scholarly journals Examining pulmonary TB patient management and healthcare workers exposures in two public tertiary care hospitals, Bangladesh

2022 ◽  
Vol 2 (1) ◽  
pp. e0000064
Author(s):  
Md. Saiful Islam ◽  
Sayera Banu ◽  
Sayeeda Tarannum ◽  
Kamal Ibne Amin Chowdhury ◽  
Arifa Nazneen ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Patient Management ◽  
Tertiary Care ◽  
Scale Up ◽  
Hospital Staff ◽  
Infection Prevention And Control ◽  
Hospital Record ◽  
Pulmonary Tb ◽  
Record Review ◽  
Tertiary Care Hospitals

Implementation of tuberculosis (TB) infection prevention and control (IPC) guidelines in public tertiary care general hospitals remain challenging due to limited evidence of pulmonary TB (PTB) patients’ duration of hospital stay and management. To fill this evidence gap, this study examined adult PTB patient management, healthcare workers’ (HCWs) exposures and IPC practices in two public tertiary care hospitals in Bangladesh.Between December 2017 and September 2019, a multidisciplinary team conducted structured observations, a hospital record review, and in-depth interviews with hospital staff from four adult medicine wards.Over 20 months, we identified 1,200 presumptive TB patients through the hospital record review, of whom 263 were confirmed PTB patients who stayed in the hospital, a median of 4.7 days without TB treatment and possibly contaminated the inpatients wards. Over 141 observation hours, we found a median of 3.35 occupants present per 10 m2 of floor space and recorded a total of 17,085 coughs and 316 sneezes: a median of 3.9 coughs or sneezes per 10 m2 per hour per ward. Only 8.4% of coughs and 21% of sneezes were covered by cloths, paper, tissues, or by hand. The HCWs reportedly could not isolate the TB patients due to limited resources and space and could not provide them with a mask. Further, patients and HCWs did not wear any respirators.The study identified that most TB patients stayed in the hospitals untreated for some duration of time. These PTB patients frequently coughed and sneezed without any facial protection that potentially contaminated the ward environment and put everyone, including the HCWs, at risk of TB infection. Interventions that target TB patients screening on admission, isolation of presumptive TB patients, respiratory hygiene, and HCWs’ use of personal protective equipment need to be enhanced and evaluated for acceptability, practicality and scale-up.

scholarly journals A tuberculin skin test survey among healthcare workers in two public tertiary care hospitals in Bangladesh

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243951
Author(s):  
Md Saiful Islam ◽  
Abrar Ahmad Chughtai ◽  
Arifa Nazneen ◽  
Kamal Ibne Amin Chowdhury ◽  
Muhammad Tauhidul Islam ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
High Risk Group ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Gynecology And Obstetrics ◽  
High Prevalence ◽  
Tertiary Care Hospitals

In Bangladesh, there is currently no data on the burden of latent TB infection (LTBI) amongst hospital healthcare workers (HCWs). This study aimed to determine the prevalence of LTBI and compare the prevalence among HCWs in two public tertiary care hospitals. Between September 2018 and August 2019, we conducted a cross-sectional study in two public tertiary care general hospitals. Using a survey and tuberculin skin test (TST), we assessed risk factors for LTBI, adjusting for known and plausible confounders. In addition, a facility assessment was undertaken to understand the implementation of relevant IPC measures. The prevalence of LTBI among HCWs was 42%. HCWs spent a median of 6 hours (SD = 1.76, IQR 2.00) per day and attended an average of 1.87 pulmonary TB patients per week. HCWs did not receive any TB IPC training, the wards lacked a symptom checklist to screen patients for TB, and no masks were available for coughing patients. Seventy-seven percent reportedly did not use any facial protection (masks or respirators) while caring for patients. In the multivariable model adjusting for hospital level clustering effect, TST positivity was significantly higher among HCWs aged 35–45 years (aOR1.36, 95% CI: 1.06–1.73) and with >3 years of service (aOR 1.67, 95% CI: 1.62–1.72). HCWs working in the medicine ward had 3.65 (95% CI: 2.20–6.05) times, and HCWs in the gynecology and obstetrics ward had 2.46 (95% CI: 1.42–4.27) times higher odds of TST positivity compared to HCWs working in administrative areas. This study identified high prevalence of LTBI among HCWs. This may be due to the level of exposure to pulmonary TB patients, and/or limited use of personal protective equipment along with poor implementation of TB IPC in the hospitals. Considering the high prevalence of LTBI, we recommend the national TB program consider providing preventative therapy to the HCWs as the high-risk group, and implement TB IPC in the hospitals.

