加纳56家急性医疗机构的感染预防与控制准备水平及相关决定因素
Infection Prevention and Control Preparedness Level and Associated Determinants in 56 Acute Healthcare Facilities in Ghana.
作者信息
Oppong Timothy Bonney, Amponsem-Boateng Cecilia, Kyere Emmanuel Kumi Duodu, Wang Ying, Gheisari Zohreh, Oppong Eunice Ekua, Opolot Godfrey, Duan Guangcai, Yang Haiyan
机构信息
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China.
Medical Department, Entrance University Hospital, Accra 00233, Ghana.
出版信息
Infect Drug Resist. 2020 Nov 24;13:4263-4271. doi: 10.2147/IDR.S273851. eCollection 2020.
BACKGROUND
Infection prevention and control (IPC) is a globally relevant aspect of all health systems impacting the health and safety of both patients and healthcare workers. However, best practices remain a challenge in healthcare delivery especially in resource limited situations. The primary objective of this study was to assess the infection prevention and control (IPC) preparedness levels of acute healthcare facilities in Ghana and to determine the factors associated with the overall IPC preparedness levels in acute healthcare facilities.
METHODS
A cross-sectional study adapting the IPC assessment framework (IPCAF) developed by the World Health Organization (WHO) was conducted. Five of the core components of the WHO IPCAF were used to assess the IPC level of 56 acute healthcare facilities in Ghana.
RESULTS
Of the 56 facilities surveyed, only 19 had an IPC program with clearly defined objectives. Overall, 8 (14.3%) facilities scored an IPC preparedness level of "Advance", 18 (32.1%) facilities received an "Intermediate" IPC preparedness score, 23 (41.1%) facilities received an IPC preparedness level of "basic" and 7 (12.5%) facilities scored an IPC preparedness level of "inadequate". IPC materials like detergents, running water and PPEs were not significantly supplied. Government owned facilities performed better in terms of IPC preparedness as compared to privately owned facilities. A PLUM-ordinal regression analysis revealed that an IPC program with clearly defined objectives (OR= 76; 95% CI; 7.23, 808.19), dedicated IPC budget (OR= 13; 95% CI; 3.8-44.3) and regular mandatory training (OR= 50.9; 95% CI; 6.1-425) were associated with increased IPC preparedness.
CONCLUSION
Generally, the IPC preparedness levels in a majority of the facilities were low and required significant improvements in several areas. Facilities must make periodic reviews and adjust their objectives based on facility priorities.
背景
感染预防与控制（IPC）是所有卫生系统中与全球相关的一个方面，影响着患者和医护人员的健康与安全。然而，最佳实践在医疗服务中仍然是一项挑战，尤其是在资源有限的情况下。本研究的主要目的是评估加纳急性医疗机构的感染预防与控制（IPC）准备水平，并确定与急性医疗机构整体IPC准备水平相关的因素。
方法
开展了一项采用世界卫生组织（WHO）制定的IPC评估框架（IPCAF）的横断面研究。使用WHO IPCAF的五个核心组成部分来评估加纳56家急性医疗机构的IPC水平。
结果
在接受调查的56家机构中，只有19家有明确目标的IPC计划。总体而言，8家（14.3%）机构的IPC准备水平得分为“先进”，18家（32.1%）机构的IPC准备得分是“中级”，23家（41.1%）机构的IPC准备水平为“基本”，7家（12.5%）机构的IPC准备水平得分为“不足”。洗涤剂、自来水和个人防护装备等IPC物资供应不足。与私立机构相比，政府所有的机构在IPC准备方面表现更好。PLUM有序回归分析显示，有明确目标的IPC计划（OR=76；95%CI；7.23，808.19）、专门的IPC预算（OR=13；95%CI；3.8 - 44.3）和定期强制培训（OR=50.9；95%CI；6.1 - 425）与IPC准备水平的提高相关。
结论
总体而言，大多数机构的IPC准备水平较低，在几个方面需要显著改进。各机构必须定期进行审查，并根据机构重点调整目标。
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