Are healthcare workers safe? Facility assessment of airborne infection control measures in public hospitals of Kerala

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Background: Nosocomial transmission of airborne infection is a major peril to health care providing community and has been linked to poor adherence to airborne infection control practices. The present study was conducted to assess the gaps in health care facilities and practices for prevention and control of transmission of air borne infections among healthcare workers in government district level hospitals of Kerala.Methods: A cross sectional survey including observation was done in 24 facilities. The tool for the survey and the check list for observation were developed based on national airborne infection control guidelines and assessment tool for prevention and control of infection by centre for disease control. The data were analysed using IBM SPSS version 23.Results: The functioning of airborne infection control system was found to be suboptimal in most of the institutions. Implementation of environmental control measures was poor when compared to administrative control and personal protection measures. Adequate ventilation was not present in more than half of the institutions (60%). All institutions had infection control committees in place but were not functioning well. Personal protective equipment’s were not available at point of use in more than half of the institutions (62.5%). Out of the 16 self-reported hospital acquired respiratory infections among the staff, pulmonary tuberculosis was predominant.Conclusions: Several barriers were identified at different levels for prevention and control of airborne infections among healthcare workers. The findings reinforce the need to implement strict guidelines to prevent occupation induced airborne infections among health workers in public health system.