and Surgical Specialties, Faculty of Health Sciences, Campus Universitaire, Champs de Foire, Cotonou 01 BP 118, Benin
| | - Anne Simon
- Centres Hospitaliers Jolimont, Prévention et Contrôle des Infections, Groupe Jolimont Asbl, Rue Ferrer, 7100 Haine-Saint-Paul, Belgium
| | - Olivia Dalleur
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain, 1200 Brussels, Belgium
- Service de Pharmacie Clinique, Clinique Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium
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Risk Factors for COVID-19 Associated Mucormycosis: The Ophthalmologist’s Perspective. J Fungi (Basel) 2022; 8:jof8030271. [PMID: 35330273 PMCID: PMC8948853 DOI: 10.3390/jof8030271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has led to a dramatic rise in the incidence of rhino-orbito-cerebral mucormycosis (ROCM) in India. The purpose of our report is to describe the prevalence of ROCM in the context of SARS-CoV-2 infection during the second Indian COVID-19 wave, as well as its diagnostics proceeding, and to discuss the challenges met in the time frame from the suspected diagnosis to the therapeutic decision in such patients. We conducted a retrospective multicentre case series study at six centres of Sudhalkar and Raghudeep group of hospitals in India. ROCM was confirmed in 38 (2.5%) of the 1546 patients admitted with SARS-CoV-2 infection. The average time to establish a diagnosis was 16 days. In total, 19 (50%) patients suffered from type 2 diabetes and were mostly treated with hypoglycaemic agents (in 90% of cases). The standard of care for SARS-CoV-2 management included systemic steroids therapy, intravenous remdesivir for 5 days, and concomitant prophylactic antibiotic therapy following admission. The median (IQR) blood glucose levels in all patients during the course of hospitalisation was 320 (250.5–375) mg/dl. A total of 16% of patients had an irreparable functional loss, and the mortality was 5%. We may hypothesise that excessive administration of antibiotics that profoundly affects human microbiota, coupled with poorly controlled glycaemia and unprotocolised haphazard steroid administration, contribute to a favourable setting for mucormycosis infections.
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Nosocomial Infections and Role of Nanotechnology. Bioengineering (Basel) 2022; 9:bioengineering9020051. [PMID: 35200404 PMCID: PMC8869428 DOI: 10.3390/bioengineering9020051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/17/2022] Open
Abstract
Nosocomial infections, termed hospital-acquired infections (HAIs), are acquired from a healthcare or hospital setting. HAI is mainly caused by bacteria, such as Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Enterococci spp., Methicillin-resistant Staphylococcus aureus (MRSA), and many more. Due to growing antibacterial resistance, nanotechnology has paved the way for more potent and sensitive methods of detecting and treating bacterial infections. Nanoparticles have been used with molecular beacons for identifying bactericidal activities, targeting drug delivery, and anti-fouling coatings, etc. This review addresses the looming threat of nosocomial infections, with a focus on the Indian scenario, and major initiatives taken by medical bodies and hospitals in spreading awareness and training. Further, this review focuses on the potential role nanotechnology can play in combating the spread of these infections.
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Saraswathy T, Nalliah S, Rosliza AM, Ramasamy S, Jalina K, Shahar HK, Amin-Nordin S. Applying interprofessional simulation to improve knowledge, attitude and practice in hospital- acquired infection control among health professionals. BMC MEDICAL EDUCATION 2021; 21:482. [PMID: 34503488 PMCID: PMC8427557 DOI: 10.1186/s12909-021-02907-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 08/25/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals. METHODS The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group. RESULTS The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p < 0.05). Overall, using the four procedures as surrogates, the interprofessional learning approach in HAIC intervention showed improvement among the participants in the experimental group following structured instructions. The IPSS approach in HAIC clearly shows its relevance in improving learning outcomes. CONCLUSIONS Well-designed interprofessional simulated scenarios can be effective in skills training in improving KAP in HAIC among health professionals.
