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      Factors affecting compliance with infection prevention and control standard precautions among healthcare workers in Songwe region, Tanzania

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          Summary

          Background

          Compliance with infection prevention and control standard precautions (IPCSPs) remains a major challenge in many countries including Tanzania. Lack of compliance exposes healthcare workers (HCWs) and patients to a high risk of developing healthcare-associated infections (HAIs) including antimicrobial-resistant microorganisms which can contribute to the spread of antimicrobial resistance (AMR). This study investigated compliance with IPCSPs and associated factors among HCWs in public healthcare facilities (HFs) in Songwe Region, Tanzania between January and March 2021.

          Methods

          A cross-sectional study was conducted in all 5 districts in Songwe Region, involved 400 HCWs from difference healthcare facilities (HFs) including dispensaries, health centres and hospitals. The Compliance with Standard Precautions scale (CSPS) tool developed by WHO was used. Descriptive and modified Poisson regression analysis was done. A P-value of less than 0.05 indicated statistical significance.

          Results

          Only 22.5% (90/400) of HCWs had high compliance (above 80%) to IPCSPs. The majority of HCWs reported highest compliance on discarding used needles/sharps into sharps containers (94%), the lowest IPCSPs compliance was for the correct handling of spills, taking a shower after extensive splashing and not re-using disposable masks, 8%, 28.5% and 34% respectively. Attending IPC training or an IPC seminar in the previous year (ARR=2.97 [1.87–4.72] P<0.001), the number of years of work experience (ARR=2.08 [1.22–3.54] P=0.007), and having experienced a needlestick injury (ARR=0.62 [0.40–0.95] P=0.028), were identified as predictors of HCWs compliance with IPCSPs.

          Conclusion

          The majority of HCWs in Songwe region had low compliance with IPCSPs according to national standards. IPC training and the number of years of work experience predicted high compliance with IPCSPs. Capacity building initiatives, mentorship and supportive supervision should be emphasised for all HCWs in all HFs.

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          Most cited references20

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          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges

          Highlights • Emergence of 2019 novel coronavirus (2019-nCoV) in China has caused a large global outbreak and major public health issue. • At 9 February 2020, data from the WHO has shown >37 000 confirmed cases in 28 countries (>99% of cases detected in China). • 2019-nCoV is spread by human-to-human transmission via droplets or direct contact. • Infection estimated to have an incubation period of 2–14 days and a basic reproduction number of 2.24–3.58. • Controlling infection to prevent spread of the 2019-nCoV is the primary intervention being used.
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            Health-care-associated infection in Africa: a systematic review.

            To assess the epidemiology of endemic health-care-associated infection (HAI) in Africa. Three databases (PubMed, the Cochrane Library, and the WHO regional medical database for Africa) were searched to identify studies published from 1995 to 2009 on the epidemiology of HAI in African countries. No language restriction was applied. Available abstract books of leading international infection control conferences were also searched from 2004 to 2009. The eligibility criteria for inclusion in the review were met by 19 articles, only 2 of which met the criterion of high quality. Four relevant abstracts were retrieved from the international conference literature. The hospital-wide prevalence of HAI varied between 2.5% and 14.8%; in surgical wards, the cumulative incidence ranged from 5.7% to 45.8%. The largest number of studies focused on surgical site infection, whose cumulative incidence ranged from 2.5% to 30.9%. Data on causative pathogens were available from a few studies only and highlighted the importance of gram-negative rods, particularly in surgical site infection and ventilator-associated pneumonia. Limited information is available on the endemic burden of HAI in Africa, but our review reveals that its frequency is much higher than in developed countries. There is an urgent need to identify and implement feasible and sustainable approaches to strengthen HAI prevention, surveillance and control in Africa.
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              Factors impacting compliance with standard precautions in nursing, China

              Summary Objectives To evaluate registered nurse compliance with standard precautions and to analyze the factors that affect compliance. Methods Study data were collected over a 3-month period from June to September 2007. The survey research method was used. A total of 1500 randomly sampled registered nurses from 18 hospitals in Hunan, China completed self-report questionnaires. Results Of the 1500 nurses included in the study, 1444 returned valid self-report questionnaires. Compliance with standard precautions was found to be low in the surveyed nurses. With a maximum possible score of 80, the quartile range of the overall score for compliance for all nurses was 48.29 (upper quartile score 76.36, lower quartile score 28.07), which was occupied by 64.7% of the participants. The factors most affecting compliance were: standard precautions training (odds ratio (OR) 2.17, 95% confidence interval (CI) 1.85–2.55) and knowledge (OR 1.94, 95% CI 1.01–3.41), followed by hospital grade (OR 1.61, 95% CI 1.79–1.86), presence of sharps disposal box in the department (OR 1.43, 95% CI 1.10–3.41), general self-efficacy (OR 1.29, 95% CI 1.04–1.59), exposure experience (OR 0.69, 95% CI 0.56–0.85), and department in which the nurse worked (OR 1.24, 95% CI 1.05–1.46). Conclusions The relevant authorities and hospital infection control department should pay more attention to nurse compliance with standard precautions. Standard precautions training should be strengthened and sufficient practical personal protection equipment provided in order to reduce hospital infections and protect the health of patients and medical staff.
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                Author and article information

                Contributors
                Journal
                Infect Prev Pract
                Infect Prev Pract
                Infection Prevention in Practice
                Elsevier
                2590-0889
                06 August 2022
                December 2022
                06 August 2022
                : 4
                : 4
                : 100236
                Affiliations
                [a ]Tanzania Field Epidemiology and Laboratory Training Program, Ministry of Health, Dodoma, Tanzania
                [b ]Ministry of Health, Dodoma, Tanzania
                [c ]Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
                Author notes
                []Corresponding author. Address: Ministry of Health, P.O. Box 743, Dodoma, Tanzania. radentap91@ 123456gmail.com
                Article
                S2590-0889(22)00037-3 100236
                10.1016/j.infpip.2022.100236
                9424571
                36052313
                31cb2c17-ada9-4649-9da6-9ec5ae9a2986
                © 2022 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 30 October 2021
                : 20 July 2022
                Categories
                Original Research Article

                standard precautions,infection prevention and control,healthcare-associated infection,antimicrobial resistance

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