Infection Prevention And Control Compliance Research Articles

Challenges of Compliance with Infection Prevention and Control (IPC) Standard Procedures among Healthcare Workers: A Hospital-Based Cross-Sectional Study

Introduction: This hospital-based cross-sectional study aimed to assess the compliance of 251 healthcare workers (HCWs) with Infective Prevention and Control (IPC) standard procedures. The study addresses the critical issue of IPC compliance among HCWs, as it plays a pivotal role in reducing the risk of infectious disease transmission within healthcare settings. Methodology: Analytical cross-sectional study was conducted at St. Francis Referral Hospital, involving 251 healthcare workers from different departments including Internal medicine, Surgery, and Emergency. The Compliance with Standard Precautions Scale (CSPS) tool developed by WHO was used. Descriptive and regression analysis was done. A P-value of less than 0.05 indicated statistical significance. Results: Overall average compliance with IPCSPs was 54% whereby only 24.7% (62/251) of healthcare workers had a good compliance. The majority of HCWs (85.3%) reported highest compliance on proper disposal of used sharp items into sharp boxes and low compliance rate (11.6%) was on the disposal of the sharp box, sharp box is only disposed when it is full. Statistically significant were found between IPCSPs and number of years of working experience, level of education, profession, IPC training and IPC meeting attendance. Conclusion: This cross-sectional study has shed light on the critical challenges faced by healthcare workers in complying with IPCSPs. Findings revealed a concerning compliance with IPCSPs which is below the WHO standard and national level standard as well. We therefore recommend enhancement of IPC training program, IPC awareness campaign, and more implementational research for IPCSPs compliance.

Assessment of Infection Control Practices among Healthcare Workers Working at Tertiary Care Hospital of Larkana, Sindh: A Cross Sectional Survey

Background: The increasing prevalence of healthcare-associated infections (HCAIs) represents a significant challenge to patient safety worldwide, particularly in tertiary care settings where the risk of transmission is heightened. Effective infection prevention and control (IPC) practices, including hand hygiene, are pivotal in mitigating these risks. Despite the critical importance of these measures, adherence varies significantly across different healthcare settings, especially in low and middle-income countries. Objective: This study aims to assess the knowledge, attitudes, and self-reported practices related to infection control among healthcare workers in a tertiary care hospital in Larkana, with a specific focus on hand hygiene practices. The study seeks to identify gaps in knowledge and practice that could be targeted to improve overall IPC measures within the hospital. Methods: A cross-sectional survey was conducted among healthcare workers at a tertiary care hospital in Larkana, utilizing a WHO-validated self-administered questionnaire. The survey covered various aspects of IPC, including hand hygiene knowledge, attitudes towards infection control, and self-reported adherence to IPC practices. The participants included doctors, nurses, paramedics, pharmacists, and technicians, with data collected on demographic details, professional roles, and specific IPC practices. Results: Out of 317 respondents, a substantial proportion, 65.93% (209 participants), reported routinely using alcohol-based hand rubs, indicating good practice adherence. Furthermore, 88.32% (280 participants) demonstrated sufficient knowledge on the correct handwashing technique as recommended by the WHO. Comparative analysis within the professional groups revealed that doctors and technicians were more likely to report higher adherence to hand hygiene practices than other healthcare workers. Conclusion: The study underscores a generally high level of knowledge and adherence to hand hygiene practices among healthcare workers in the surveyed tertiary care hospital in Larkana. Despite these positive findings, the variability in self-reported practices across different professional groups suggests the need for targeted educational and policy interventions to ensure uniform IPC compliance.

Infection prevention and control compliance among nurses and nursing students during COVID-19 in Malaysia

The Malaysian COVID-19 hospital admission rate and the intensive care wards usage are now declining as the health service system enters a stage of recovery in the endemic phase. This study aimed to explore the barriers to and facilitators of infection prevention and control (IPC) compliance among staff nurses and nursing students and to observe their IPC compliance when attending to the patients in the respective wards. Qualitative study using in-depth interviews was conducted with staff nurses and the nursing students as primary data collection methods and supported with direct observation in the wards. A total of 21 staff nurses and 14 undergraduate nursing students from multiple wards were purposively sampled from April to December 2022. Data were analyzed using thematic analysis in Nvivo software. Four key themes were emerged in this study such as the partcipants i) Narrating IPC compliance; ii) IPC compliance adherence; iii) Perceived barriers for noncompliance to IPC; iv) Empowering staff nurses and nursing students on IPC compliance. The study findings served as key evidence for the hospital top management and the nursing faculty in planning the strategies to improve the IPC training and monitoring by empowering staff nurses and nursing students at their teaching hospitals.

