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喀麦隆一家转诊医院妇产科医护人员对标准预防措施的认知与实践

Standard precautions perception and practice among health workers in the obstetrics-gynecology department of a referral hospital in Cameroon.

作者信息

Cheuyem Fabrice Zobel Lekeumo, Lyonga Emilia Enjema, Takougang Innocent

机构信息

Department of Public Health, Faculty of Medicine and Biomedical Science, The University of Yaoundé 1, Yaoundé, Cameroon.

Department of Microbiology, Hematology and Infectious diseases, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaoundé, Cameroon.

出版信息

BMC Health Serv Res. 2025 Sep 1;25(1):1165. doi: 10.1186/s12913-025-13448-4.

Abstract

BACKGROUND

In the context of Cameroon, where maternal and neonatal mortality remain a serious concern, unsystematic compliance with standard precautions increases the risk of healthcare-associated infections (HAIs) and other medical hazards. The present investigation aimed at assessing the baseline understanding of hand hygiene principles and perceptions, experience of occupational exposure to body fluids, and preventive vaccination coverage among HCWs in the obstetrics-gynecology ward of a referral hospital in Yaoundé.

METHODS

A descriptive cross-sectional study was conducted in the obstetrics-gynecology department of the health facility from April to July 2024. A self-administered questionnaire, adapted from the WHO Knowledge Questionnaire for Health Care Workers, was used to collect data from consenting HCWs.

RESULTS

A total of 41 healthcare workers participated in the study. Participants were predominantly female (78%) and ranged in age from 20 to 57 years. Overall staff knowledge of hand hygiene was average, with a median score of 60%. The majority of respondents considered hand hygiene an essential part of their care (90%). A significant proportion of paramedical staff (82%) agreed they had been properly trained on hand hygiene during their training ( = 0.006). More than half of respondents (59%) experienced an accidental exposure to body fluids in the previous 12 months. A high level of education was a significant factor associated with occurrence of occupational exposure to blood and other body fluids (aOR = 14.2;  = 0.044). The coverage of fully vaccinated HCWs was 27% for hepatitis B, 19% for COVID-19, and 0% for cholera. Factors associated with low adherence to vaccination included having received no training in ICP interventions (aOR = 7.4;  = 0.046) for hepatitis B vaccination and having completed tertiary education (aOR = 43.6;  = 0.043) for COVID-19. Half of the HCWs exposed (12/24 = 50%) to blood and body fluids were not fully vaccinated against hepatitis B.

CONCLUSIONS

This study revealed gaps in knowledge of hand hygiene, high occupational exposure to biological fluids, and low vaccination coverage. Health facility managers and national health authorities must therefore commit to implementing specific strategies to increase staff training in standard precautions and promote vaccination.

摘要

背景

在喀麦隆,孕产妇和新生儿死亡率仍然是一个严重问题,不系统地遵守标准预防措施会增加医疗保健相关感染(HAIs)和其他医疗风险。本调查旨在评估雅温得一家转诊医院妇产科病房医护人员对手卫生原则的基线理解和认知、职业接触体液的经历以及预防性疫苗接种覆盖率。

方法

2024年4月至7月在该医疗机构的妇产科进行了一项描述性横断面研究。采用一份根据世界卫生组织医护人员知识问卷改编的自填式问卷,从同意参与的医护人员中收集数据。

结果

共有41名医护人员参与了研究。参与者以女性为主(78%),年龄在20至57岁之间。医护人员对手卫生的总体知识水平一般,中位数得分60%。大多数受访者认为手卫生是其护理工作的重要组成部分(90%)。相当比例的辅助医疗人员(82%)同意他们在培训期间接受了关于手卫生的适当培训(P = 0.006)。超过一半的受访者(59%)在过去12个月中经历过意外接触体液。高学历是与职业接触血液和其他体液发生相关的一个重要因素(调整后比值比 = 14.2;P = 0.044)。医护人员中乙肝疫苗全程接种覆盖率为27%,新冠疫苗接种覆盖率为19%,霍乱疫苗接种覆盖率为0%。与疫苗接种依从性低相关的因素包括未接受感染控制预防措施培训(乙肝疫苗接种调整后比值比 = 7.4;P = 0.046)和完成高等教育(新冠疫苗接种调整后比值比 = 43.6;P = 0.043)。接触血液和体液的医护人员中有一半(12/24 = 50%)未接种乙肝疫苗。

结论

本研究揭示了手卫生知识方面的差距、职业接触生物体液的情况较多以及疫苗接种覆盖率较低。因此,医疗机构管理人员和国家卫生当局必须致力于实施具体战略,以增加工作人员在标准预防措施方面的培训并促进疫苗接种。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a8a/12400657/d47e44510751/12913_2025_13448_Fig2_HTML.jpg

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