Current Status of Infection Control Practice in Surgical Settings of Leading Academic and Private Service Hospitals in Dhaka, Bangladesh

Abstract

Health-Care Associated Infection (HCAI) is such a risk and 1.4 millions of people worldwide suffer from HCAIs at any time. To describe the current practice for prevention of health-care associated infections in surgical settings of academic and private hospitals in Dhaka and to propose intervention for improving the conditions with existing resources. This is a descriptive type of exploratory, cross-sectional study and was designed to focus on various dimensions of infection prevention and control that includes- optimum designing of care settings, existing systems, clean-hygienic physical environment and safe practices. This study revealed that uninterrupted water supply and natural ventilation, two basic structural facilities of pivotal importance in infection control engineering were present on all premises under study. However, inadequate toilet and hand washing basins, absence of isolation room, overcrowding of wards was found to pose continuous threat to infection in most of the inpatient wards. Absence of explicit and comprehensive infection control program, clear and current policies on various infection control interventions like hand hygiene, isolation precaution, environmental cleaning, prevention and management of blood borne pathogen, antibiotic usage, injection safety and management of job related illness was revealed from this study. None of the other hospitals maintained post exposure evaluation and follow-up procedures. Although healthcare workers were formally trained in the following matters, unsafe practices for injection, improper use of personal protective equipment, low level of adherence to hand hygiene and cough etiquette were frequently observed during the study. From this study it can be concluded that academic and private hospitals, whether it is government, autonomous or private could not establish the policy, infrastructure, program, processes and safety culture in terms of standard infection prevention and control interventions, except one private service hospital.