Effect of a Multifaceted Intervention on Adherence to Hand Hygiene among Healthcare Workers: A Cluster-Randomized Trial

2010 ◽  
Vol 31 (11) ◽  
pp. 1170-1176 ◽  
Author(s):  
Dominik Mertz ◽  
Nancy Dafoe ◽  
Stephen D. Walter ◽  
Kevin Brazil ◽  
Mark Loeb
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Intervention Group ◽  
Multifaceted Intervention ◽  
Cluster Randomized ◽  
Hospital Acquired ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Mrsa Colonization

Objectives.Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization.Design.Cluster-randomized controlled trial.Setting.Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada.Intervention.After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008.Results.We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P < .001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group.Conclusion.Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.

Nosocomial Acquisition of Methicillin-ResistantStaphylococcus aureusDuring an Outbreak of Severe Acute Respiratory Syndrome

2005 ◽  
Vol 26 (2) ◽  
pp. 134-137 ◽  
Author(s):  
Susan M. Poutanen ◽  
Mary Vearncombe ◽  
Allison J. McGeer ◽  
Michael Gardam ◽  
Grant Large ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Retrospective Cohort ◽  
Healthcare Workers ◽  
Community Hospital ◽  
Tertiary Care ◽  
Appropriate Use ◽  
Contact Precautions ◽  
Control Education ◽  
Tertiary Care Hospitals

AbstractObjective:The four hospitals assessed in this study use active surveillance cultures for methicillin-resistantStaphylococcus aureus(MRSA) and contact precautions for MRSA-positive patients as part of routine infection control practices. The objective of this study was to determine whether nosocomial acquisition of MRSA decreased in these hospitals during an outbreak of severe acute respiratory syndrome (SARS) when barrier precautions were routinely used for all patients.Design:Retrospective cohort study.Setting:Three tertiary-care hospitals (a 1,100-bed hospital; a 500-bed hospital; and an 823-bed hospital) and a 430-bed community hospital, each located in Toronto, Ontario, Canada.Patients:All admitted patients were included.Results:The nosocomial rate of MRSA in all four hospitals combined during the SARS outbreak (3.7 per 10,000 patient-days) was not significantly different from that before (4.7 per 10,000 patient-days) or after (3.4 per 10,000 patient-days) the outbreak (P= .30 andP= .76, respectively). The nosocomial rate of MRSA after the outbreak was significantly lower than that before the outbreak (P= .003). Inappropriate reuse of gloves and gowns and failure to wash hands between patients on non-SARS wards were observed during the outbreak. Increased attention was paid to infection control education following the outbreak.Conclusions:Inappropriate reuse of gloves and gowns and failure to wash hands between patients may have contributed to transmission of MRSA during the SARS outbreak. Attention should be paid to training healthcare workers regarding the appropriate use of precautions as a means to protect themselves and patients.

scholarly journals Compliance to infection prevention and control practices for prevention of SARS-CoV-2 transmission at tertiary care hospital in North Mumbai

2021 ◽  
Vol 8 (10) ◽  
pp. 4837
Author(s):  
Kinjal Patel ◽  
Suraj Purusottaman ◽  
Trupti Carval ◽  
Lekhan Narvekar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Infection Prevention And Control ◽  
Care Hospital ◽  
And Control

