Family caregivers in public tertiary care hospitals in Bangladesh: Risks and opportunities for infection control

Abstract

Background Family caregivers are integral to patient care in Bangladeshi public hospitals. This study explored family caregivers’ activities and their perceptions and practices related to disease transmission and prevention in public hospitals. Methods Trained qualitative researchers conducted a total of 48 hours of observation in 3 public tertiary care hospitals and 12 in-depth interviews with family caregivers. Results Family caregivers provided care 24 hours a day, including bedside nursing, cleaning care, and psychologic support. During observations, family members provided 2,065 episodes of care giving, 75% (1,544) of which involved close contact with patients. We observed family caregivers washing their hands with soap on only 4 occasions. The majority of respondents said diseases are transmitted through physical contact with surfaces and objects that have been contaminated with patient secretions and excretions, and avoiding contact with these contaminated objects would help prevent disease. Conclusion Family caregivers are at risk for hospital-acquired infection from their repeated exposure to infectious agents combined with their inadequate hand hygiene and knowledge about disease transmission. Future research should explore potential strategies to improve family caregivers’ knowledge about disease transmission and reduce family caregiver exposures, which may be accomplished by improving care provided by health care workers.

Nipah Virus Transmission from Bats to Humans Associated with Drinking Traditional Liquor Made from Date Palm Sap, Bangladesh, 2011–2014

“…In Bangladesh, family caregivers commonly provide close-contact care to hospitalized patients ( 31 ). Infected patients often shed the virus through body secretions and excretions and can contaminate foods and surfaces, including bed rails, bed sheets, and towels ( 32 , 33 ).…”

Examining the inclusion of patients and their family members in infection prevention and control policies and guidelines across Bangladesh, Indonesia, and South Korea

“…Of concern also is the fact that from the few studies conducted, it appears that the knowledge about HAI and IPC strategies such as hand hygiene among family members of patients is limited. 1,29,32 The literature suggests that IPC guidelines utilised in many Asian countries have been based on those established in the United States, United Kingdom, Canada, or Australia, as well as by global organizations such as WHO and the Centers for Disease Control and Prevention (CDC). [33][34][35][36][37] Considering the magnitude of cultural influence over health care delivery and the important role of family carers for Asian countries, 3,6,24,38 this study aimed to examine whether the role of patients' families has been accounted for in the IPC guidelines and policies used in Asian countries.…”

Investigating Rare Risk Factors for Nipah Virus in Bangladesh: 2001–2012

“…For Nipah infection spread, handwashing with soap has had a significantly protective effect (Gurley et al 2007a) and interventions to promote handwashing and increase access to handwashing stations in hospitals are urgently needed. Though some infection control has been ongoing, limited infection control within hospitals and by family caregivers continue to be major contributors to disease transmission (Ram et al 2011; Islam et al 2014). The recent West Africa Ebola outbreak made evident the difficulty of infection control in limited resource settings and the need for interventions to prevent person-to-person transmission, especially for similarly fatal, emerging infections (Chertow et al 2014).…”