scholarly journals Mixed methods study evaluating the implementation of the WHO hand hygiene strategy focusing on alcohol based handrub and training among health care workers in Faranah, Guinea

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256760
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Carlos Rocha ◽  
Rebekah Wood ◽  
Lena Landsmann ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hand Hygiene ◽  
Mixed Methods Study ◽  
Local Production ◽  
Healthcare Associated Infection ◽  
Improvement Strategy ◽  
Post Intervention ◽  
Local Staff ◽  
Healthcare Associated

Introduction The most frequent adverse health events in healthcare worldwide are healthcare-associated infection. Despite ongoing implementation of the WHO multimodal Hand Hygiene (HH) Improvement Strategy, healthcare-associated infection rate continues to be twofold higher in low- than in high-income countries. This study focused on continued evaluation of HH compliance and knowledge. The mixed method approach, with inclusion of patients and care-givers, provided insight into challenges and facilitators of the WHO HH Improvement Strategy, and highlighted improvement points. Methods An uncontrolled, before-and–after intervention, mixed methods study in Faranah Regional Hospital was conducted from December 2017 to August 2019. The intervention implemented the WHO HH Strategy including HH training for healthcare workers (HCWs), and the relaunch of the local production of alcohol-based handrub (ABHR). A baseline assessment of HH knowledge, perception and compliance of HCWs was done prior to the intervention and compared to two follow-up assessments. The second follow-up assessment was complemented by a qualitative component. Results Overall compliance six months post-intervention was 45.1% and significantly higher than baseline but significantly lower than in first follow-up. Knowledge showed similar patterns of improvement and waning. The perception survey demonstrated high appreciation of the intervention, such as local production of ABHR. HCW’s were concerned about overconsuming of ABHR, however simultaneous quantitative measurements showed that consumption in fact was 36% of the estimated amount needed for sufficient HH compliance. Potential fields for improvement identified by HCWs to enhance sustainability were permanent ABHR availability, having a dedicated person with ownership over continuous simulation HH trainings including simulations to improve technique. Conclusion The study shows that the WHO multimodal HH strategy has a positive effect on HCW compliance and knowledge. Improvement points identified by local staff like sensitization on appropriate ABHR amount per HH action should be considered for sustainable HH improvement.

scholarly journals Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2020 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Comparison Results ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

scholarly journals Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2019 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Knowledge Score ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent Healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea.Methods: In a participatory approach, a team of HRF staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison.Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption.Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

scholarly journals Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2020 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Comparison Results ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

scholarly journals Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2020 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Comparison Results ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

An Affair to Remember: A Mixed-Methods Survey Examining Therapists’ Experiences Treating Infidelity

2021 ◽  
pp. 106648072110618
Author(s):  
Taylor J. Irvine ◽  
Paul R. Peluso
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Study ◽  
Personal History ◽  
Future Research ◽  
Present Survey ◽  
Training Standards ◽  
Recovery Treatment ◽  
And Training

In this mixed-methods study, we analyzed data from 351 couple therapists who completed our Therapists' Experiences Treating Infidelity (TETI) survey. The present survey is a follow-up of previous iterations that examined therapists' attitudes toward infidelity and affair recovery treatment. Our TETI survey provided additional questions pertaining to therapists' personal history with affairs and perceptions on current research and training standards. Results showed that various therapist and couple factors serve to impede affair recovery treatment. Additionally, this survey revealed several similarities in therapists' attitudes from prior surveys, despite decades having passed between when the present survey and previous versions. In this article, we (a) outline findings from this mixed-methods survey, (b) discuss implications for the field, and (c) offer directions for future research.

Preventability of hospital onset bacteremia and fungemia: A pilot study of a potential healthcare-associated infection outcome measure

2019 ◽  
Vol 40 (3) ◽  
pp. 358-361 ◽  
Author(s):  
Raymund B. Dantes ◽  
Clare Rock ◽  
Aaron M. Milstone ◽  
Jesse T. Jacob ◽  
Sheri Chernetsky-Tejedor ◽  
...  
Keyword(s):  
Pilot Study ◽  
Outcome Measure ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Follow Up Studies ◽  
Potential Measure ◽  
Healthcare Associated

AbstractHospital-onset bacteremia and fungemia (HOB), a potential measure of healthcare-associated infections, was evaluated in a pilot study among 60 patients across 3 hospitals. Two-thirds of all HOB events and half of nonskin commensal HOB events were judged as potentially preventable. Follow-up studies are needed to further develop this measure.

Care coordination and follow-up practices in the community pharmacy setting: A mixed methods study

2020 ◽  
Vol 60 (4) ◽  
pp. 631-638.e2
Author(s):  
Chelsea P. Renfro ◽  
Jessica M. Robinson ◽  
Kea Turner ◽  
Tashani Gaskins ◽  
Stefanie P. Ferreri
Keyword(s):  
Mixed Methods ◽  
Community Pharmacy ◽  
Care Coordination ◽  
Mixed Methods Study ◽  
Pharmacy Setting

scholarly journals Follow-up of Abnormal Estimated GFR Results Within a Large Integrated Health Care Delivery System: A Mixed-Methods Study

2019 ◽  
Vol 74 (5) ◽  
pp. 589-600 ◽  
Author(s):  
Kim N. Danforth ◽  
Erin E. Hahn ◽  
Jeffrey M. Slezak ◽  
Lie Hong Chen ◽  
Bonnie H. Li ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Delivery System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Mixed Methods Study ◽  
Estimated Gfr ◽  
System A

scholarly journals Does Sense make sense? Mixed methods study of a Dutch sexual health program

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Joosten ◽  
L Jochems ◽  
C Wijsen ◽  
T Heijman ◽  
A Timen
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Young People ◽  
Sexual Health ◽  
Health Care Professionals ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Open Atmosphere ◽  
Study Results

Abstract In the Netherlands, the Sense program addresses several key elements of sexual health for young people <25 year. This program offers free consultations at the PHS concerning STI, contraceptives, pregnancy or sexuality. The performance of this program has not been studied yet. This mixed methods study investigates facilitators and barriers of a Sense consultation from the perspective of clients and health care professionals (HCP) and investigates the outcome of the consultation at three points in time. Semi-structured interviews were conducted after consultation among 16 clients and 6 HCP. Questionnaires were collected directly after consultation and at 3, 6 and 12 months after consultation. Two cohorts were recruited; clients with STI consultation only and clients with questions related to sexuality, contraception and pregnancy (Sense consultation, SC). Satisfaction of the consultation and applicability of the given advice was measured. In the follow up presence of STI, pregnancy, sexual problem and contraceptive use was measured. A minority of the interviewed clients were familiar with Sense, highly valued the expertise of the HCP and the open atmosphere during the consultation. Reasons for visiting Sense included expertise, more anonymity and feeling more comfortable than at the GP. The questionnaire after consultation was returned by 144 STI clients and 32 SC clients. Both type of consultation were highly valued and advice was easily applicable. The follow up cohort included 97 STI clients and 23 SC clients. Response rate of the 3- and 6 month-questionnaires was 61%. Results of the full one year follow-up are expected in September 2019. Study results provide evidence for a highly valued Sense program, by both clients and HCP. Sense is a platform to discuss STI, contraception and sexuality in an open atmosphere, though familiarity with Sense is low. A major conclusion is that an STI consultation provides the opportunity to address questions related to sexuality. Key messages The Sense program is highly valued by young people, and yet the program is not widely known among young people. There is need for more publicity to the program to enable more young people to use this program and to improve the sexual health care of young Dutch people.

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