Background: Infection control practices played a major role in prevention of SARS-CoV-2 in healthcare settings. Aim of the study was to know the compliance to infection control and prevention practices by healthcare workers in COVID-19 pandemic and the measures taken for prevention of SARS-CoV-2 spread in the hospital.Methods: An observational study was conducted at tertiary care hospital for a period of one month. All healthcare workers involved in patient care of COVID-19 and non COVID-19 was observed for their infection control practices. Areas were divided in two category, intensive care unit and indoor wards for audit. Environmental samples of various surfaces from intensive care unit and wards were taken and analyzed for the presence of SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction.Results: Overall compliance to infection prevention practices were improved during pandemic. Hand hygiene compliance in intensive care unit and indoor wards of COVID-19 unit were 78.66% and 74.36% whilst in non COVID-19 units was 72.47% and 62.31% respectively. Compliance to revised biomedical waste (BMW) policy at COVID-19 unit were 85.20% and 71.49% in intensive care unit and ward respectively. However, at non COVID-19 unit, it was 65.22% and 57.60%. Nursing station and doffing area of ICU at non-COVID-19 unit showed presence of SARS-CoV-2 virus. While all samples collected from COVID-19 unit were negative.Conclusions: Infection prevention and control practices play a key role to curtail transmission of infection. Awareness among healthcare workers, hospital environment, and usage of personal protective equipment should be optimized even at non COVID-19 facility.

scholarly journals Development of « Escape COVID-19 », a Serious Game Designed to Promote Safe Behaviors Among Healthcare Workers During the COVID-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Mélanie Suppan ◽  
Gaud Catho ◽  
Tomàs Robalo Nunes ◽  
Valérie Sauvan ◽  
Monique Perez ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Critical Role ◽  
Hospital Staff ◽  
Target Audience ◽  
Serious Game ◽  
High Rate ◽  
Infection Prevention And Control ◽  
University Hospitals ◽  
Hospital Employees ◽  
Improve Compliance

BACKGROUND As many countries fear and even experience the emergence of a second wave of COVID-19, reminding healthcare workers (HCW) and other hospital employees of the critical role they play in avoiding SARS-CoV-2 transmission is more important than ever. Building and strengthening the intrinsic motivation of HCW to apply infection prevention and control (IPC) guidelines to avoid contaminating their colleagues, patients, friends and relatives is a goal that must be energetically pursued. A high rate of nosocomial infections during the first COVID wave was detected by the IPC specialists and further cemented their belief in the need for an engaging intervention which could improve compliance with COVID safe behaviors. OBJECTIVE Our aim was to develop a serious game which would promote IPC practices with a specific focus on COVID-19 among HCW and other hospital employees. METHODS The first three stages of the SERES framework were used to develop this serious game. A brainswarming session between developers and IPC specialists was used to identify the target audience and acquisition objectives. Nicholson’s RECIPE mnemonic (reflection, engagement, choice, information, play, exposition) for meaningful gamification was used to guide the general design. A common and simple terminology was used to suit the broad target audience. The game was tested on various platforms (smartphones, tablets, laptops, desktop computers) by different users during each development loop and before its final release. RESULTS The game was designed to target all hospital staff who could be in direct contact with patients within the Geneva University Hospitals. Ten acquisition objectives were defined by IPC specialists and implemented into the game according to the principles of meaningful gamification. A simple storyboard was first created under Microsoft PowerPoint and progressively refined through multiple iteration loops. Articulate Storyline was then used to create two successive versions of the actual game. In the final version, a unique graphic atmosphere was created thanks to Eric Buche, a professional graphic designer. Feedback mechanisms were used extensively throughout the game to strengthen key IPC messages. CONCLUSIONS The SERES framework was successfully used to create “Escape COVID-19”, a serious game designed to promote safe IPC practices among HCW and other hospital employees during the COVID-19 pandemic.

scholarly journals Operational experiences associated with the implementation of near point-of-care early infant diagnosis of HIV in Myanmar: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Win Lei Yee ◽  
Hla Htay ◽  
Yasmin Mohamed ◽  
Claire E. Nightingale ◽  
Htay Htay Tin ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Technical Assistance ◽  
Point Of Care ◽  
Scale Up ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Early Infant Diagnosis ◽  
Structured Interviews ◽  
Early Infant ◽  
The Impact

