Abstract
Aims & Objectives: Hospital-acquired infections (HAIs) are important causes of morbidity and mortality, particularly in PICU patients (Mbim et al., 2016). Mercy James Centre (MJC), the first PICU in Malawi, experienced a sharp increase in HAIs. The established MJC Infection Prevention (IP) Team initiated practical improvement measures (PIM) which aimed at reducing the HAI rate in the unit. Methods: PIM focus on practical, contextually-relevant interventions for nursing care. These measures include hand hygiene audits, ventilator filter changes every 48 hours, and isolation strategies for all patients. Bedside nurses are educated on these measures and compliance is tracked by the IP team. Results: Of the 88 health workers that were observed performing hand hygiene, 65 adhered, representing 73.9%. After six months of observation, 50 out of the 60 patients that were ventilated for longer than 48 hours had their ventilator filters changed, representing 83.3% of patients. Six months after implementation, the number of patients with HAIs dropped from 75% to 25% in the unit. Conclusions: The improvement shown suggests that these PIM might be similarly appropriate in other resource-limited settings. Of note, medical and environmental interventions were also implemented, though these were not rigorously tracked. Future plans include systematic tracking of all PIM, ongoing education of all staff, and conducting quality improvement studies.
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