Healthcare-Associated Infections and Shanghai Clinicians: A Multicenter Cross-Sectional Study

Abstract

Literature about healthcare-associated infection (HCAI) in China is scarce. A cross-sectional anonymous survey was conducted on 647 clinicians (199 physicians and 448 nurses) from six Shanghai hospitals (grades A–C) to investigate their cognizance, knowledge, attitude, self-reported practice, and risks regarding HCAI with emphasis on precautions. The mean overall score of HCAI knowledge was 40.89±11.4 (mean±SD; range, 13∼72) out of 100 for physicians and 43.48±9.9 (10∼70) for nurses. The respondents generally received high scores in hand hygiene, HCAI core concept, and healthcare worker safety but low scores in HCAI pathogen identification and isolation precautions. There were substantial variations in the knowledge scores of various demographic groups across individual hospitals and within hospital grades (ps<0.05). Within-hospital comparisons showed that the nurses were better than physicians particularly in hand hygiene knowledge in 4 hospitals (ps<0.05). Multiple linear regression analysis showed that longer work experience was inversely and independently associated with the overall and categorical knowledge of nurses, whereas independent associations between older age or higher education and categorical knowledge were noted for physicians. The respondents' self-reported practices and adherence to standard precautions were less than satisfactory. This multi-center study reports a high level of cognizance, patchy knowledge, suboptimal adherence to infection control precautions, and self-protective attitudes among the practicing clinicians regarding HCAI, with potential safety risk to patients and healthcare providers. Providing quality learning resources, enforcing knowledge-informed practice, and promoting a healthcare safety culture are recommended as interventions. Future studies are warranted for social and behavioral aspects of healthcare safety with emphasis on infection control.

Motivos e consequências da baixa adesão às precauções padrão pela equipe de enfermagem

“…It should also be stressed the need to include in nursing curricula contents targeted to the practice of health and safety at work, not only biosafety, but also the other norms that regulate work in health services, in order to make it safer and focused on the perception of risks by professionals (14,(31)(32)(37)(38)(39)(46)(47)(48)(49)(50)(51) . These studies, which account for 40.0% of the analyzed sample stress that risk perception should be included in continuing education actions, since the way in which health professionals perceive risks is directly related to the protective measures adopted by them.…”

The Importance of Implementation of Hand Hygiene Practice in Reducing Healthcare-associated Infections: A Systematic Review

“…The 2nd ICHA higher compliance than physician which nurses achieved higher hand hygiene compliance (93%) than physicians (78%) [9]. Another study showed that nurses were generally better than physicians particularly in hand hygiene, perhaps because nursing job is more patient oriented and compliance demanding meanwhile physician considered play important roles as opinion leaders, decision makers, and role models in clinical environment [1].…”

“…Healthcare-associated Infections (HAIs) become the priority attentions of health authorities worldwide since it became the most frequent adverse event of infections in health care system [1]. World Health Organizations defines HAIs referred to nosocomial or hospital infection as an infection occur in a patient during the process of care in a hospital or other healthcare facility which was not present or incubating at the time of admission [2].…”

“…Emori and Gaynes said that Healthcare Associated Infections (HAIs) is defined as one in which there is no evidence of patient infection (or colonization) at the time of admission to a hospital [3]. HAIs related to prolonged hospital stay, increased morbidity and mortality, extra financial burden, increase length of stay (LOS) and increased microbial resistance to anti microbe [1]. The future burden of endemic HAIs is congruent to the WHO Report in 2011.…”

Assessment of the quality of hospital hygiene at Gaweye District hospital in Niamey in 2018

“…In addition, it guarantees the quality of benefits in a health facility suggests that the hospital is not a risk environment for its different users and populations, as well. The failure or absence of this sector leads to the emergence of nosocomial infections (NIA) more widely today, the infections associated with care and services (IAS) that complicate the state of health of patients (Geberemariyam et al 2018, Zhou et al, 2014. In developed countries, nosocomial infections affect 5% to 15% of patients hospitalized in regular services and up to 50% or more of patients in intensive care units (Nejad et al, 2011).…”