Department of Health Informatics Technology, Debre Tabor Health Science College, Debre Tabor, Ethiopia.
Department of Health Systems and Policy, University of Gondar, Gondar, Ethiopia.
BMC Infect Dis. 2023 May 22;23(1):343. doi: 10.1186/s12879-023-08263-3.
Healthcare-Acquired Infections are a major problem in the world and within the healthcare delivery system. An estimated 5-10% and around 25% of hospitalized patients have healthcare-acquired infections in developed and developing countries, respectively. Infection prevention and control programs have proven to be successful in lowering the incidence and spread of infections. Thus, this evaluation aims to evaluate the implementation fidelity of infection prevention practices at Debre Tabor comprehensive specialized hospital in Northwest Ethiopia.
A facility-based cross-sectional design with a concurrent mixed method was used to evaluate the implementation fidelity of infection prevention practices. A total of 36 indicators were used to measure adherence, participant responsiveness, and facilitation strategy dimensions. A total of 423 clients were administered for an interview, an inventory checklist, a document review, 35 non-participatory observations, and 11 key informant interviews were conducted. A multivariable logistic regression analysis was used to identify factors significantly associated with the satisfaction of clients. The findings were presented using descriptions, tables, and graphs.
The overall implementation fidelity of the infection prevention practices was 61.8%. The dimensions of adherence to infection prevention and control guidelines were 71.4%, participant responsiveness was 60.6%, and facilitation strategy was 48%. In multivariable analysis, ward admission and educational level had a p-value of below 0.05 and were significantly associated with the satisfaction of clients with infection prevention practices at the hospital. The major themes that emerged in qualitative data analysis were healthcare worker-related factors, management-related factors, and patient- and visitor-related factors.
The evaluation result of this study concluded that the overall implementation fidelity of infection prevention practice was judged to be medium and needed improvement. It included dimensions of adherence and participant responsiveness that were rated as medium, as well as a facilitation strategy that was rated as low. Enablers and barriers were thematized into factors related to healthcare providers, management, institutions, and patient and visitor relations.
医疗保健相关感染是全球和医疗保健系统内的一个主要问题。据估计，发达国家和发展中国家分别有 5-10%和 25%左右的住院患者发生医疗保健相关感染。感染预防和控制方案已被证明可成功降低感染的发生率和传播。因此，本评价旨在评估埃塞俄比亚西北部德布雷塔博尔综合专科医院感染预防实践的实施准确性。
采用基于设施的横断面设计和同时进行的混合方法，评估感染预防实践的实施准确性。共使用 36 个指标来衡量依从性、参与者响应性和促进策略维度。对 423 名患者进行了访谈、库存清单检查、文件审查、35 次非参与性观察和 11 次关键知情人访谈。采用多变量逻辑回归分析来确定与患者满意度显著相关的因素。研究结果以描述、表格和图表的形式呈现。
感染预防实践的整体实施准确性为 61.8%。感染预防和控制指南的依从性维度为 71.4%，参与者响应性为 60.6%，促进策略为 48%。在多变量分析中，病房入院和教育程度的 p 值均低于 0.05，与医院感染预防实践的患者满意度显著相关。定性数据分析中出现的主要主题包括与医护人员相关的因素、与管理相关的因素以及与患者和访客相关的因素。
本研究的评价结果表明，感染预防实践的整体实施准确性被判断为中等，需要改进。其中包括依从性和参与者响应性维度被评为中等，以及促进策略被评为低等。促进因素和障碍被主题化为与医护人员、管理、机构以及患者和访客关系相关的因素。
