Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India

Diwan, Vishal; Gustafsson, Charlotte; Rosales-Klintz, Senia; Joshi, Sudhir Chandra; Joshi, Rita; Sharma, Megha; Shah, Harshada; Pathak, Ashish; Tamhankar, Ashok J.; Lundborg, Cecilia Stålsby

doi:10.1371/journal.pone.0163347

Cited by 39 publications

(42 citation statements)

References 41 publications

(54 reference statements)

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“…Lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level is a barrier to good hand hygiene practices (10). This was noted in our study were only 41% of observed participants wash their hands after patient examination or dressing.…”

Section: Discussionmentioning

confidence: 58%

Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation

Emmanuel¹,

Tirivanhu²,

Gerald³

et al. 2019

Preprint

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Background A healthcare-associated infection (HAI) is defined as an infection originating in the environment of a health facility that was not present or incubating at the time of patient admission. HAIs can be prevented through infection, prevention and control (IPC) measures. No hazard identification and risk assessment IPC rounds and monthly meetings were conducted in Goromonzi district since 1st of January to 30th of June 2018. No trainings nor orientation for the new employees was conducted. We therefore evaluated Goromonzi District IPC program. Methods A process-outcome evaluation using the logic model was conducted in Goromonzi district’s 15 health facilities. Checklists, interviewer administered questionnaires and key informant guides were used to collect data on availability of inputs, knowledge of health workers, processes performed, outputs and outcomes achieved. Data were entered into Epi Info 7TM, which was used to generate frequencies and proportions. Qualitative data from checklists and key informants interviews was sorted manually into themes and analysed. Results All 15 health facilities had adequate stocks of HIV test kits and PEP kits. Adequate bins and detergents were found in only 3/15 (20%) of health facilities. All facilities failed to hold a single IPC meeting and none had specific budget for IPC in 2018. No IPC mentorship activities were carried out in the district. Only 7/13 (54%) health workers who had needle pricks received PEP with 2/7 (29%) of them finishing the course. No health facility had a functional HAI surveillance system. The overall knowledge rating was fair. Conclusion The IPC program inputs in Goromonzi district were inadequate hence its failure to achieve the intended outputs and outcomes. Inadequate knowledge, unavailability of health worker training plans, specific budgets and absence of IPC committees reflected non prioritisation of the program.

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Section: Discussionmentioning

confidence: 58%

Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation

Emmanuel¹,

Tirivanhu²,

Gerald³

et al. 2019

Preprint

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“…Other optional materials included 'Only water', 'Water and antiseptic solution' and 'Water and liquid soap. This study also showed the HCWs were willing to learn about hand hygiene in the future and willing to implement the same [11] . In resource limited countries the WHO manual on hand hygiene is not followed and a study shows that 17% of the doctors agreed that they were not aware of the manual [12] CONCLUSIONS Our hospital needs a proper hospital infection control team which should consist of a senior nurse as infection control nurse and a microbiologist.…”

Section: Various Hand Hygiene Products Usedmentioning

confidence: 63%

Assessment of Knowledge, Attitude and Practice of Hand Hygiene Among Health Care Workers in the Aimsr and District Government Hospital of Chittoor, Andhra Pradesh- An Observational Study

Jayakar¹,

Reddy²

2019

jemds

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BACKGROUND As the number of multi-drug resistant bacteria is increasing worldwide, it is essential to know the proper steps of hand washing in order to protect both the patient and the doctor. This study was under taken in the district hospital to throw light on the existing hand hygiene practices among the health care workers and to implement certain hand hygiene policies or practices in our hospital. METHODS The study was done at the District Hospital and AIMSR Hospital, Chittoor. As it is a collaboration of both the Government and Apollo Hospitals, the study was done on Apollo employees who were about 100 in all. We used a standard WHO questionnaire which was distributed to the participants along with their consent. The results were analysed and compiled. RESULTS In our study, we found that though the knowledge about hand hygiene is present, their day to day implementation seems to have been lost. We also can see that 17 doctors agreed that hand washing immediately after body fluid contact is not needed. Many also believed that hand washing is not needed before touching a patient even for a physical examination. CONCLUSIONS In conclusion, the following study was done to throw light on such malpractices and to implement proper hand washing practices for the betterment of the patient and the health care worker.

