Healthcare workers' compliance with the catheter associated urinary tract infection prevention guidelines: an observational study in Yemen

BACKGROUND

Catheter-associated urinary tract infection is a global problem but it can be prevented with the appropriate implementation of evidence-based guidelines. This study was conducted to assess the level of compliance of healthcare workers with the catheter-associated urinary tract infection prevention guidelines during the insertion of a urinary catheter.

METHODS

An observational study using a descriptive cross-sectional design was conducted at Sana'a City hospitals, Yemen. All the nurses and physicians from the governmental, teaching, and private hospitals were eligible to participate in the study. The data collection was performed through convenience sampling from March 2020 to December 2020, using a structured observational checklist prepared specifically for this study.

RESULTS

The majority of the urinary catheter insertions were performed by nurses. There were no written policy or procedures for an urinary catheter insertion and no in-service education or training departments in the majority of the hospitals. The overall mean score of compliance was 7.31 of 10. About 71% of the healthcare workers had a high or acceptable level of compliance and 29% had an unsafe level of compliance. Compliance was low for maintaining aseptic technique throughout the insertion procedure, using a single use packet of lubricant jelly, performing hand hygiene immediately before insertion, and securing the urinary catheter once inserted. Factors affecting the healthcare workers compliance were gender, the working ward/unit of the healthcare workers, the availability of a written policy/procedure and a department or unit for in-service education.

CONCLUSION

Yemeni healthcare workers' overall compliance was acceptable but it was unsafe in several critical measures. There is an urgent need for developing, implementing, and monitoring national guidelines and institutional policy and procedures for catheter-associated urinary tract infection prevention. Periodical in-service education and training programs and adequate access to the necessary materials and supplies are paramount.

Psychosocial Effects of COVID-19 pandemic on Yemeni healthcare workers: A Web-based, Cross-sectional Survey

Yemeni healthcare workers (HCWs) experience high levels of psychosocial stress. The current study provides a psychosocial assessment of Yemeni HCWs during the COVID19 pandemic and the factors that influence this. Between 6 November 2020, and 3 April 2021, 1220 HCWs inside Yemen self-reported levels of stress, anxiety, insomnia, depression and quality of life using a web-based, cross-sectional survey. According to the findings, 73.0%, 57.3%, 49.8%, 53.2%, and 85.2% of all HCWs reported moderate or severe stress, insomnia, anxiety, depression, and a lower quality of life, respectively. Significant positive correlations were found between stress and anxiety, insomnia, and depression scores, as well as anxiety and insomnia and depression, and insomnia and depression (p < 0.001). There was also a significant inverse relationship between wellbeing scores and stress, anxiety, insomnia, and depression scores (p < 0.001). A high percentage of respondents (85.8%) were 40 years old or younger and 72.7% had fewer than 10 years' experience, suggesting that experienced medics leave Yemen for safer and more secure jobs elsewhere. Psychosocial support to assist in building resilience to the prevailing conditions may need to be embedded in medical school training and continuing professional development to help support HCWs within Yemen and prevent even more from leaving the country.

Associated ICU nurses' characteristics to clinical enteral nutrition knowledge at public hospitals in Sana'a, Yemen: A basis for remodeling safety and quality of care standards

Background: Nurses have a pivotal role in initiating and managing enteral nutrition (EN) and monitoring any potential complications. Yet, it is unclear whether Yemeni nurses have adequate knowledge to deliver and manage enteral nutrition safely. Therefore, the aim of this study was to assess the level of ICU nurses' knowledge regarding the care of EN. Methods: A descriptive cross-sectional study was conducted from February 2019 to March 2019. A probability sampling method was used to recruit 174 nurses from four public hospitals in the capital city of Yemen. A self-administered 17-item questionnaire related to ICU nurses' knowledge regarding EN intervention was used to collect the data. Results: Based on our findings, only 10.9% of the respondents had an adequate level of knowledge about EN care, while 43.1% of them had a moderate level of knowledge, and 46.0% of them had an inadequate level of knowledge. Only 16.1% of the participants were knowledgeable of EN pre-administration care, whereas 5.80% of them were knowledgeable of EN administration care, and 9.20% were knowledgeable of EN post-administration care. There were significant associations between ICU nurses' level of knowledge of EN care and their level of education and knowledge sources. Conclusions: The significant gap in ICU nurses' knowledge regarding EN care identified implies the need to upgrade and refresh of the ICU nurses' knowledge by implementing a regular training program concerning EN care.