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Affiliation(s)
- T Saraswathy
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- International Medical College, Subang Jaya, Malaysia
| | - S Nalliah
- Department of Obstetrics and Gynaecology, Clinical Sciences, International Medical University, Seremban, Negeri Sembilan, Malaysia
| | - A M Rosliza
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - S Ramasamy
- Department of Psychology, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - K Jalina
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Hayati Kadir Shahar
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Institute of Aging(MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - S Amin-Nordin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
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Hameed T, Bashir EA, Khan AQ, Ahmad M. Safety culture implications on safe work practices and work place exposure incidents in Operation Theater. Pak J Med Sci 2021; 37:379-383. [PMID: 33679917 PMCID: PMC7931327 DOI: 10.12669/pjms.37.2.2946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background & Objectives: The study was undertaken to estimate the prevalence of body and blood fluid exposure incidents such as needle stick injuries, direct contact, splashes, and cuts among health care personnel (HCP) in operation theaters (OTs). The study objective was to investigate perception of safety culture and potential challenges faced by HCP in Pakistani context. Methods: An analytical cross-sectional survey was conducted in four tertiary care hospitals of Rawalpindi and Islamabad that were Akbar Niazi Teaching Hospital (ANTH), Fauji Foundation Hospital (FFH), Benazir Bhutto Hospital (BBH) and Holy Family Hospital (HFH) during March, 2019 to June, 2019. The data of the current study was collected from surgical staff in OTs at four tertiary care teaching hospitals including nurses, house officers, post graduate trainees, registrars, consultants, and technicians in the twin cities i.e., Rawalpindi and Islamabad. Results: In our findings (N=367) there was a high prevalence of exposure incidents in past six months, 45% had had got a needle injury, 36% have got a splash, 28.8% had direct contact and 35.6% had a cut once respectively in past six months, the occurrence of exposure incidents twice, thrice and more is also enormous. Conclusion: The study reflected a dire need of trainings at hospitals so that very strategically the importance of safety being a priority and value of HCP is inculcated on daily basis.
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Affiliation(s)
- Tahira Hameed
- Dr. Tahira Hameed, MBBS, MRCS. Registrar, Fauji Foundation Hospital, Rawalpindi, Pakistan
| | - Eitezaz Ahmed Bashir
- Brig. Dr. Eitezaz Ahmed Bashir, FCPS (Surg), Professor and Head General Surgery, Fauji Foundation Hospital, Rawalpindi, Pakistan
| | | | - Murtaza Ahmad
- Dr. Murtaza Ahmad, MBBS, Resident Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan
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Nontuberculous mycobacteria - clinical and laboratory diagnosis: experiences from a TB endemic country. Future Sci OA 2020; 6:FSO612. [PMID: 33235807 PMCID: PMC7668123 DOI: 10.2144/fsoa-2020-0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aim To evaluate the performance of VITEK®MS with DNA sequencing for laboratory diagnosis of non-tuberculous mycobacteria (NTM) species in a resource-limited setting. Methods 16SrRNA sequencing and MALDI-TOF mass spectrometry (VITEK®MS) was performed at a tertiary-care hospital in India. MALDI-TOF results were confirmed by 16S rRNA sequencing. In addition, sequencing of the internal transcribed spacer region was performed on slowly growing NTM. Results Commonest species isolated were M. abscessus, M. intracellulare, M. avium, M. fortuitum and M. simiae. 16S rRNA sequencing and MALDI-TOF results had agreement of 94.5% for rapidly growing and 77.5% for slowly growing NTM. Conclusion There is good correlation between VITEK®MS and sequencing for rapidly growing NTM. For slowly growing species, sequencing would be required in a third isolates.
