scholarly journals Pathology Laboratories and Infection Prevention and Control

2014 ◽  
Vol 4 (8) ◽  
pp. I
Author(s):  
R Baral
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
World Health ◽  
Asia Pacific ◽  
Infection Prevention And Control ◽  
Effective Manner ◽  
And Control

Laboratory health care workers are vulnerable to infection with the Hospital Acquired Infections (HAIs) while receiving, handling and disposing biological samples. Ideally the infrastructure of the lab should be according to the best practices like good ventilation, room pressure differential, lighting, space adequacy, hand hygiene facilities, personal protective equipments, biological safety cabinets etc. Disinfection of the environment, and specific precautions with sharps and microbial cultures should follow the protocols and policies of the Infection Prevention and Control Practices (IPAC). If Mycobacterium tuberculosis or Legionella pneumophila are expected, diagnostic tests should be performed in a bio-safety level 3 facilities (for agents which may cause serious or potentially lethal disease in healthy adults after inhalation). Laboratory access should be limited only to people working in it.Along with the advent of new technologies and advanced treatment we are now facing problems with the dreadful HAIs with Antimicrobial Resistant Organisms (AROs) which is taking a pandemic form. According to WHO, hundreds of millions of patients develop HAI every year worldwide and as many as 1.4 million occur each day in hospitals alone. The principal goals for hospital IPAC programs are to protect the patient, protect the health care worker (HCW), visitors, and other persons in the health environment, and to accomplish the previous goals in a cost-effective manner like hand hygiene, surveillance, training of the HCWs, initiating awareness programs and making Best Practices and Guidelines to be followed by everyone in the hospital.The initiation for the best practices in the Pathology Laboratories can be either Sporadic or Organizational. Sporadic initiation is when the laboratories make their own IPAC policies. It has been seen that in few centres these policies have been conceptualized but not materialized. Organizational initiation is much more effective since the best practices are the same for all hospitals and this helps in standardizing the policies. There are organizations which work in promoting IPAC through education, standards, and advocacy and consumer awareness. Examples of organizations working in this field are IPAC Canada, Centers for Disease Control and Prevention (CDC) USA, Infection Prevention Society UK, Asia Pacific Society of Infection Control (APSIC), World Health Organization (WHO). In Nepal organizational initiation to address the issues of IPAC has been recently taken by Healthy Life Foundation Nepal (HELF Nepal) which is an organization with the mission to inform, promote and implement best practices of IPAC to prevent HAIs in the patients as well as the healthcare workers in all healthcare settings in Nepal.In Nepal awareness on IPAC in Pathology Laboratories can be brought about by initiating trainings, surveillance, regular CMEs and demonstration of techniques to the Lab personnel. Administration will have to be involved in initiating the program and maintaining it with administrative resources and financial support. Before it is too late we have to address the issues of HAIs, AROs and safety in our laboratories.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11603

scholarly journals Train-the-Trainers in hand hygiene: a standardized approach to guide education in infection prevention and control

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Ermira Tartari ◽  
Carolina Fankhauser ◽  
Sarah Masson-Roy ◽  
Hilda Márquez-Villarreal ◽  
Inmaculada Fernández Moreno ◽  
...  
Keyword(s):  
South Africa ◽  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
World Health ◽  
Infection Prevention And Control ◽  
Rank Test ◽  
Hand Hygiene Improvement ◽  
And Control

Abstract Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.

scholarly journals Core components of infection prevention and control programs at the facility level in Georgia: key challenges and opportunities

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Anna Deryabina ◽  
Meghan Lyman ◽  
Daiva Yee ◽  
Marika Gelieshvilli ◽  
Lia Sanodze ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Hospital Staff ◽  
Training System ◽  
World Health ◽  
Infection Prevention And Control ◽  
Standard Case ◽  
Core Components ◽  
And Control

Abstract Background The Georgia Ministry of Labor, Health, and Social Affairs is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff. Methods In 2018, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews. Results IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system. Conclusions Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.

scholarly journals Core Components of Infection Prevention and Control Programs at the Facility Level in Georgia: Key Challenges and Opportunities

2020 ◽  
Author(s):  
Anna Deryabina ◽  
Meghan Lyman ◽  
Daiva Yee ◽  
Marika Gelieshvilli ◽  
Lia Sanodze ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Hospital Staff ◽  
Training System ◽  
World Health ◽  
Infection Prevention And Control ◽  
Standard Case ◽  
Core Components ◽  
And Control

Abstract Background The Georgia Ministry of Labor, Health, and Social Affairs (MoLHSA) is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff. Methods In 2017, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews. Results IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system. Conclusions Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.

