Mixed methods evaluation of the impact of a short term training program on sterile processing knowledge, practice, and attitude in three hospitals in Benin

Olive Fast,Michelle White,Dan Fast,Christina Fast,Suzanne Veltjens,Zouliha Salami

doi:10.1186/s13756-018-0312-6

Olive Fast, Michelle White + Show 4 more

Open Access

https://doi.org/10.1186/s13756-018-0312-6

Copy DOI

Abstract

BackgroundProper sterile processing is fundamental to safe surgical practice and optimal patient outcomes. Sterile processing practices in low and middle-income countries often fall short of recommended standards. The impact of education and training on sterile processing practices in low and middle-income countries is unknown. We designed a sterile processing education course, including mentoring, and aimed to evaluate the impact on participants’ personal knowledge, skills, and practices. We also aimed to identify institutional changes in sterile processing practices at participants’ work places.MethodsA mixed methods design study was conducted using a Hospital Sterile Processing Assessment Tool, knowledge tests, and open-ended interviews.ResultsEducation and mentoring improved how workers understood and approached their work and to what they paid attention. Sterile processing workers were also better able to identify resources available to do their work and showed improved understanding of the impact of their work on patient safety.ConclusionsHealth care organizations seeking to improve surgical outcomes can find easy wins requiring minimal cost expenditures by paying attention to sterile processing practices. Investing in education and low-cost resources, such as cleaning detergents and brushes, must be part of any quality improvement initiative aimed at providing safe surgery in low and middle-income countries.

Highlights

Proper sterile processing is fundamental to safe surgical practice and optimal patient outcomes
Available evidence highlights the poor condition of instruments, lack of resources, and lack of standards for surgical device reprocessing in Low Middle-Income Countries (LMIC) [6]
We report on comparisons between the three separate data sets -interviews, pre and post-hospital assessments, and pre and post-test results - to identify changes in sterile processing (SP) knowledge, practices, and attitudes [9]

Summary

Introduction

Proper sterile processing is fundamental to safe surgical practice and optimal patient outcomes. Sterile processing practices in low and middle-income countries often fall short of recommended standards. The impact of education and training on sterile processing practices in low and middle-income countries is unknown. Proper sterile processing (SP) is fundamental to successful surgeries and improved patient outcomes, yet low and middle income countries (LMICs) often do not meet the World Health Organization’s (WHO) recommended standards [1,2,3,4]. Without properly cleaning instruments before autoclaving, microorganisms survive under bioburden that is “baked on”, forming a hard, protective coating during the autoclave process Later, when this protective coating is dislodged during surgical procedures, microorganisms are freed to infect patients [5]. Reprocessing of surgical devices in LMICs is done by individuals with little to no training, Fast et al Antimicrobial Resistance and Infection Control (2018) 7:20 increasing the risk of missing steps to ensure sterility during the SP process [4]

Objectives

Methods

Results

Conclusion