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中低收入国家医疗机构医护人员标准预防措施实施情况的评估:系统评价和荟萃分析。

Magnitude of standard precautions practices among healthcare workers in health facilities of Low and Middle Income Countries: A systematic review and meta-analysis.

机构信息

School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.

School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

PLoS One. 2024 Apr 30;19(4):e0302282. doi: 10.1371/journal.pone.0302282. eCollection 2024.

Abstract

BACKGROUND

Standard precautions are the minimum standard of infection control to prevent transmission of infectious agents, protect healthcare workers, patients, and visitors regardless of infection status. The consistent implementation of standard precautions is highly effective in reducing transmission of pathogens that cause HAIs. Despite their effectiveness, compliance, resources, patient behavior, and time constraints are some of the challenges that can arise when implementing standard precautions. The main objective of this meta-analysis was to show the pooled prevalence of safe standard precaution practices among healthcare workers in Low and Middle Income Countries (LMICs).

METHODS

A systematic review and meta-analysis was conducted for this study. We systematically searched observational study articles from PubMed Central and Google Scholar. We included articles published any year and involving healthcare workers. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The random effect model was used to estimate the pooled prevalence. The meta-analysis, sensitivity analysis, subgroup analysis, and publication bias (funnel plot, and Egger's tests) were conducted.

RESULTS

A total of 46 articles were included in this study. The pooled prevalence of standard precautions practices among healthcare workers in LMICs was 53%, with a 95% CI of (47, 59). These studies had a total sample size of 14061 with a minimum sample size of 17 and a maximum sample size of 2086. The majority of the studies (82.6%) were conducted in hospitals only (all kinds), and the remaining 17.4% were conducted in all health facilities, including hospitals.

CONCLUSIONS

The pooled prevalence of standard precautions practices among healthcare workers in LMICs was suboptimal. The findings of this study can have substantial implication for healthcare practice and policy making by providing robust evidence with synthesized and pooled evidence from multiple studies.

TRIAL REGISTRATION

Registered on PROSPERO with record ID: CRD42023395129, on the 9th Feb. 2023.

摘要

背景

标准预防措施是预防传染病传播的最低感染控制标准,无论患者的感染状态如何,都能保护医护人员、患者和访客。持续执行标准预防措施在降低医院获得性感染病原体的传播方面非常有效。尽管标准预防措施非常有效,但在实施过程中,医护人员可能会遇到依从性、资源、患者行为和时间限制等挑战。本荟萃分析的主要目的是展示中低收入国家(LMICs)医护人员安全实施标准预防措施的综合流行率。

方法

本研究采用系统综述和荟萃分析。我们从 PubMed Central 和 Google Scholar 系统地检索了观察性研究文章。我们纳入了任何年份发表的、涉及医护人员的文章。我们使用了系统评价和荟萃分析的首选报告项目(PRISMA)。采用随机效应模型来估计综合流行率。进行了荟萃分析、敏感性分析、亚组分析和发表偏倚(漏斗图和 Egger 检验)。

结果

本研究共纳入 46 篇文章。中低收入国家医护人员实施标准预防措施的综合流行率为 53%,95%可信区间为(47,59)。这些研究的总样本量为 14061 例,最小样本量为 17 例,最大样本量为 2086 例。大多数研究(82.6%)仅在医院(各类)进行,其余 17.4%在包括医院在内的所有卫生机构进行。

结论

中低收入国家医护人员实施标准预防措施的流行率不理想。本研究结果可以为医疗保健实践和政策制定提供实质性的启示,为多个研究提供综合和汇总证据,具有较强的说服力。

试验注册

于 2023 年 2 月 9 日在 PROSPERO 上以记录 ID:CRD42023395129 注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dda9/11060540/d2f309319167/pone.0302282.g001.jpg

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