Infection prevention and control compliance of healthcare workers towards COVID-19 in conflict-affected public hospitals of Ethiopia

ObjectiveNon-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19...

A qualitative study of infection prevention and control practices in the maternal units of two Ghanaian hospitals

IntroductionHealthcare-associated infections (HAIs) remain a common challenge in healthcare delivery, with a significant burden in low- and middle-income countries. Preventing HAIs has gained enormous attention from policy makers and healthcare managers and providers, especially in resource-limited settings. Despite policies to enforce infection prevention and control (IPC) measures to prevent HAIs, IPC compliance remains a challenge in hospital settings. In this study, we explore the experiences of healthcare providers and women in the post-natal phase and investigate factors influencing IPC practices in two hospitals in Ghana.MethodsThe study used a qualitative approach involving semi-structured interviews, focus group discussions, and observations among healthcare providers and women in the postnatal phase in two maternity units from January 2019 to June 2019. Interviews were recorded and transcribed verbatim for thematic analysis. The data sets were uploaded into the qualitative software NVivo 12 to facilitate coding and analysis.FindingsHealthcare providers were driven by the responsibility to provide medical care for their patients and at the same time, protect themselves from infections. IPC facilitators include leadership commitment and support, IPC training and education. Women were informed about IPC in educational talks during antenatal care visits, and their practices were also shaped by their background and their communities. IPC barriers include the poor documentation or ‘invisibility’ of HAIs, low prioritization of IPC tasks, lack of clear IPC goals and resources, discretionary use of guidelines, and communication-related challenges. The findings demonstrate the need for relevant power holders to position themselves as key drivers of IPC and develop clear goals for IPC. Hospital managers need to take up the responsibility of providing the needed resources and leadership support to facilitate IPC. Patient engagement should be more strategic both within the hospital and at the community level.

Factors associated with compliance with Infection Prevention and Control measures during the COVID-19 pandemic among healthcare workers in Kampala City, Uganda.

In the context of the COVID-19 pandemic that originated from China in December 2019 and spread around the world, Kampala City witnessed a high number of infections and deaths among healthcare workers (HCWs). This study assessed the level of compliance with Infection Prevention and Control (IPC) measures and its associated factors among HCWs during the COVID-19 pandemic, in Kampala City, Uganda. A cross-sectional study was conducted in Nakawa Division, Kampala City, among 240 HCWs and used multistage sampling in government and private not-for-profit (PNFP) healthcare facilities. The outcome variable was self-reported IPC compliance which was composed of the use of masks, gloves, and hand hygiene. These were assessed using a 4-scale tool: always as recommended, most of the time, occasionally, and rarely. Only HCWs who responded "always as recommended" were considered compliant while the rest were considered non-compliant. Data was analyzed in STATA 14.0 using Modified Poisson regression to obtain factors associated with IPC compliance at 95% confidence interval (CI). Forty-six (19.2%) respondents were compliant with all the three IPC measures, and this was associated with the presence of a COVID-19 patients' ward in the healthcare facility (Adjusted Prevalence Ratio, APR: 2.51, 95%CI: 1.24-5.07). Factors associated with the use of masks were being of the Muslim religion (APR: 1.31, CI: 1.05-1.65), and working in a healthcare facility that has COVID-19 patients' ward (APR: 1.29, CI: 1.06-1.59). Factors associated with the use of gloves were the age of the HCW, those above 40 years old being less complaint (APR: 0.47, CI: 0.24-0.93), working in the diagnosis department (APR: 2.08, CI: 1.17-3.70), and working in a healthcare facility that has COVID-19 patients' ward (APR: 1.73, CI: 1.13-2.64). Factors associated with hand hygiene were working in a health center (HC) IV (PR: 1.7, CI: 1.26-2.30) or a HC II (PR: 1.68, CI: 1.28-2.21). Considering the elevated risk of disease transmission in health settings, IPC compliance was low; indicating an increased risk of COVID-19 infection among health care workers in Kampala City.

Psychosocial determinants associated with healthcare workers’ self-reported compliance with infection prevention and control during the COVID-19 pandemic: a cross-sectional study in Dutch residential care facilities for people with intellectual and developmental disabilities