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Oza HH, Fisher MB, Abebe L, Cronk R, McCord R, Reuland F, Behnke N, Kafanikhale H, Mofolo I, Hoffman I, Bartram J. Application of tools to monitor environmental conditions, identify exposures, and inform decision-making to improve infection prevention and control practices in Malawian maternity wards. ENVIRONMENTAL MONITORING AND ASSESSMENT 2020; 192:134. [PMID: 31970501 DOI: 10.1007/s10661-020-8089-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 01/10/2020] [Indexed: 06/10/2023]
Abstract
Healthcare-acquired infections (HAIs) contribute to maternal and neonatal morbidity and mortality, especially in low- and middle-income countries (LMICs). Deficient environmental health (EH) conditions and infection prevention and control (IPC) practices in healthcare facilities (HCFs) contribute to the spread of HAIs, but microbial sampling of sources of contamination is rarely conducted nor reported in low-resource settings. The purpose of this study was to assess EH conditions and IPC practices in Malawian HCFs and evaluate how EH deficiencies contribute to pathogen exposures and HAIs, and to provide recommendations to inform improvements in EH conditions using a mixed-methods approach. Thirty-one maternity wards in government-run HCFs were surveyed in the three regions of Malawi. Questionnaires were administered in parallel with structured observations of EH conditions and IPC practices and microbial testing of water sources and facility surfaces. Results indicated significant associations between IPC practices and microbial contamination. Facilities where separate wards were not available for mothers and newborns with infections and where linens were not used for patients during healthcare services were more likely to have delivery tables with surface contamination (relative risk = 2.23; 1.49, 3.34). E. coli was detected in water samples from seven (23%) HCFs. Our results suggest that Malawian maternity wards could reduce microbial contamination, and potentially reduce the occurrence of HAIs, by improving EH conditions and IPC practices. HCF staff can use the simple, low-cost EH monitoring methods used in this study to incorporate microbial monitoring of EH conditions and IPC practices in HCFs in low-resource settings.
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Affiliation(s)
- Hemali Harish Oza
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA.
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Michael Benjamin Fisher
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA.
| | - Lydia Abebe
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
- United States Agency for International Development (USAID), Washington, DC, USA
| | - Ryan Cronk
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
| | - Ryan McCord
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- Carolina Population Center, UNC-CH, Chapel Hill, NC, USA
| | - Frances Reuland
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
| | - Nikki Behnke
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
| | | | - Innocent Mofolo
- UNC Project-Malawi, Lilongwe, Malawi
- Department of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Irving Hoffman
- UNC Project-Malawi, Lilongwe, Malawi
- Department of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Jamie Bartram
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA.
- School of Civil Engineering, University of Leeds, Leeds, UK.
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Muszyńska B, Dąbrowska M, Starek M, Żmudzki P, Lazur J, Pytko-Polończyk J, Opoka W. Lentinula edodes Mycelium as Effective Agent for Piroxicam Mycoremediation. Front Microbiol 2019; 10:313. [PMID: 30846979 PMCID: PMC6393367 DOI: 10.3389/fmicb.2019.00313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/05/2019] [Indexed: 02/02/2023] Open
Abstract
Pollution of the environment with inorganic and organic substances is one of the main problems in the world. For this reason, it is necessary to conduct researches for effective methods of biodegradation of xenobiotics, including drugs whose unmetabolized forms are introduced into the environment, especially into water. One possible solution to this problem may be the use of white rot fungi, such as Lentinula edodes. This is an edible species used in medicine because of its beneficial anti-cancer, hypocholesterolemic, hypotensive, hypoglycemic and antioxidant effects. Due to the fact that the mycelium of L. edodes produces enzymes with oxidizing properties that can degrade xenobiotics. The aim of the work was verification if in vitro cultures of L. edodes can be used for bioremediation of non-steroidal, anti-inflammatory drug: piroxicam. For this purpose, the in vitro culture of L. edodes was derived and the mycelial cultures of this species enriched with piroxicam were analyzed. The biodegradation pathway of piroxicam by L. edodes mycelium was carried out by the UPLC/MS/MS method. The degradation process of piroxicam was found to affect primarily the linker between the thiazine and the piperidine ring, leading to its oxidation and cleavage. Additionally, oxidation of the benzothiazine moiety was observed, leading to hydroxylation and oxidation of the phenyl ring as well as oxidation of the thiazine ring leading to partial or complete removal of the sulfonamide moiety. It seems that the degradation process led finally to 2-hydroxybenozquinone, which may be further oxidized to inorganic compounds. What's more, concentration of piroxicam in in vitro cultures of L. edodes was not correlated with effectiveness of biodegradation of this compound - on each experimental series, the level of degradation was the same. The results confirm the possibility of using the investigated L. edodes mycelium for remediation of piroxicam.