Abstract Background Timely diagnosis and early initiation of life-saving antiretroviral therapy are critical factors in preventing mortality among HIV-infected infants. However, resource-limited settings experience numerous challenges associated with centralised laboratory-based testing, including low rates of testing, complex sample referral pathways and unacceptably long turnaround times for results. Point-of-care (POC) HIV testing for HIV-exposed infants can enable same-day communication of results and early treatment initiation for HIV-infected infants. However, complex operational issues and service integration can limit utility and must be well understood prior to implementation. We explored and documented the challenges and enabling factors in implementing the POC Xpert® HIV-1 Qual test (Cepheid, Sunnyvale, CA, USA) for early infant diagnosis (EID) as part of routine services in four public hospitals in Myanmar. Methods This sub-study was part of a randomised controlled stepped-wedge trial (Australian and New Zealand Clinical Trials Registry, number 12616000734460) designed to investigate the impact of POC testing for EID in Myanmar and Papua New Guinea. Infants recruited during the intervention phase underwent POC testing at the participating hospitals as part of routine care. Semi-structured interviews with 23 caregivers, 12 healthcare providers and 10 key informants were used to explore experiences of POC-EID testing. The research team and hospital staff documented and discussed implementation challenges throughout the study. Results Overall, caregivers and healthcare workers were satisfied with the short turnaround time of the POC test. Occasional delays in POC testing were mostly attributable to late receipt of samples by laboratory technicians and communication constraints among healthcare staff. Hospital staff valued technical assistance from the research group and the National Health Laboratory. Despite staff shortages and infrastructure challenges such as unreliable electricity supply and cramped space, healthcare workers and caregivers found the implementation of the POC test to be feasible at pilot sites. Conclusions As plans for national scale-up evolve, there needs to be a continual focus on staff training, communication pathways and infrastructure. Other models of care, such as allowing non-laboratory-trained personnel to perform POC testing, and cost effectiveness should also be evaluated.

Adoption of infection prevention and control practices by healthcare workers in Québec: A qualitative study

2019 ◽  
Vol 40 (12) ◽  
pp. 1361-1366
Author(s):  
Eve Dubé ◽  
Armelle Lorcy ◽  
Nathalie Audy ◽  
Nadia Desmarais ◽  
Patrice Savard ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Medical Laboratory ◽  
Infection Prevention And Control ◽  
Clinical Practices ◽  
Good Communication ◽  
Qualitative Research Design ◽  
And Control

AbstractObjective:To describe barriers and facilitators to the adoption of recommended infection prevention and control (IPC) practices among healthcare workers (HCWs).Methods:A qualitative research design was used. Individual semistructured interviews with HCWs and observations of clinical practices were conducted from February to May 2018 in 8 care units of 2 large tertiary-care hospitals in Montreal (Québec, Canada).Results:We interviewed 13 managers, 4 nurses, 2 physicians, 3 housekeepers, and 2 medical laboratory technologists. We conducted 7 observations by following IPC nurses (n = 3), nurses (n = 2), or patient attendants (n = 2) in their work routines. Barriers to IPC adoption were related to the context of care, workplace environment issues, and communication issues. The main facilitator of the IPC adoption by HCWs was the “development of an IPC culture or safety culture.” The “IPC culture” relied upon leadership support by managers committed to IPC, shared belief in the importance of IPC measures to limit healthcare-associated infections (HAIs), collaboration and good communication among staff, as well as proactivity and ownership of IPC measures (ie, development of local solutions to reduce HAIs and “working together” toward common goals).Conclusions:Adoption of recommended IPC measures by HCWs is strongly influenced by the “IPC culture.” The IPC culture was not uniform within hospital and differences in IPC culture were identified between care units.

