Dramowski Angela, Whitelaw Andrew, Cotton Mark F
a Department of Paediatrics and Child Health, Division of Paediatric Infectious Diseases, Faculty of Medicine and Health Sciences , Stellenbosch University and Tygerberg Childrens' Hospital.
b Department of Medical Microbiology , Stellenbosch University and the National Health Laboratory Service (NHLS) , Cape Town , South Africa.
Paediatr Int Child Health. 2016 Aug;36(3):225-31. doi: 10.1179/2046905515Y.0000000032.
Healthcare (HC) providers' knowledge, attitudes and practices with regard to infection control (IC) may positively or adversely affect rates of institutional healthcare-associated infection (HAI).
To determine paediatric HC providers' knowledge, attitudes and practices regarding HAI and guide IC interventions in a resource-limited setting.
Paediatric HC providers at Tygerberg Children's Hospital, Cape Town, South Africa completed an anonymous, self-administered, 37-item questionnaire.
Questionnaires (201, 66.6% participation rate) were completed by medical (90, 44.7%), allied health (16, 8%) and nursing providers (95, 47.3%). Median age was 34 years (IQR 27-43), and 84% were female. Knowledge scores were low [57% correct, mean (SD) 7.7 (1.7)/14 questions] but higher in the medical/allied category (P ≤ 0.001) and those qualified for ≥ 10 years (P = 0.008). Providers lacked knowledge of the main routes of infection transmission and misunderstood hand hygiene and terminal cleaning recommendations. Nurses scored higher for attitude questions [63% desired responses, mean 5 (1.2)/8 questions] (P = 0.02). Only 38% reported adequate undergraduate teaching on HAI and most (93%) wanted more in-service IC training. Providers agreed with punitive measures for colleagues ignoring IC recommendations (89%). Nurses scored higher for practice questions [53% desired responses, mean 3.2 (1.2)/6 questions] (P ≤ 0.001). Self-reported adherence to IC recommendations was high, 88% for hand hygiene and 74% for use of personal protective equipment. However, there was poor uptake of annual influenza vaccination (25%) and N95 respirator fit-testing (28%), and many felt obliged to report for work when sick (67%).
Expanded in-service and undergraduate training in IC should emphasize methods of hand hygiene and routes of infection transmission. Paediatric providers support mandatory reporting of HAI events and stricter enforcement of IC recommendations.
医疗保健（HC）提供者在感染控制（IC）方面的知识、态度和做法可能对机构内医疗保健相关感染（HAI）的发生率产生积极或消极影响。
确定儿科医疗保健提供者对HAI的知识、态度和做法，并在资源有限的环境中指导感染控制干预措施。
南非开普敦泰格伯格儿童医院的儿科医疗保健提供者完成了一份匿名的、自行填写的37项问卷。
问卷（201份，参与率66.6%）由医疗人员（90份，44.7%）、专职医疗人员（16份，8%）和护理人员（95份，47.3%）完成。中位年龄为34岁（四分位间距27 - 43岁），84%为女性。知识得分较低[57%正确，平均（标准差）7.7（1.7）/14题]，但在医疗/专职医疗类别中得分较高（P≤0.001），且在资格≥10年的人员中得分较高（P = 0.008）。提供者缺乏对感染传播主要途径的知识，对手卫生和终末清洁建议存在误解。护士在态度问题上得分较高[63%为期望的回答，平均5（1.2）/8题]（P = 0.02）。只有38%的人报告本科阶段有足够的HAI教学内容，大多数（93%）希望有更多的在职感染控制培训。提供者同意对忽视感染控制建议的同事采取惩罚措施（89%）。护士在实践问题上得分较高[53%为期望的回答，平均3.2（1.2）/6题]（P≤0.001）。自我报告的对感染控制建议的依从性较高，手卫生为88%，使用个人防护设备为74%。然而，年度流感疫苗接种率较低（25%），N95呼吸器适合性检测率较低（28%），许多人在生病时仍觉得有义务上班（67%）。
扩大在职和本科阶段的感染控制培训应强调手卫生方法和感染传播途径。儿科提供者支持对HAI事件进行强制报告，并更严格地执行感染控制建议。