scholarly journals Infection prevention and control (IPC) at a Lassa fever treatment center before and after the implementation of an intensive IPC program

2020 ◽  
Vol 3 (3) ◽  
pp. 213-216
Author(s):  
Olayinka Stephen Ilesanmi ◽  
Oladele Olufemi Ayodeji ◽  
Ayobami A. Bakare ◽  
Nelson Adedosu ◽  
Anthonia Adeagbo ◽  
...  
Keyword(s):  
Health Care ◽  
World Health Organization ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Lassa Fever ◽  
Medical Centre ◽  
World Health ◽  
Infection Prevention And Control ◽  
Health Organization ◽  
And Control

Background: Infection prevention and control (IPC) programs are important to control the Lassa Fever (LF) outbreak. We reported IPC's status at the Federal Medical Centre, Owo, southwest Nigeria, before and after implementing the IPC program during a surge in the LF outbreak. Methods: We conducted a longitudinal observational study among five health care professionals at the Federal Medical Centre, Owo, between February 2019 and May 2019 using the IPC Assessment Framework (IPCAF). The tool has eight core components with a score of 0-100 per component and provided a baseline assessment of the IPC program and evaluation after three months. We interviewed relevant unit heads and IPC committee members in the first phase. In the second phase, we designed and implemented the IPC program, and in the third phase, we conducted a repeat interview similar to the first phase. The program initiated included training healthcare workers and providing relevant IPC items according to identified gaps and available funding. Results: We interviewed five health care professionals, two female nurses, and three male doctors responsible for organizing and implementing IPC activities at the Federal Medical Centre, Owo, with an in-depth understanding of IPC activities.  The overall IPC level score increased from 318.5 at baseline to 545 at three months later. IPC improvements were reported in all the components, with IPC education and training [baseline (20), final (70)], IPC guidelines [baseline (50), final (92.5)] and monitoring/audits of IPC practices and feedback [baseline (40), final (82.5)] recording the highest improvements. Healthcare-associated infection [baseline (10), final (25)], and built environment, materials, and equipment for IPC [baseline (43.5), final (55)] had the least improvement. Poor motivation to adopt recommended changes among hospital staff were major issues preventing improvements. Conclusion: Promotion of IPC program and activities should be implemented at the Federal Medical Centre, Owo.   References World Health Organization, WHO. Lassa fever. Available from: https://www.who.int/health-topics/lassa-fever/#tab=tab_1. [Accessed on 11 October 2020] Nigeria Centre for Disease Control. Lassa fever. Available from: https://ncdc.gov.ng/diseases/factsheet/47. [Accessed on 11 October 2020]. World Health Organization, WHO. Lassa fever. Available from: https://www.who.int/news-room/fact-sheets/detail/lassa-fever. [Accessed on 11 October 2020]. Ijarotimi IT, Ilesanmi OS, Aderinwale A, Abiodun-Adewusi O, Okon IM. Knowledge of Lassa fever and use of infection prevention and control facilities among health care workers during Lassa fever outbreak in Ondo state, Nigeria. Pan Afr Med J. 2018; 30:1-13. https://doi.org/10.11604/pamj.2018.30.56.13125 Mateer EJ, Huang C, Shehu NY, Paessler S. Lassa fever–induced sensorineural hearing loss: A neglected public health and social burden. PLoS Negl Trop Dis. 2018;12(2):1-11. https://doi.org/10.1371/journal.pntd.0006187 Ijarotimi I., Oladejo J., Nasidi A, Jegede O. Lassa fever in the State Specialist Hospital Akure, Nigeria: Case report, Contact tracing and outcome of hospital contacts. Int J Infect Trop Dis. 2016;3(1):20-28. https://doi.org/10.14194/ijitd.3.1.4 Ireye F, Ejiyere H, Aigbiremolen AO, Famiyesin OE, Rowland-Udoh EA, Ogeyemhe CO, Okudo I, Onimisi AB. Knowledge, attitude and infection prevention and control practices regarding Lassa fever among healthcare workers in Edo State, Nigeria. Int J Prev Treat. 2019;8(1):21-27. https://doi.org/10.5923/j.ijpt.20190801.03 World Health Organization. Infection prevention and control assessment framework at the facility level. 2018; 2016:1-15. Available from: https://www.who.int/infection-prevention/tools/core-components/IPCAF-facility.PDF?ua=1 [Accessed on 11 October 2020]. World Health Organization, WHO. Communicable disease surveillance and response systems - Guide to monitoring and evaluating. Epidemic and pandemic alert and response. Published online 2006:90. doi: rr5305a1 [pii] Ousman K, Kabego L, Talisuna A, Diaz J, Mbuyi J, Houndjo B, et al. The impact of Infection Prevention and control (IPC) bundle implementation on IPC compliance during the Ebola virus outbreak in Mbandaka/Democratic Republic of the Congo: A before and after design. BMJ Open. 2019;9(9):1-6. https://doi.org/10.1136/bmjopen-2019-029717 Nzinga J, Mbindyo P, Mbaabu L, Warira A, English M. Documenting the experiences of health workers expected to implement guidelines during an intervention study in Kenyan hospitals. Implement Sci. 2009;4(1):1-9. https://doi.org/10.1186/1748-5908-4-44. Ataiyero Y, Dyson J, Graham M. Barriers to hand hygiene practices among health care workers in sub-Saharan African countries: A narrative review. Am J Infect Control. 2019 May;47(5):565-573. https://doi.org/10.1016/j.ajic.2018.09.014. Gilbert GL, Kerridge I. The politics and ethics of hospital infection prevention and control: a qualitative case study of senior clinicians’ perceptions of professional and cultural factors that influence doctors’ attitudes and practices in a large Australian hospital. BMC Health Serv Res. 2019; 19(212). https://doi.org/1186/s12913-019-4044-y.  

