Lakoh Sulaiman, Maruta Anna, Kallon Christiana, Deen Gibrilla F, Russell James B W, Fofanah Bobson Derrick, Kamara Ibrahim Franklyn, Kanu Joseph Sam, Kamara Dauda, Molleh Bailah, Adekanmbi Olukemi, Tavernor Simon, Guth Jamie, Sagili Karuna D, Wilkinson Ewan
Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
Department of Medicine, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone.
Int J Environ Res Public Health. 2022 Mar 23;19(7):3787. doi: 10.3390/ijerph19073787.
Healthcare-associated infections (HAIs) result in millions of avoidable deaths or prolonged lengths of stay in hospitals and cause huge economic loss to health systems and communities. Primarily, HAIs spread through the hands of healthcare workers, so improving hand hygiene can reduce their spread. We evaluated hand hygiene practices and promotion across 13 public health hospitals (six secondary and seven tertiary hospitals) in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021. The mean score for all hospitals was 273 ± 46, indicating an intermediate level of hand hygiene. Nine hospitals achieved an intermediate level and four a basic level. More secondary hospitals 5 (83%) were at the intermediate level, compared to tertiary hospitals 4 (57%). Tertiary hospitals were poorly rated in the reminders in workplace and institutional safety climate domains but excelled in training and education. Lack of budgets to support hand hygiene implementation is a priority gap underlying this poor performance. These gaps hinder hand hygiene practice and promotion, contributing to the continued spread of HAIs. Enhancing the distribution of hand hygiene resources and encouraging an embedded culture of hand hygiene practice in hospitals will reduce HAIs.
医疗保健相关感染（HAIs）导致数百万可避免的死亡或住院时间延长，并给卫生系统和社区造成巨大经济损失。主要地，医疗保健相关感染通过医护人员的手传播，因此改善手部卫生可以减少其传播。2021年5月，我们在塞拉利昂西部地区的13家公立卫生医院（6家二级医院和7家三级医院）开展了一项横断面研究，使用世界卫生组织手部卫生自我评估框架评估手部卫生实践和推广情况。所有医院的平均得分为273±46，表明手部卫生处于中等水平。9家医院达到中等水平，4家达到基本水平。与三级医院的4家（57%）相比，更多的二级医院5家（83%）处于中等水平。三级医院在工作场所提醒和机构安全氛围领域的评分较低，但在培训和教育方面表现出色。缺乏支持手部卫生实施的预算是导致这种不佳表现的一个首要差距。这些差距阻碍了手部卫生实践和推广，导致医疗保健相关感染持续传播。加强手部卫生资源的分配，并在医院鼓励一种根深蒂固的手部卫生实践文化，将减少医疗保健相关感染。
