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2019冠状病毒病大流行期间的感染预防与控制:肯尼亚公立医院面临的挑战与机遇

Infection prevention and control during the COVID-19 pandemic: challenges and opportunities for Kenyan public hospitals.

作者信息

Maina Michuki, Tosas-Auguet Olga, English Mike, Schultsz Constance, McKnight Jacob

机构信息

Health Services Research Group, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya.

Department of Global Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Wellcome Open Res. 2020 Sep 10;5:211. doi: 10.12688/wellcomeopenres.16222.1. eCollection 2020.

Abstract

Infection prevention and control, and water sanitation and hygiene have an essential role in ensuring the quality of care and patient outcomes in hospitals. Using a modification of the World Health Organization's water sanitation and hygiene facility improvement tool, we undertook assessments in 14 public hospitals in Kenya in 2018. The hospitals received written feedback on areas where they could make improvements. Following the first confirmed cases of COVID-19 in Kenya, we were drawn to ask whether the results of our pre-pandemic survey had led to action, and whether or not the threat of COVID-19 had focused more attention on infection prevention and control and water sanitation and hygiene. Using a semi-structured interview guide, we carried out phone interviews with key hospital leaders in 11 of the 14 hospitals. The data were transcribed and coded into thematic areas. We draw on these interviews to describe the status and awareness of infection prevention and control. The infection prevention and control committee members are training health workers on infection prevention and control procedures and proper use of personal protective equipment and in addition, providing technical support to hospital managers. While some hospitals have also accessed additional funds to improve infection prevention and control, they tended to be small amounts of money.  Long-standing challenges with supplies of infection prevention and control materials and low staff morale persist.  Crucially, the reduced supply of personal protective equipment has led to fear and anxiety among health care personnel. As funds are mobilised to support care for COVID-19, we ask that funds prioritise infection prevention and control measures. This would have a profoundly positive effect on within hospital virus transmission, patient and staff safety but also lasting benefits beyond the COVID-19 pandemic.

摘要

感染预防与控制以及水卫生与环境卫生在确保医院护理质量和患者治疗效果方面发挥着至关重要的作用。我们对世界卫生组织的水卫生与环境卫生设施改善工具进行了修改,并于2018年在肯尼亚的14家公立医院进行了评估。这些医院收到了关于可改进领域的书面反馈。在肯尼亚首次确诊COVID-19病例后,我们不禁要问,大流行前调查的结果是否促使采取了行动,以及COVID-19的威胁是否使人们更加关注感染预防与控制以及水卫生与环境卫生。我们使用半结构化访谈指南,对14家医院中的11家的关键医院领导进行了电话访谈。数据被转录并编码为主题领域。我们利用这些访谈来描述感染预防与控制的现状和认识。感染预防与控制委员会成员正在对医护人员进行感染预防与控制程序以及个人防护装备正确使用方面的培训,此外,还为医院管理人员提供技术支持。虽然一些医院也获得了额外资金来改善感染预防与控制,但资金数额往往较少。感染预防与控制物资供应方面长期存在的挑战以及员工士气低落的问题依然存在。至关重要的是,个人防护装备供应减少导致医护人员产生恐惧和焦虑情绪。在筹集资金以支持COVID-19护理工作时,我们要求资金优先用于感染预防与控制措施。这将对医院内病毒传播、患者和员工安全产生极其积极的影响,而且在COVID-19大流行之后还会带来持久的益处。

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