scholarly journals Infection Prevention and Control Measures at the Children Hospital Lahore: A My Child Matters Collaborative Project

2020 ◽  
pp. 1540-1545
Author(s):  
Mahwish Faizan ◽  
Miguela A. Caniza ◽  
Saadia Anwar ◽  
Rahat-ul-Ain Kashif ◽  
Rabia Saleem ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Assessment Framework ◽  
Improvement Strategy ◽  
Self Assessment ◽  
And Control

PURPOSE Infection prevention among children with cancer is a major challenge at Children Hospital Lahore (CHL), a public health care facility in Pakistan with 1,000 new pediatric cancer admissions annually. The objective has been to reduce infections through collaboration between CHL and the St Jude Children’s Hospital Global Infectious Disease program via a grant by the Sanofi Espoir foundation through the My Child Matters program. The aim of the current study was to describe the effect of the collaborative improvement strategy on existing infection prevention and control (IPC) standards at CHL. MATERIALS AND METHODS Our work was a prospective before-and-after study to improve IPC standards. We compared the WHO Hand Hygiene Self-Assessment Framework and four modules of the St Jude modified Infection Control Assessment Tool (ICAT) scores over a 3-year period. Our strategy included creating a multidisciplinary team of pediatric oncologists, infectious disease physicians, nurses, a microbiologist, and a data manager; engaging in monthly online IPC mentoring sessions with St Jude Children’s Hospital Global Infectious Disease program and My Child Matters mentors; performing daily inpatient health care–associated infection surveillance rounds; and performing regular hand hygiene training and compliance audits. RESULTS Baseline needs assessment showed health care–associated infections identified by positive blood cultures as 8.7 infections per 1,000 patient-days. Deficient hand hygiene supplies, health education measures, and bed sharing of neutropenic patients were identified as major challenges. Our hand hygiene facility level, per WHO scores, increased from Inadequate to Intermediate/Consolidation by the end of the 3-year implementation (122 v 352 WHO Hand Hygiene Self-Assessment Framework scores). The sink:bed and hand sanitizer:bed ratios improved to 1:6 and 1:1, respectively. The ICAT general infection control module increased by 40% (45 v 78 ICAT scores) and hygiene compliance improved by 20%. CONCLUSION Implementing a collaborative improvement strategy improved IPC standards in our center, which can be easily replicated in other pediatric oncology centers in lower- and middle-income countries.

scholarly journals COVID-19: a time to focus on nurses, hand hygiene and infection prevention and control

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Nasim Lotfinejad ◽  
Alexandra Peters ◽  
Didier Pittet
Keyword(s):  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Disease Outbreaks ◽  
World Health ◽  
Infection Prevention And Control ◽  
Effective Response ◽  
Global Campaign ◽  
And Control ◽  
Nurses And Midwives

With the global concern of the 2019 novel coronavirus (COVID-19), infection prevention and control (IPC) is increasingly perceived as a major contributor to achieve a highly effective response to the outbreak and to prevent or limit transmission in healthcare settings. Improving health results is highly reliant on well-trained nurses especially during unexpected infectious disease outbreaks. The World Health Organization (WHO) promotes hand hygiene, which is the cornerstone of infection prevention, through its annual global campaign on 5 May every year. The 2020 campaign targets nurses and midwives with the overall theme “Nurses and Midwives: CLEAN CARE is in YOUR HANDS”.

