Wasswa Peter, Nalwadda Christine K, Buregyeya Esther, Gitta Sheba N, Anguzu Patrick, Nuwaha Fred
African Field Epidemiology Network, Kampala, Uganda.
School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
BMC Infect Dis. 2015 Jul 14;15:268. doi: 10.1186/s12879-015-0999-4.
At least 1.4 million people are affected globally by nosocomial infections at any one time, the vast majority of these occurring in low-income countries. Most of these infections can be prevented by adopting inexpensive infection prevention and control measures such as hand washing. We assessed the implementation of infection control in health facilities and determined predictors of hand washing among healthcare workers (HCWs) in Arua district, Uganda.
We interviewed 202 HCWs that included 186 randomly selected and 16 purposively selected key informants in this cross-sectional study. We also conducted observations in 32 health facilities for compliance with infection control measures and availability of relevant supplies for their implementation. Quantitative data underwent descriptive analysis and multiple logistic regressions at 95 % confidence interval while qualitative data was coded and thematically analysed.
Most respondents (95/186, 51 %) were aware of at least six of the eight major infection control measures assessed. Most facilities (93.8 %, 30/32) lacked infection control committees and adequate supplies or equipment for infection control. Respondents were more likely to wash their hands if they had prior training on infection control (AOR = 2.71, 95 % CI: 1.03-7.16), had obtained at least 11 years of formal education (AOR = 3.30, 95 % CI: 1.44-7.54) and had reported to have acquired a nosocomial infection (AOR = 2.84, 95 % CI: 1.03-7.84).
Healthcare workers are more likely to wash their hands if they have ever suffered from a nosocomial infection, received in-service training on infection control, were educated beyond ordinary level, or knew hand washing as one of the infection control measures. The Uganda Ministry of Health should provide regular in-service training in infection control measures and adequate necessary materials.
全球任何时候至少有140万人受到医院感染的影响,其中绝大多数发生在低收入国家。这些感染大多可通过采取如洗手等廉价的感染预防和控制措施来预防。我们评估了乌干达阿鲁阿区医疗机构感染控制措施的实施情况,并确定了医护人员洗手的预测因素。
在这项横断面研究中,我们采访了202名医护人员,其中包括186名随机抽取的人员和16名有目的挑选的关键信息提供者。我们还对32家医疗机构进行了观察,以了解其感染控制措施的遵守情况以及实施这些措施所需相关用品的可用性。定量数据进行了描述性分析和95%置信区间的多因素逻辑回归分析,而定性数据进行了编码和主题分析。
大多数受访者(95/186,51%)知晓所评估的八项主要感染控制措施中的至少六项。大多数医疗机构(93.8%,30/32)缺乏感染控制委员会以及用于感染控制的充足用品或设备。如果受访者接受过感染控制方面的前期培训(调整后比值比[AOR]=2.71,95%置信区间:1.03 - 7.16)、接受过至少11年的正规教育(AOR = 3.30,95%置信区间:1.44 - 7.54)以及报告曾感染医院感染(AOR = 2.84,95%置信区间:1.03 - 7.84),那么他们洗手的可能性更大。
如果医护人员曾患医院感染、接受过感染控制方面的在职培训、受过高中以上教育或者知晓洗手是感染控制措施之一,那么他们洗手的可能性更大。乌干达卫生部应定期提供感染控制措施方面的在职培训以及充足的必要物资。