Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic.
Front Public Health. 2023 Sep 20;11:1239228. doi: 10.3389/fpubh.2023.1239228. eCollection 2023.
Hospital-acquired infections (HAIs) are significant public health issues, especially in low-and middle-income countries (LMICs). Hand hygiene and low-level disinfection of equipment practices among healthcare workers are some of the essential measures to reduce HAIs. Various infection prevention and control (IPC) interventions to reduce HAI incidence have been developed. However, effective interventions have not been well developed in the LMICs context. Therefore, this protocol aims to develop, pilot, and assess the feasibility and acceptability of an IPC intervention in Cambodia and the Lao People's Democratic Republic.
This study will consist of four phases guided by the Medical Research Council (MRC) Framework. Three hospitals will be purposely selected - each from the district, provincial, and national levels - in each country. The gap analysis will be conducted in Phase 1 to explore IPC practices among healthcare workers at each hospital through desk reviews, direct observation of hand hygiene and low-level disinfection of equipment practices, in-depth interviews with healthcare workers, and key informant interviews with stakeholders. In Phase 2, an IPC intervention will be developed based on the results of Phase 1 and interventions selected from a systematic literature review of IPC interventions in LMICs. In Phase 3, the developed intervention will be piloted in the hospitals chosen in Phase 1. In Phase 4, the feasibility and acceptability of the developed intervention will be assessed among healthcare workers and representatives at the selected hospitals. National consultative workshops in both countries will be conducted to validate the developed intervention with the national technical working groups.
The MRC Framework will be employed to develop and evaluate an intervention to reduce HAIs in two LMICs. This theoretical framework will be used to explore the factors influencing hand hygiene compliance among healthcare workers. The gap analysis results will allow us to develop a comprehensive IPC intervention to reduce HAI incidence in Cambodia and Lao People's Democratic Republic. Findings from this protocol will feed into promising IPC interventions to reduce HAI incidence in other resource-limited settings.
ClinicalTrial.Gov, identifier NCT05547373.
医院获得性感染（HAI）是一个重大的公共卫生问题，尤其是在中低收入国家（LMICs）。医护人员的手部卫生和设备的低水平消毒措施是减少 HAI 的重要措施之一。已经开发了各种感染预防和控制（IPC）干预措施来降低 HAI 的发生率。然而，在 LMIC 环境中，尚未很好地开发有效的干预措施。因此，本方案旨在柬埔寨和老挝人民民主共和国制定、试点和评估 IPC 干预措施的可行性和可接受性。
本研究将分为四个阶段，由医学研究委员会（MRC）框架指导。每个国家将从地区、省和国家三个层面有目的地选择三家医院。在第一阶段将进行差距分析，通过桌面审查、直接观察医护人员的手部卫生和设备低水平消毒实践、对医护人员进行深入访谈以及对利益相关者进行关键人物访谈，探索每家医院的 IPC 实践。在第二阶段，将根据第一阶段的结果和从针对 LMIC 中 IPC 干预措施的系统文献综述中选择的干预措施制定 IPC 干预措施。在第三阶段，将在第一阶段选择的医院中试点开发的干预措施。在第四阶段，将在选定的医院中的医护人员和代表中评估所开发干预措施的可行性和可接受性。将在两个国家举行国家协商研讨会，以便与国家技术工作组一起验证所开发的干预措施。
将采用 MRC 框架来开发和评估针对两个 LMIC 减少 HAI 的干预措施。这个理论框架将用于探索影响医护人员手部卫生依从性的因素。差距分析结果将使我们能够制定一项全面的 IPC 干预措施，以降低柬埔寨和老挝人民民主共和国的 HAI 发生率。本方案的结果将为在其他资源有限的环境中减少 HAI 发生率的有希望的 IPC 干预措施提供信息。
ClinicalTrials.gov，标识符 NCT05547373。