NosocomialSerratia marcescensInfections Associated With Extrinsic Contamination of a Liquid Nonmedicated Soap

2000 ◽  
Vol 21 (3) ◽  
pp. 196-199 ◽  
Author(s):  
Catherine Sartor ◽  
Véronique Jacomo ◽  
Cédric Duvivier ◽  
Hervé Tissot-Dupont ◽  
Roland Sambuc ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Hand Washing ◽  
Environmental Investigation ◽  
Hospital Units ◽  
Before And After ◽  
Tertiary Care Hospitals ◽  
The Relationship ◽  
Control Study

AbstractObjective:To determine the role of nonmedicated soap as a source ofSerratia marcescensnosocomial infections (NIs) in hospital units with endemicS marcescensNI and to examine the mechanisms of soap colonization.Setting:University-affiliated tertiary-care hospitals.Methods:A prospective case-control study and an environmental investigation were performed to assess the relationship betweenS marcescensNIs in hospital units andS marcescens-contaminated soap. Soap-bottle use and handwashing practices were reviewed. Cultures of healthcare workers’ (HCWs) hands were obtained before and after hand washing with soap.Results:5 of 7 hospital units withS marcescensNIs had soap bottles contaminated withS marcescens, compared to 1 of 14 other units (P=.006). After hand washing with anS marcescens-contaminated soap pump, HCWs' hands were 54 times more likely to be contaminated withS marcescens(P<.001).Conclusions:Extrinsic contamination of a non-medicated liquid soap byS marcescensresulted in handborne transmission ofS marcescensNIs by HCWs in our setting. This finding led to the application of strict guidelines for nonmedicated soap use and to the reinforcement of alcoholic hand disinfection.

scholarly journals Post-vaccination SARS-CoV-2 infection among healthcare workers in tertiary care hospitals in Saudi Arabia: A case series

2021 ◽  
Author(s):  
Majid M. Alshamrani ◽  
Fayssal M Farahat ◽  
Aiman El-Saed ◽  
Mohammed Alzunitan ◽  
Asim Alsaedi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Case Series ◽  
Post Vaccination ◽  
Tertiary Care Hospitals

scholarly journals Recipients Perception of Blood Transfusion Risk in Some Selected Tertiary Care Hospitals

2014 ◽  
Vol 5 (2) ◽  
pp. 30-33
Author(s):  
MM Rahman ◽  
TT Sajani
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Large Scale ◽  
Tertiary Care ◽  
Community Based ◽  
Medical College ◽  
Level Of Understanding ◽  
Record Review ◽  
Demographic Condition ◽  
Tertiary Care Hospitals

This was a descriptive study carried out in the Medicine, Surgery, Gynae and Orthopedics ward of three randomly selected tertiary care hospitals at Dhaka, Bogra and Rangpur. It was aimed to evaluate the extent of understanding about the risk of blood transfusion among the blood recipients, to identify the common indications for blood transfusion through record review, to determine the recipients knowledge about indications of blood transfusion, their level of understanding about blood group, blood donors, and risk of blood transfusion and to find out the socio-demographic condition of recipients admitted at tertiary care hospitals. It was found that most of the respondents 63.17% were in the age group of 15-39 years and 56.95% were between primary to secondary level of education. More than half 56.83% respondents were housewife. The idea about indications of blood transfusion was found among 60.37% respondents. The idea about own blood group was found among 73.54% respondents. However, 52.93% respondents were unaware about the persons who can donate blood. Professional blood donor were the choice for own to only 15.60% respondents. The study also identified 57.32% respondents having risk of blood transmissible diseases. The respondents idea about transmissible diseases were identified as AIDs, Hepatitis-B, Syphilis and Malaria by 90.48%, 42.38%, 5.25% and 5.25% respectively. The study demands awareness and motivational program among younger and adult females in regards to transfusion transmissible diseases and its prevention. The importance of knowing blood group,donor selection and adverse effects of transfusion may also considered as a part of awareness program. It also demands a large scale community based survey to generate information towards development of effective strategy in minimizing risk of transfusion transmissible diseases in particular. DOI: http://dx.doi.org/10.3329/akmmcj.v5i2.21129 Anwer Khan Modern Medical College Journal Vol. 5, No. 2: July 2014, Pages 30-33

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