Critical Care Nurses’ Perceptions of Enteral Nutrition: A Descriptive Cross-Sectional Study

Background and Objective:

Nutritional support is an essential component of critical care with a significant effect on the outcomes of critically ill patients. Critical care nurses are in a central position to achieve the nutritional goals and preserve the nutritional status of patients at the best possible level. This study aimed to investigate the critical care nurses’ perceptions of the responsibility, knowledge, and documentation system support regarding enteral nutrition.

Methods:

Using a quantitative, descriptive, cross-sectional design data were collected from 292 critical care nurses in different healthcare sectors in Sana’a, the capital city of Yemen. A self-administered questionnaire containing 50 items was used for data collection. The data were collected between March and June 2021. The Statistical Package for the Social Sciences (SPSS) version 16 was used for the data analysis.

Results:

The study found that most of the critical care units did not have guidelines, protocols, or a nutritional support team, and the physicians prescribed the enteral nutrition. The critical care nurses perceived that they had a low responsibility, low knowledge, and moderate documentation support regarding enteral nutrition. The nurses in private hospitals had the highest responsibility, the nurses who received in-service education about enteral nutrition reported the highest level of knowledge, and the nurses in the Neuro critical care units had the best support from a documentation system. Scientific workshops and conferences were the main sources of knowledge regarding enteral nutrition. The nurses’ educational needs included the ability to evaluate the outcomes, goal setting, and nutritional assessment.

Conclusions:

The critical care nurses perceived a low responsibility, low level of knowledge, and moderate support from a documentation system regarding enteral nutrition. There is an urgently need to create or adopt enteral nutrition evidence-based guidelines, and protocols, and establish multidisciplinary nutritional support team with clear roles and responsibilities. In-service education and training related to enteral nutrition is paramount.

Lack of access to COVID-19 vaccines could be a greater threat than vaccine hesitancy in low-income and conflict nations: the case of Yemen

Background

Vaccine hesitancy and vaccine inequity are two major hurdles towards achieving population immunity to COVID-19. Although several studies have been published on vaccine hesitancy among numerous populations, there is inadequate information on any potential correlation between vaccine acceptance and lack of access to vaccines. Our cross-sectional study in a low-income country aimed to fill this gap.

Methods

We conducted a nation-wide cross-sectional survey among the general population in Yemen, a low-income conflict country. Participants from all the provinces in Yemen were included in the study. We evaluated factors influencing agreement to accept a COVID-19 vaccine and any potential correlation between vaccine hesitancy and lack of access to vaccines.

Results

Overall, 50.1% of the 5329 respondents agreed to accept a COVID-19 vaccine. Only 39.9% of the participants agreed to having access to a COVID-19 vaccine, with females indicating lower access than males. Potential determinants of vaccine acceptance included being male, updating self on the development of vaccines against COVID-19, opinion about severity of COVID-19, anxiety about contracting COVID-19, concerns about the safety of COVID-19 vaccines and lack of access to vaccines.

Conclusions

our results indicate that the immediate threat in Yemen towards achieving population immunity is the severe shortage and lack of access to vaccines, rather than vaccine hesitancy.

Implementation of an educational module on nosocomial infection control measures: a randomised hospital-based trial

Background

Previous cross-sectional studies have reported limited knowledge and practices among nurses regarding controlling nosocomial infections (NIs). Even though health institutions offer many irregular in-service training courses to solve such issues, a three year-nursing educational programme at institutions is not adequate to enable nurses to handle NIs. Therefore, this study aims to evaluate the implementation of an educational module on NIs control measures among Yemeni nurses.

