Yilma Mengistu, Taye Girma, Tefera Muluwork, Tassew Berhan, Fentie Atalay Mulu, Abebe Workeabeba
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Front Public Health. 2024 Jan 19;12:1329410. doi: 10.3389/fpubh.2024.1329410. eCollection 2024.
Infection prevention and control (IPC) is a set of practices that are designed to minimize the risk of healthcare-associated infections (HAIs) spreading among patients, healthcare workers, and visitors. Implementation of IPC is essential for reducing infection incidences, preventing antibiotic use, and minimizing antimicrobial resistance (AMR). The aim of the study was to assess IPC practices and associated factors in Pediatrics and Child Health at Tikur Anbessa Specialized Hospital.
In this study, we used a cross-sectional study design with a simple random sampling method. We determined the sample size using a single population proportion formula with the assumption of a 55% good IPC practice, a 5% accepted margin of error, and a 15% non-response rate and adjusted with the correction formula. The final sample size was 284 healthcare workers. The binary logistic regression model was used for analysis. The World Health Organization (WHO) Infection Prevention and Control Assessment Framework (IPCAF) tool was used to assess IPC core components.
A total of 272 healthcare workers participated in the study, with a response rate of 96%. Of the total participants, 65.8% were female and 75.7% were nurses. The overall composite score showed that the prevalence of good IPC practices among healthcare workers was 50.4% (95% CI: 44.3-56.5). The final model revealed that nursing professionals and healthcare workers who received IPC training had AORs of 2.84 (95% CI: 1.34-6.05) and 2.48 (95% CI: 1.36-4.52), respectively. The final average total IPCAF score for the IPC level was 247.5 out of 800 points.
The prevalence of good IPC practice was suboptimal. The study participants, who were nursing professionals and healthcare workers who received IPC training, showed a statistically significant association with the IPC practice level. The facility-level IPCAF result showed a "Basic" level of practice based on the WHO categorization. These evidences can inform healthcare workers and decision-makers to identify areas for improvement in IPC practice at all levels. Training of healthcare workers and effective implementation of the eight IPC core components should be strengthened to improve suboptimal practices.
感染预防与控制（IPC）是旨在将医疗保健相关感染（HAIs）在患者、医护人员和访客之间传播的风险降至最低的一系列措施。实施IPC对于降低感染发生率、防止抗生素使用以及将抗菌药物耐药性（AMR）降至最低至关重要。本研究的目的是评估提库尔安贝萨专科医院儿科和儿童健康领域的IPC措施及相关因素。
在本研究中，我们采用了横断面研究设计和简单随机抽样方法。我们使用单总体比例公式确定样本量，假设IPC措施执行良好率为55%，允许误差为5%，无应答率为15%，并使用校正公式进行调整。最终样本量为284名医护人员。采用二元逻辑回归模型进行分析。使用世界卫生组织（WHO）感染预防与控制评估框架（IPCAF）工具评估IPC核心要素。
共有272名医护人员参与了研究，应答率为96%。在所有参与者中，65.8%为女性，75.7%为护士。总体综合评分显示，医护人员中IPC措施执行良好的比例为50.4%（95%CI：44.3 - 56.5）。最终模型显示，护理专业人员和接受过IPC培训的医护人员的调整后比值比分别为2.84（95%CI：1.34 - 6.05）和2.48（95%CI：1.36 - 4.52）。IPC水平的最终平均IPCAF总评分为800分中的247.5分。
IPC措施执行良好的比例未达最佳。研究参与者中，护理专业人员和接受过IPC培训的医护人员与IPC措施执行水平存在统计学上的显著关联。根据WHO的分类，机构层面的IPCAF结果显示为“基本”水平的措施执行情况。这些证据可为医护人员和决策者指明各级IPC措施执行中有待改进的领域。应加强对医护人员的培训并有效实施八项IPC核心要素，以改善执行情况欠佳的问题。
