AustralieFrV1, Main, Exploration, bibRecord, 000991

Infection control in hospitals managing drug-resistant tuberculosis in Pakistan: how are we doing?

Identifieur interne : 000991 ( Main/Exploration ); précédent : 000990; suivant : 000992

Infection control in hospitals managing drug-resistant tuberculosis in Pakistan: how are we doing?

Auteurs : Y. Waheed [Pakistan] ; M. A. Khan [Pakistan] ; R. Fatima [Pakistan] ; A. Yaqoob [Pakistan] ; A. Mirza [Pakistan] ; E. Qadeer [Pakistan] ; M. Shakeel [Australie] ; E. Heldal [Norvège] ; A. M. V. Kumar [France, Inde]

Source :

Public Health Action [ 2220-8372 ] ; 2017.

RBID : PMC:5526491

Abstract

Setting: Ten hospitals managing drug-resistant tuberculosis (TB) in Pakistan.

Objective: To assess the implementation of TB infection control (IC) practices and reasons for non-adherence to guidelines.

Design: This was a descriptive study conducted between April and October 2016 with three components: 1) non-participant observation of service delivery areas (SDAs) (n = 82) in hospitals (n = 10) using structured checklists; 2) exit interviews with 100 patients (10 per hospital); and 3) interviews with 100 health-care workers (HCWs, 10/hospital).

Results: Of the 82 SDAs, posters were displayed in 34 (41%), mechanical ventilation was implemented in 79% and functional ultraviolet germicidal irradiation (UVGI) was available in only 26%. Patient interviews showed 50–65% adherence to triage and use of personal protective measures. Key reasons for non-adherence were lack of adequate supplies, discomfort using N-95 masks, a lack of knowledge or training, perceived non-cooperation by patients, poor maintenance of mechanical ventilators and UVGI due to unstable electricity supply, a lack of clarity in roles (no-one designated in charge) and staff shortages and subsequent workloads. Adherence to natural ventilation usage was poor for reasons related to climate and privacy.

Conclusion: Implementation of TBIC measures in hospitals was suboptimal. Urgent measures need to be put in place, including retraining of HCWs, addressing weaknesses in mask and poster supplies and constant supervision and monitoring.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526491

DOI: 10.5588/pha.16.0125
PubMed: 28775940
PubMed Central: 5526491

Affiliations:

Australie, France, Inde, Norvège, Pakistan
Île-de-France, Østlandet
Oslo, Paris

Le document en format XML

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<front><div type="abstract" xml:lang="en"><p><bold>Setting:</bold>
 Ten hospitals managing drug-resistant tuberculosis (TB) in Pakistan.</p>
<p><bold>Objective:</bold>
 To assess the implementation of TB infection control (IC) practices and reasons for non-adherence to guidelines.</p>
<p><bold>Design:</bold>
 This was a descriptive study conducted between April and October 2016 with three components: 1) non-participant observation of service delivery areas (SDAs) (<italic>n</italic>
 = 82) in hospitals (<italic>n</italic>
 = 10) using structured checklists; 2) exit interviews with 100 patients (10 per hospital); and 3) interviews with 100 health-care workers (HCWs, 10/hospital).</p>
<p><bold>Results:</bold>
 Of the 82 SDAs, posters were displayed in 34 (41%), mechanical ventilation was implemented in 79% and functional ultraviolet germicidal irradiation (UVGI) was available in only 26%. Patient interviews showed 50–65% adherence to triage and use of personal protective measures. Key reasons for non-adherence were lack of adequate supplies, discomfort using N-95 masks, a lack of knowledge or training, perceived non-cooperation by patients, poor maintenance of mechanical ventilators and UVGI due to unstable electricity supply, a lack of clarity in roles (no-one designated in charge) and staff shortages and subsequent workloads. Adherence to natural ventilation usage was poor for reasons related to climate and privacy.</p>
<p><bold>Conclusion:</bold>
 Implementation of TBIC measures in hospitals was suboptimal. Urgent measures need to be put in place, including retraining of HCWs, addressing weaknesses in mask and poster supplies and constant supervision and monitoring.</p>
</div>
</front>
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Infection control in hospitals managing drug-resistant tuberculosis in Pakistan: how are we doing?

Infection control in hospitals managing drug-resistant tuberculosis in Pakistan: how are we doing?

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