scholarly journals A health worker knowledge, attitudes and practices survey of SARS-CoV-2 infection prevention and control in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saiendhra Vasudevan Moodley ◽  
Muzimkhulu Zungu ◽  
Molebogeng Malotle ◽  
Kuku Voyi ◽  
Nico Claassen ◽  
...  
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Health Facilities ◽  
World Health ◽  
Infection Prevention And Control ◽  
Successful Implementation ◽  
And Control

Abstract Background Health workers are crucial to the successful implementation of infection prevention and control strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces of South Africa as well as explore some elements of health worker and health facility infection prevention and control practices. Methods A cross-sectional study design was utilised. The study population comprised both clinical and non-clinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A structured self-administered questionnaire was developed using the World Health Organization guidance as the basis for the knowledge questions. COVID-19 protocols were observed during data collection. Results A total of 286 health workers from 47 health facilities at different levels of care participated in the survey. The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%) answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants (50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had received infection prevention and control training. Some participants indicated they did not have access to medical masks (11.8%) and gloves (9.9%) in their departments. Conclusions The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring adequate infection prevention and control training for all staff and universal access to appropriate PPE were identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings that needed to be addressed were provided to the relevant provincial departments of health.

scholarly journals The experience of European hospital-based health care workers on following infection prevention and control procedures for COVID-19

2020 ◽  
Author(s):  
Denise van Hout ◽  
Paul Hutchinson ◽  
Marta Wanat ◽  
Caitlin Pilbeam ◽  
Herman Goossens ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Risk ◽  
Infection Prevention And Control ◽  
Emotional Wellbeing ◽  
Care Workers ◽  
And Control ◽  
The Impact

ABSTRACTBackgroundWorking under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. Protecting the physical and psychological health of HCWs is a key priority. This study assessed the perceptions of European hospital HCWs of local infection prevention and control (IPC) procedures during the COVID-19 pandemic and the impact on their emotional wellbeing.MethodsWe performed two rounds of an international cross-sectional survey, between 31 March and 17 April 2020 via existing research networks (round 1), and between 14 May and 31 August 2020 via online convenience sampling (round 2). Main outcome measures were (1) behavioural determinants of HCW adherence with IPC procedures, (2) WHO-5 Well-Being Index, a validated scale of 0-100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression.Results2,289 HCWs (round 1: n=190, round 2: n=2,099) from 40 countries in Europe participated. Mean age of respondents was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n=1699) of HCWs were directly treating patients with COVID-19, of which 32% (n=527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This was more common among junior than senior HCWs (46% versus 38%, P value <.01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2-1.8).ConclusionsIn Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.

scholarly journals Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis in an Egyptian University Hospital.

2021 ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Iman Heweidy ◽  
Samiha Abdu ◽  
Abouelata Omar ◽  
Caroline Ackley ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Theoretical Domains Framework ◽  
Control Measures ◽  
World Health ◽  
Infection Prevention And Control ◽  
Surgical Prophylaxis ◽  
Context Specific ◽  
And Control

Abstract Background: Antimicrobial resistance (AMR) is increasingly pervasive due to multiple, complex prescribing and consuming behaviours. Accordingly, behaviour change is an important component of response to AMR. Little is known about the best approaches to change antibiotic use practices and behaviours. This project aims to develop a context-specific behaviour change strategy focusing on promoting appropriate prescription practices following the World Health Organization recommendations for surgical prophylaxis in an orthopaedic surgery unit in Egypt.Methods: The project included a formative qualitative research study was based on the Theoretical Domains Framework (TDF) to explore the determinants for inappropriate prescription of surgical antibiotic prophylaxis at an orthopaedic unit. The intervention was developed to following the Behaviour Change Wheel (BCW) in a knowledge co-production workshop with infection prevention and control experts that ensured that the theory based intervention was a culturally acceptable, practical and implementable intervention. Results: The prescription of surgical prophylaxis was influenced by five TDF domains including, knowledge, belief in consequences (mistrust towards infection prevention and control measures), environmental factors (lack of prescription guidelines) , professional role and reinforcement (a lack of appropriate follow up actions influenced prescription of surgical prophylaxis). The appropriate set of behaviour change functions of BCW and related activities to improve the current practices included education, enablement, persuasion, environmental restructuring and restriction. Conclusions The study showed that a theory based and context specific intervention can be created by using the TDF and BCW together with knowledge-co creation to improve the prescription of surgical prophylaxis in and Egyptian orthopaedic unit. The intervention need to piloted and scaled up.

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