Methods

A single-blinded randomised hospital-based trial was undertaken involving 540 nurses assigned to two intervention groups and a waitlist group. Intervention group-1 received a face-to-face training course comprising 20 h spread over six weeks and a hard copy of the module, while intervention group-2 only received the hard copy of the module “without training”. In contrast, the waitlist group did not receive anything during the period of collecting data. A self-administered NI control measures-evaluation questionnaire was utilised in collecting the data from the participants; before the intervention, at six weeks and 3 months after the end of the intervention. The period of data collection was between 1^st May and 30^th October 2016.

Results

The results from collecting and analysing the data showed a statistically significant difference in the mean knowledge scores between the intervention groups that were detectable immediately post-intervention with a mean difference (MD) of 4.31 (P < 0.001) and 3 months after the end of the intervention (MD = 4.48, P < 0.001) as compared to the waitlist group. Similarly, the results showed a statistically significant difference in the mean practice scores between the intervention groups immediately post-intervention (MD = 2.74, P < 0.001) and 3 months after the intervention (MD = 2.46, P < 0.001) as compared to the waitlist group. Intervention-1 (face-to-face training + module) was more effective than intervention-2 (module only) in improving Yemeni nurses’ knowledge and practices regarding NI control measures compared to the waitlist group.

Conclusion

The findings of this study found that intervention-1 could be offered to nurses in the form of an in-service training course every six months. The NI course should also be included in nursing curricula, particularly for the three-year-nursing diploma in Yemen.

Trial registration

Nosocomial infection educational module for nurses ISRCTN19992640, 20/6/2017. The study protocol was retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00551-0.

Knowledge, attitudes, anxiety, and preventive behaviours towards COVID-19 among health care providers in Yemen: an online cross-sectional survey

BACKGROUND

The growing incidence of coronavirus (COVID-19) continues to cause fear, anxiety, and panic amongst the community, especially for healthcare providers (HCPs), as the most vulnerable group at risk of contracting this new SARS-CoV-2 infection. To protect and enhance the ability of HCPs to perform their role in responding to COVID-19, healthcare authorities must help to alleviate the level of stress and anxiety amongst HCPs and the community. This will improve the knowledge, attitude and practice towards COVID-19, especially for HCPs. In addition, authorities need to comply in treating this virus by implementing control measures and other precautions. This study explores the knowledge, attitude, anxiety, and preventive behaviours among Yemeni HCPs towards COVID-19.

METHODS

A descriptive, web-based-cross-sectional study was conducted among 1231 Yemeni HCPs. The COVID-19 related questionnaire was designed using Google forms where the responses were coded and analysed using the Statistical Package for the Social Sciences software package (IBM SPSS), version 22.0. Descriptive statistics and Pearson's correlation coefficient test were also employed in this study. A p-value of < 0.05 with a 95% confidence interval was considered as statistically significant. The data collection phase commenced on 22nd April 2020, at 6 pm and finished on 26th April 2020 at 11 am.

RESULTS

The results indicated that from the 1231 HCPs participating in this study, 61.6% were male, and 67% were aged between 20 and 30 years with a mean age of 29.29 ± 6.75. Most (86%) held a bachelor's degree or above having at least 10 years of work experience or less (88.1%). However, while 57.1% of the respondents obtained their information via social networks and news media, a further 60.0% had never attended lectures/discussions about COVID-19. The results further revealed that the majority of respondents had adequate knowledge, optimistic attitude, moderate level of anxiety, and high-performance in preventive behaviours, 69.8, 85.10%, 51.0 and 87.70%, respectively, towards COVID-19.

CONCLUSION

Although the Yemeni HCPs exhibited an adequate level of knowledge, optimistic attitude, moderate level of anxiety, and high-performance in preventive behaviours toward COVID-19, the results highlighted gaps, particularly in their knowledge and attitude towards COVID-19.