Compliance of Physicians with Standard Precautions of Handling Patients with Infectious Respiratory Disease

Background: Standard precautions (SPs) are the minimum infection prevention practices that aim to protect Health care workers (HCWs) including physicians and prevent them from transmitting the infections to their patients. Purpose: To assess the level of compliance of physicians with standard precautions of handling patients with infectious respiratory disease. Method: A cross sectional questionnaire-based study was conducted in two tertiary level hospitals named M Abdur Rahim Medical College and Hospital, Dinajpur, Bangladesh and Rajshahi Medical College and Hospital, Rajshahi, Bangladesh to assess the level of compliance of physicians with standard precautions. Purposive sampling technique was applied as per inclusion criteria and data was collected by face to face interview from 285 physicians. Statistical analysis of the results was done by SPSS and a p value less than 0.05 was considered as significant. Result: The study revealed that maximum physicians (76.5%) handling patients with infectious respiratory disease had a moderate level of compliance with standard precautions. 78.6% of the physicians had moderate level of awareness about standard precautions. Only 20.35% of the physicians had training on infection control. 94.4% of the respondents didn’t know the component of standard precaution and most of the physicians were not aware of the sequence of wearing and removing the different components of PPEs. Conclusion: The study result implies that with increased awareness, the compliance of the physicians with standard precautions increased. The main reasons of non-compliance with standard precautions were found to be lack of resources, lack of regular training and excess workload.

Impact of designed infection control educational program on nurses’knowledge and compliance with standard precautions at maternity hospitals

Objectives:This study aimed to assess the nurses’knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses’knowledge and compliance with standard precautions at the maternity hospital.Materials and Methods:A quasi‑experimental one‑group pretest‑posttest design was used on convenient sample of 60 nurses working at Obstetrics and Gynecological hospital in Cairo University Hospital,Kasr El Ainy,who received“designed infection control educational program”for 6 months.The data were collected through the questionnaire comprising demographics,knowledge,and compliance with standard precautions questionnaire.The nurses’knowledge and compliance score were compared before and after intervention.Results:The studied nurses had higher level of knowledge(85.3%)and compliance(92.8%)regarding infection control standard precautions after the educational program compared to before the program.The results revealed statistically significant difference between before and after the program regarding nurses’knowledge score(15.5±2.9 vs.17.1±1.6,P<0.001)and compliance score(58.5±13.2 vs.74.3±5.1,P<0.001).In addition,there was insignificant relation between nurses’knowledge and compliance with standard precautions both before(r=0.952,P=0.474)and after educational program(r=0.164,P=0.223).Conclusion:The nurses’level of knowledge and compliance regarding infection control standard precautions was significantly improved after the program.Therefore,it is recommended that periodical educational programs regarding the standard precautions of infection control are essential for nurses at maternity hospital.

Health Facilities Readiness to Implement Standard Precautions for Infection Prevention and Control in Tanzania: Lesson Learnt from SARA Reports

Introduction: Standard Precautions are a set of measures applied in the care of all individuals/patients regardless of their infectious status aiming at preventing healthcare workers and patients from infections, preventing environmental contamination and spread of infections to the community. Many health facilities have not implemented them to an acceptable level. The purpose of the study is to report progress of improvement in health facilities readiness to implement standard precautions for infection prevention and control based on SARA reports. Methods: We generated mean scores of all standard precautions each year and calculated their standard deviations, variances and confidence intervals. One-way ANOVA was used to determine if the mean scores were equal. Finally, the trend of improvement in health facilities readiness to implement the standard precautions was generated. Results: A total of nine standard precautions were reported in SARA reports for 2012, 2017 and 2020. The mean scores of the standard precautions were 52.22% in 2012, 64.55% in 2017 and 69.66% in 2020. The overall trend showed an increase in health facilities readiness to implement standard precautions, although the mean scores were not statistically different (p-value 0.3217). Conclusion: SARA surveys conducted in Tanzania in 2012, 2017 and 2020 have shown an overall increase in health facilities readiness to implement standard precautions. Safe final waste disposal was being done in fewest facilities while single-use or auto-disable syringes were in most facilities that were sampled in all years. SARA surveys may be a useful way to evaluate Infection Prevention and Control adherence in health facilities.

Challenges and Adherence to Standard Precautions for Prevention of Percutaneous Injuries and Exposure to Blood Borne Pathogens in Clinical Practice: A Review

Background: Standard Precautions (SP) was introduced by Centre for Disease Control to minimise the risks of disease transmission in the process of healthcare. Many factors are thought to influence the knowledge and the practice of these measures. Objective: To review challenges and adherence to SP for the prevention of percutaneous injuries and exposure to patients’ blood in clinical practice. Methods: The World Wide Web sites such as, Pub Med central, Google scholar were searched using key words such as percutaneous, needle stick injuries, standard precautions, adherence. Relevant articles were reviewed and included based on defined criteria. Results: The prevalence of needle stick injuries (NSI) varies among health care workers (HCWs) and across countries and is as high as 73% among some groups. The knowledge of SP varied among HCWs in different nations;however the practice of SP was noted to be lower than knowledge across most studies. Majority of HCWs in developing countries that sustained NSI failed to report the incident to appropriate authorities. Adherence to Standard Precautions is influenced by lack of proper training, poor supplies, low commitment of HCWs and health facility managers etc. Conclusion: Needle stick injuries and exposure to patients’ blood remain a risk for disease transmission among HCWs. Despite appreciable knowledge of standard precautions, the practice has remained low across the globe. Factors that had positive influence on practice of SP such as use of devices with safety features, adherence to infection control guideline, comfortable working environment, repeated and intense training etc. should be adopted and promoted.

