Ghana Health Service, Awutu Senya East Municipal, Kasoa, Central Region, Ghana.
Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Antimicrob Resist Infect Control. 2023 Nov 13;12(1):125. doi: 10.1186/s13756-023-01330-z.
Healthcare-associated infections (HAIs) remain a common challenge in healthcare delivery, with a significant burden in low- and middle-income countries. Preventing HAIs has gained enormous attention from policy makers and healthcare managers and providers, especially in resource-limited settings. Despite policies to enforce infection prevention and control (IPC) measures to prevent HAIs, IPC compliance remains a challenge in hospital settings. In this study, we explore the experiences of healthcare providers and women in the post-natal phase and investigate factors influencing IPC practices in two hospitals in Ghana.
The study used a qualitative approach involving semi-structured interviews, focus group discussions, and observations among healthcare providers and women in the postnatal phase in two maternity units from January 2019 to June 2019. Interviews were recorded and transcribed verbatim for thematic analysis. The data sets were uploaded into the qualitative software NVivo 12 to facilitate coding and analysis.
Healthcare providers were driven by the responsibility to provide medical care for their patients and at the same time, protect themselves from infections. IPC facilitators include leadership commitment and support, IPC training and education. Women were informed about IPC in educational talks during antenatal care visits, and their practices were also shaped by their background and their communities. IPC barriers include the poor documentation or 'invisibility' of HAIs, low prioritization of IPC tasks, lack of clear IPC goals and resources, discretionary use of guidelines, and communication-related challenges. The findings demonstrate the need for relevant power holders to position themselves as key drivers of IPC and develop clear goals for IPC. Hospital managers need to take up the responsibility of providing the needed resources and leadership support to facilitate IPC. Patient engagement should be more strategic both within the hospital and at the community level.
在医疗保健提供中，医疗保健相关感染（HAI）仍然是一个常见的挑战，在中低收入国家负担沉重。预防 HAI 已引起政策制定者和医疗保健管理人员和提供者的极大关注，特别是在资源有限的环境中。尽管有政策强制实施感染预防和控制（IPC）措施以预防 HAI，但在医院环境中，IPC 合规性仍然是一个挑战。在这项研究中，我们探讨了医疗保健提供者和产后阶段妇女的经验，并调查了加纳两家医院影响 IPC 实践的因素。
该研究采用定性方法，于 2019 年 1 月至 6 月期间，在两家产科病房中，对医疗保健提供者和产后阶段的妇女进行了半结构式访谈、焦点小组讨论和观察。访谈内容被记录下来并逐字转录，以便进行主题分析。数据集被上传到定性软件 NVivo 12 中，以方便编码和分析。
医疗保健提供者的驱动力是为患者提供医疗护理，同时保护自己免受感染。IPC 促进因素包括领导力承诺和支持、IPC 培训和教育。妇女在产前保健访问期间的教育讲座中了解了 IPC，她们的做法也受到自身背景和社区的影响。IPC 障碍包括 HAI 记录不佳或“不可见”、IPC 任务优先级低、缺乏明确的 IPC 目标和资源、指南的自由裁量使用以及沟通相关挑战。研究结果表明，需要让相关权力持有者将自己定位为 IPC 的关键推动者，并为 IPC 制定明确的目标。医院管理人员需要承担起提供必要资源和领导力支持的责任，以促进 IPC。患者参与应该在医院内部和社区层面更加具有战略性。