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“…Similar results were shown in two studies conducted at general surgery department in Western India (26) and at a private tertiary healthcare hospital in Southern India (27), where third-generation cephalosporins were reported as the most commonly prescribed class of antibiotics. The preference to a broader spectrum antibiotic, such as the third-generation cephalosporin, might be due to the overall increase in prevalence of bacterial resistance to antibiotics in India that has been observed in other settings (4).De-escalation of antibiotic therapy is suggested for settings where broad-spectrum antibiotics are the first drug of choice, but was not found at our settings (28). Overall, nine out of ten patients who underwent clean-contaminated surgery were prescribed prophylactic antibiotic treatment for more than one day.…”

Section: Discussionmentioning

confidence: 73%

“…It is worth mentioning that the risk of SSI in clean surgery is reported to be less than 2% (22). Reasons to use a 'safety approach' could be a high patient burden per physician or presumed poor hygienic conditions of the patients as the catchment area included villages of low socio-economic status (28).All these presumptions need to be verified through a suggested qualitative study.…”

Section: Discussionmentioning

confidence: 99%

Diagnose-Specific Antibiotic Prescribing Patterns at the Otorhinolaryngology Inpatient Departments of Two Private Healthcare Facilities in Central India: A Five Year Observational Study

Silfwerbrand

Verma

Sjökvist

et al. 2019

Preprint

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Background Antibiotics are overprescribed in low-and-middle-income countries where the infection rate is high. The global paucity of standard treatment guidelines and reliable prescription data is a barrier to rationalise antibiotic use and combat antibiotic resistance. Moreover, there is a lack of diagnose-specific prescription data from high infection risk departments such as the otorhinolaryngology (ENT). The purpose of the study was to present diagnose-specific antibiotic prescribing patterns at ENT inpatient departments of a teaching hospital and a non-teaching hospital from Indian private healthcare sector. Methods Data of all consecutive inpatients at the department (n=3527) were collected for five years (2008-2013). Analyses were conducted for inpatients aged >15 years (n=2909) using the World Health Organization’s methodologies. Patient records were divided into four diagnoses (indication) groups, i.e., surgical, non-surgical, chronic suppurative otitis media (CSOM) and others. Results Of 2909 inpatients, 51% had surgical diagnoses. An average of 83% inpatients in the clean surgery group, 78% in viral infection and 75% in non-infectious groups were prescribed antibiotics. CSOM was the most common diagnosis at both settings (883/2909 inpatients), where nearly 90% inpatients were prescribed antibiotics. Overall, third-generation cephalosporins and fluoroquinolones were most commonly prescribed. Conclusions This study highlights prescribing antibiotic to the unindicated diagnosis groups, i.e., clean surgeries, viral infections, and non-infectious diagnoses. Recommended single-prophylactic dose of antibiotic was not prescribed for the majority of clean-contaminated surgeries. Prolonged empirical prescribing and insignificant use of the microbiology laboratory was evident in both settings. A meticulous analysis of clean surgery group highlighted the universal applicability issue of available global guidelines.

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Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India

Cited by 39 publications

References 41 publications

Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation

Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation

Assessment of Knowledge, Attitude and Practice of Hand Hygiene Among Health Care Workers in the Aimsr and District Government Hospital of Chittoor, Andhra Pradesh- An Observational Study

Diagnose-Specific Antibiotic Prescribing Patterns at the Otorhinolaryngology Inpatient Departments of Two Private Healthcare Facilities in Central India: A Five Year Observational Study

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