Midwives and Nurses Compliance with Standard Precautions in Palestinian Hospitals

Midwives and nurses should use the standard precautions as the basic level of infection control precautions when delivering care to all patients, regardless of their presumed infection status. Therefore midwifes and nurses should have sound knowledge and compliance with standard precaution. Aim of the study: The study aimed to assess the level of the compliance of standard precautions among the midwives and nurses in the Palestinian Hospitals. Method: A cross sectional study was conducted from May to June 2015 on 81 midwives and nurses from Palestinian hospitals. The data were collected from labor rooms and postpartum departments of Palestinian hospitals. Data were collected using pretested questionnaire on 81 midwives and nurses selected by convenience sample. Results: The current study showed that the average of standard precautions knowledge level and compliance are 74.6% and 83.8% respectively. There are an association between age, education, work experience, and compliance with standard precautions at p p < 0.05 (0.191). Conclusion: The midwives and nurses in the current study for both knowledge and compliance have high level regarding standard precautions. There is an association between age, education, work experience, and compliance with standard precautions. Recommendations: Knowledge of midwives and nurses should be updated;the importance of latest evidence-based practices of infection control in continuing education/training program should be emphasized;and training programs for newly midwives and nurses about standard precaution and at regular intervals should be provided.

Health care-associated hepatitis C virus infection

Hepatitis C virus(HCV)is a blood-borne pathogen that has a worldwide distribution and infects millions of people.Care-associated HCV infections represented a huge part of hepatitis C burden in the past via contaminated blood and unsafe injections and continue to be a serious problem of public health.The present review proposes a panorama of health care-associated HCV infections via the three mode of contamination that have been identified:(1)infected patient to non-infected patient;(2)infected patient to non-infected health careworker(HCW);and(3)infected HCW to non infected patient.For each condition,the circumstances of contamination are described together with the means to prevent them.As a whole,the more important risk is represented by unsafe practices regarding injections,notably with the improper use of multidose vials used for multiple patients.The questions of occupational exposures and infected HCWs are also discussed.In terms of prevention and surveillance,the main arm for combating care-associated HCV infections is the implementation of standard precautions in all the fields of cares,with training programs and audits to verify their good application.HCWs must be sensitized to the risk of blood-borne pathogens,notably by the use of safety devices for injections and good hygiene practices in the operating theatre and in all the invasive procedures.The providers performing exposed-prone procedures must monitor their HCV serology regularly in order to detect early any primary infection and to treat it without delay.With the need to stay vigilant because HCV infection is often a hidden risk,it can be hoped that the number of people infected by HCV via health care will decrease very significantly in the next years.

Evaluation of the Validity of SARS-CoV-2 Infection Control Measures through Antibody Testing for Employees of a University and Hospital

Introduction: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spread through person-to-person transmission and has become a global pandemic. At Saitama Medical University Hospital, many medical staff members have been involved in treating patients with COVID-19. The Care Task Force was established in collaboration with physicians, medical staff, and clerical staff in the various hospital departments to strengthen infection control measures based on standard precautions. Methods: To determine the outcome of infection control measures, we administered anti-SARS-CoV-2 antibody tests and questionnaires to all 2461 employees including nonhospital workers, as a local standard, between June 29 and July 10, 2020. Results: Among the hospital workers, 698 (33.99%) had contact with patients with COVID-19 and 325 healthcare workers worked in specialized wards for the COVID-19, intensive care unit, and high-fever outpatient clinics. Positive for the anti-SARS-CoV-2 antibody were only 4 (0.16%) employees. Among them, the past histories of two employees were unknown, while the other two had a history of COVID-19 before the test and were not involved in the medical care of COVID-19 patients at our hospital. Conclusion: It is the first study assessing the seropositive rate in Saitama-prefecture, a bed-town of Tokyo. Compared with the local standard, we found that health care workers are not at risk for viral droplet transmission, especially with SARS-CoV-2 and even with the current pandemic, with infection control measures based on standard precautions. Based on our findings and with no clusters formed in our university and hospital, we continued current infection control measures.

Progress in applying patient experience in nursing quality improvement

Background： Improving and sustaining the quality of nursing care is an intractable and persistent challenge. The patient experience of nursing care can give a different perspective on nursing quality and help clinical nursing staff to direct quality improvement. Attempts to identify what is patient experience,the relationship with nursing care, and the application of patient experience in nursing quality improvement practice, in order to provide advices for constructing the quality standards and quality improvement strategies of nursing care.Methods： We conducted a literature review of original research publications. The database platforms Pubmed, Web of Science, China National Knowledge Infrastructure（CNKI） and Wanfang were searched from inception until end of August 2015. After screening retrieved articles, 40 sources（articles and organizational websites） were selected for analysis for the connotation, development and application of patient experience in nursing quality researches.Results： Our study identified several concepts about patient experience, roughly sorted out the development path of patient experience in worldwide and the application of patient experience in nursing quality improvement. It points out four precautions when applying patient experience in nursing quality improvement, which are differentiating patient satisfaction and patient experience, choosing appropriate data collection method and appropriate feedback time, and the last but the most important, applying theories to actual clinical practice.Conclusions： Professional indexes are important to maintain the care quality, but it cannot fully reflect quality of nursing care, which needs patient experience as the supplement. Nursing staffs need to make more efforts to enhance patient＇s nursing care experience, and apply the research results to clinical practice, and finally make patient-centered care come true. For future study, the evaluation system and management strategies about patient experience need to be developed to guide nursing quality improvement.