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坦桑尼亚滨海地区部分医疗机构护士对新生儿败血症感染预防与控制的实践及依从性的决定因素

Determinants of Practice and Adherence to Infection Prevention and Control of Neonatal Sepsis Among Nurses in Selected Health Facilities of Pwani Region, Tanzania.

作者信息

Pendo Maua Halfani, Hussein Mahamudu Rashid, Moshi Fabiola Vincent

机构信息

Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Tanzania.

Department of Nursing Management and Education, School of Nursing and Public Health, The University of Dodoma, Tanzania.

出版信息

East Afr Health Res J. 2024;8(3):432-442. doi: 10.24248/eahrj.v8i3.814. Epub 2025 Jan 30.

Abstract

BACKGROUND

Although guidelines on neonatal care and infection prevention exist, it is unclear what factors influence nurses' adherence to infection prevention and control (IPC) in neonatal care. This study aimed to assess the determinants of nurses' adherence to IPC in neonatal sepsis prevention in the Pwani Region, Tanzania.

METHODS

A cross-sectional study with 282 nurses was conducted. Assessing the how Socio demographic characteristics, Health facility factors, attitude of the nurses affect the Nurse's practices on adherence to IPC for prevention of neonatal sepsis. Data collection methods included a questionnaire and an observation checklist. Bivariate and multivariate logistic regression were employed to determine the factors influencing nurses' adherence to IPC. Nurse's adherence to IPC was measured using the mean score whereby those who score above the mean were regarded as adequate adherence. A Probability value of .05 and a 95% confidence interval was regarded as statistically significant.

RESULTS

The present study found that only one-third (37.0%) of the nurses had adequately adhered to IPC. Significant associations were observed between nurse's adherence to IPC in the prevention of neonatal sepsis and; working experience of 13 to 24, 7 to 12, and 6 months [AOR =5.30, ], [AOR=3.9, ] and [AOR=3.640, ] respectively, >10 years in nursing professional [AOR=2.627, ], staffing of 6-10 and 1-5 [AOR=5.992, ] and [AOR=3.791, ] respectively, 3 and >3 staffs per shift [AOR=3.276, ] and [AOR=2.364, ) respectively, working at District and regional hospitals [AOR=1.101, ] and [AOR= 2.320, ] respectively, on-job training [AOR = 2.08, ], isolation room availability [AOR=1.783, ], SOPs and IPC guidelines availability [AOR=4.320, ], sufficient medical equipment and supply [AOR =1.414, ] and positive attitude [AOR=1.490, ].

CONCLUSION

The study results indicated Nurse's adherence to IPC in the prevention of neonatal sepsis is associated with working experience, staffing, healthcare level, on-job training, isolation room availability, current SOPs and IPC guidelines, access to medical equipment/supply, and positive attitude. Strategies should be employed to strengthen the adherence of nurses to IPC guidelines to minimize the morbidity and mortality resulting from neonatal sepsis. Interventional studies from each factor for nurse's adherence to IPC in the prevention of neonatal sepsis should be of priority.

摘要

背景

尽管存在新生儿护理和感染预防指南,但尚不清楚哪些因素会影响护士在新生儿护理中对感染预防与控制(IPC)的遵守情况。本研究旨在评估坦桑尼亚滨海地区护士在预防新生儿败血症方面遵守IPC的决定因素。

方法

对282名护士进行了一项横断面研究。评估社会人口统计学特征、卫生设施因素、护士态度如何影响护士在预防新生儿败血症方面遵守IPC的行为。数据收集方法包括问卷调查和观察清单。采用双变量和多变量逻辑回归来确定影响护士遵守IPC的因素。护士对IPC的遵守情况通过平均得分来衡量,得分高于平均分的被视为充分遵守。概率值为0.05和95%置信区间被视为具有统计学意义。

结果

本研究发现,只有三分之一(37.0%)的护士充分遵守了IPC。在预防新生儿败血症方面,护士对IPC的遵守情况与以下因素之间存在显著关联:工作经验为13至24个月、7至12个月和6个月,[调整后比值比(AOR)=5.30],[AOR=3.9]和[AOR=3.640],护理专业工作超过10年,[AOR=2.627],人员配备为6至10人和1至5人,[AOR=5.992]和[AOR=3.791],每班3人和超过3人,[AOR=3.276]和[AOR=2.364],分别在地区和区域医院工作,[AOR=1.101]和[AOR=2.320],在职培训,[AOR=2.08],有隔离室,[AOR=1.783],有标准操作规程(SOPs)和IPC指南,[AOR=4.320],有充足的医疗设备和物资供应,[AOR=1.414]以及积极态度,[AOR=1.490]。

结论

研究结果表明,护士在预防新生儿败血症方面对IPC的遵守情况与工作经验、人员配备、医疗保健水平、在职培训、隔离室可用性、现行SOPs和IPC指南、获得医疗设备/物资供应以及积极态度有关。应采取策略加强护士对IPC指南的遵守,以尽量减少新生儿败血症导致的发病率和死亡率。针对护士在预防新生儿败血症方面遵守IPC的每个因素进行干预研究应作为优先事项。

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The Global Burden of Sepsis and Septic Shock.脓毒症和感染性休克的全球负担
Epidemiologia (Basel). 2024 Jul 25;5(3):456-478. doi: 10.3390/epidemiologia5030032.
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Neonatal sepsis.新生儿败血症。
Lancet. 2017 Oct 14;390(10104):1770-1780. doi: 10.1016/S0140-6736(17)31002-4. Epub 2017 Apr 20.
10
Sample size for pre-tests of questionnaires.问卷预测试的样本量。
Qual Life Res. 2015 Jan;24(1):147-51. doi: 10.1007/s11136-014-0752-2. Epub 2014 Jul 10.

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