Limenyande Mitima Jean-Marie, Isunju John Bosco, Musoke David
Makerere University School of Public Health, Kampala, Uganda.
PLOS Glob Public Health. 2024 Dec 9;4(12):e0004021. doi: 10.1371/journal.pgph.0004021. eCollection 2024.
During the COVID-19 pandemic, Infection Prevention and Control (IPC) was crucial to reduce the spread of the virus in health facilities. This study explored the barriers and facilitators of IPC compliance among healthcare workers (HCWs) during the COVID-19 pandemic in Kampala City, Uganda. Key informant interviews were conducted with 14 participants in 12 health facilities located in Nakawa division, Kampala City. Of these facilities, 3 were government-owned, and 9 were private not-for-profit. Each health facility's participant was either the IPC focal person or a HCW knowledgeable about the IPC measures implemented there. Transcripts were coded using a newly generated codebook in Atlas.ti version 9, and thematic analysis was carried out to analyze the study findings. Participants identified the fear of contracting the virus as one of the primary facilitators for IPC compliance among HCWs during the COVID-19 pandemic. They explained that the sustainability of IPC measures in health facilities was partly due to HCWs' belief that they served as role models in the community for observing and implementing health-related behaviors, especially regarding COVID-19. Among the barriers, participants mentioned that not all HCWs got the opportunity to be trained on COVID-19 IPC. Only HCWs working in high-risk departments for COVID-19 such as triage or Intensive Care Units were prioritized. However, regardless of the department, all HCWs were exposed to potential COVID-19 patients, and the high workload led them to sometimes skip the required IPC measures. This study found that addressing the spread of COVID-19 among HCWs necessitated a comprehensive approach to IPC in health facilities. This approach should encompass capacity building, as well as provision of necessary supplies. In addition, HCWs, the hospital management and government have a role to play to ensure that IPC is fully implemented in the case of future related outbreaks.
在新冠疫情期间，感染预防与控制（IPC）对于减少病毒在医疗机构内的传播至关重要。本研究探讨了乌干达坎帕拉市新冠疫情期间医护人员遵守IPC的障碍和促进因素。对坎帕拉市纳卡瓦区12家医疗机构的14名参与者进行了关键信息人访谈。这些医疗机构中，3家为政府所有，9家为私立非营利性机构。每个医疗机构的参与者要么是IPC协调人，要么是了解该机构实施的IPC措施的医护人员。使用Atlas.ti 9版本中新生成的编码手册对访谈记录进行编码，并进行主题分析以分析研究结果。参与者认为，对感染病毒的恐惧是新冠疫情期间医护人员遵守IPC的主要促进因素之一。他们解释说，医疗机构中IPC措施的可持续性部分归因于医护人员认为自己在社区中是遵守和实施健康相关行为（尤其是关于新冠疫情的行为）的榜样。在障碍方面，参与者提到并非所有医护人员都有机会接受新冠疫情IPC培训。只有在新冠疫情高风险科室（如分诊处或重症监护病房）工作的医护人员被优先考虑。然而，无论在哪个科室，所有医护人员都接触过潜在的新冠患者，高工作量导致他们有时会跳过所需的IPC措施。本研究发现，应对新冠病毒在医护人员中的传播需要在医疗机构中采取全面的IPC方法。这种方法应包括能力建设以及提供必要的物资。此外，医护人员、医院管理层和政府都应发挥作用，以确保在未来相关疫情爆发时IPC能得到全面实施。