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Affiliation(s)
- Bożena Muszyńska
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland
| | - Monika Dąbrowska
- Department of Inorganic Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Starek
- Department of Inorganic Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Żmudzki
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland
| | - Jan Lazur
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Włodzimierz Opoka
- Department of Inorganic Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland
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Johnston BE, Lou-Meda R, Mendez S, Frush K, Milne J, Fitzgerald T, Sexton JB, Rice H. Teaching patient safety in global health: lessons from the Duke Global Health Patient Safety Fellowship. BMJ Glob Health 2019; 4:e001220. [PMID: 30899564 PMCID: PMC6407551 DOI: 10.1136/bmjgh-2018-001220] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/27/2018] [Accepted: 01/19/2019] [Indexed: 11/23/2022] Open
Abstract
Health systems in low-income and middle-income countries (LMICs) have a high burden of medical errors and complications, and the training of local experts in patient safety is critical to improve the quality of global healthcare. This analysis explores our experience with the Duke Global Health Patient Safety Fellowship, which is designed to train clinicians from LMICs in patient safety, quality improvement and infection control. This intensive fellowship of 3-4 weeks includes (1) didactic training in patient safety and quality improvement, (2) experiential training in patient safety operations, and (3) mentorship of fellows in their home institution as they lead local safety programmes. We have learnt several lessons from this programme, including the need to contextualise training to local needs and resources, and to focus training on building interdisciplinary patient safety teams. Implementation challenges include a lack of resources and data collection systems, and limited recognition of the role of safety in global health contexts. This report can serve as an operational guide for intensive training in patient safety that is contextualised to global health challenges.
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Affiliation(s)
- Bria E Johnston
- Surgery and Global Health, Duke University Medical Center, Durham, North Carolina, USA
| | - Randall Lou-Meda
- Pediatric Nephrology Unit, Hospital Roosevelt de Guatemala, Guatemala, Guatemala
| | - Sindy Mendez
- Pediatric Nephrology Unit, Hospital Roosevelt de Guatemala, Guatemala, Guatemala
| | - Karen Frush
- Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Judy Milne
- Patient Safety Office, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara Fitzgerald
- Pediatric Surgery, Duke University Hospital, Durham, North Carolina, USA
| | - J Bryan Sexton
- Patient Safety Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Henry Rice
- Surgery and Global Health, Duke University Medical Center, Durham, North Carolina, USA
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Älgå A, Karlow Herzog K, Alrawashdeh M, Wong S, Khankeh H, Stålsby Lundborg C. Perceptions of Healthcare-Associated Infection and Antibiotic Resistance among Physicians Treating Syrian Patients with War-Related Injuries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122709. [PMID: 30513739 PMCID: PMC6313556 DOI: 10.3390/ijerph15122709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/22/2018] [Accepted: 11/29/2018] [Indexed: 12/11/2022]
Abstract
Healthcare-associated infections (HAIs) constitute a major contributor to morbidity and mortality worldwide, with a greater burden on low- and middle-income countries. War-related injuries generally lead to large tissue defects, with a high risk of infection. The aim of this study was to explore how physicians in a middle-income country in an emergency setting perceive HAI and antibiotic resistance (ABR). Ten physicians at a Jordanian hospital supported by Médecins Sans Frontières were interviewed face-to-face. The recorded interviews were transcribed verbatim and analyzed by qualitative content analysis with an inductive and deductive approach. The participants acknowledged risk factors of HAI and ABR development, such as patient behavior, high numbers of injured patients, limited space, and non-compliance with hygiene protocols, but did not express a sense of urgency or any course of action. Overuse and misuse of antibiotics were reported as main contributors to ABR development, but participants expressed no direct interrelationship between ABR and HAI. We conclude that due to high patient load and limited resources, physicians do not see HAI as a problem they can prioritize. The knowledge gained by this study could provide insights for the allocation of resources and development of hygiene and wound treatment protocols in resource-limited settings.
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Affiliation(s)
- Andreas Älgå
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 11883 Stockholm, Sweden.
- Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden.
| | - Karin Karlow Herzog
- Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden.
| | | | - Sidney Wong
- Médecins Sans Frontières, Operational Centre Amsterdam, 1018 DD Amsterdam, The Netherlands.
| | - Hamidreza Khankeh
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 11883 Stockholm, Sweden.
- Health in Emergency and Disaster Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran.
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