BackgroundHealthcare workers’ (HCWs) compliance with infection prevention and control (IPC) is crucial to reduce the infection transmission risk. However, HCWs’ compliance with IPC in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs) is known to be suboptimal. Therefore, this study examined sociodemographic and psychosocial determinants associated with IPC non-compliance in this setting, to inform IPC policy and promotion programmes for adequate IPC behaviour.MethodsAn online questionnaire was administered to 285 HCWs from 16 RCFs between March 2021 and March 2022. Determinants associated with IPC non-compliance were assessed using logistic regression analyses.ResultsBeing a woman (OR: 3.57; 1.73–7.37), and being a non-medical professional were associated with increased odds of non-compliance (social workers, OR: 2.83; 1.65–4.85; behavioural specialists, OR: 6.09; 1.98–18.72). Perceived inadequate education/training (aOR: 1.62; 1.15–2.27) and perceived time constraints/competing priorities (aOR: 1.43; 1.03–1.98) were also associated with increased odds of non-compliance, independent of sociodemographic variables. In contrast, the belief that the supervisor complies with IPC (descriptive norm supervisor) was associated with decreased odds of non-compliance (aOR: 0.60; 0.41–0.88).ConclusionsTo improve IPC in disability care settings, the implementation of tailored and structural IPC education and training programmes (e.g., on-the-job training) is recommended to increase HCWs’ capabilities and bridge the IPC compliance gap between medical and non-medical professionals. In addition, role models, particularly supervisors, are crucial for promoting IPC behaviour. Facilities should create a culture of IPC compliance by norm setting, acting on, and modelling IPC behaviours at all levels of the organisation (management, medical, and non-medical staff).

Self-reported compliance with infection prevention and control of healthcare workers in Dutch residential care facilities for people with intellectual and developmental disabilities during the COVID-19 pandemic: A cross-sectional study

BackgroundCompliance of healthcare workers (HCWs) with infection prevention and control (IPC) is crucial to resident safety. Nevertheless, HCWs’ compliance with IPC has not been previously studied in a disability care setting. ObjectiveTo assess levels of self-reported compliance with IPC among HCWs in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs), and to assess whether IPC compliance varies among different professional groups. MethodsA total of 285 HCWs from 16 Dutch RCFs completed an online questionnaire assessing 16 IPC procedures, following national guidelines. Data were analysed using descriptive statistics and chi-square tests to assess potential differences in compliance between professional groups. ResultsOverall, HCWs complied on average with 68.7% of IPC. Only 30.1% of HCWs had sufficient compliance (defined as compliance with ≥80% of IPC practices). Compliance varied considerably between individual IPC procedures, in which compliance with wearing short-sleeved clothes (30.9%) and using disposable protective clothing (32.7%) were the lowest. Compliance with jewellery and hair regulations was suboptimal (45.6% and 55.4%, respectively). Non-medical professionals complied with IPC less frequently (social workers, 24.2%; behavioural specialists, 12.9%) than medical professionals (47.4%) (p < 0.001). ConclusionsThe majority of HCWs had suboptimal compliance with IPC. As IPC compliance differs between professionals, recommendations are to 1) implement tailored education and training programmes, and 2) pursue a facility-wide minimum required IPC compliance. Implementing and communicating a minimum set of IPC procedures – including hand hygiene, personal hygiene, and clothing requirements − applying to all professionals is important to minimise the infection transmission risk in RCFs for people with IDDs.

Infection prevention and control perspective and practices among healthcare workers in Bangladesh: A multicenter cross section

Background: Infection prevention and control (IPC) is a critical feature of preventing the spread of healthcare-associated infections (HAIs) in hospitals. IPC practices are particularly important in resource-constrained and crowded hospital settings. The successful implementation of infection prevention measures depends on healthcare worker (HCW) knowledge of, attitude toward, and practice (KAP) of IPC. In this project, we assessed the KAP of HCWs and identified factors associated with IPC compliance at tertiary-care hospitals in Bangladesh. Methods: From September 2020 to January 2021, we conducted this hospital-based cross-sectional assessment at 11 tertiary-care hospitals. A semistructured questionnaire was used to conduct face-to-face interviews with physicians, nurses, and cleaning staff who were directly involved in patient care. Based on &gt;75% of the total score, each KAP component was divided into adequate knowledge, favorable attitude, and safe practice. We performed descriptive analysis and multivariate logistic regression to determine the KAP score and associated factors influencing IPC compliance in hospital settings. Results: In total, 1,728 HCWs were interviewed; 76.8% of the participants had adequate knowledge on IPC and 54.6% reported safe practices. However, only 16.2% of HCWs had a favorable attitude toward IPC. Among the 3 HCW groups, nurses had the highest KAP scores (76.07±12.7) followed by physicians (69.8±16.2), and cleaning staff (34.4±27.3). Only 29.2% of HCWs reported having received IPC training, and they cited heavy workload as a barrier to IPC guideline adherence. HCWs having adequate knowledge showed 9 times higher odds of safe IPC practice (AOR, 9.36; 95% CI, 5.47–16.04). HCWs who had a favorable attitude toward IPC were 16 times as likely to perform safe practice toward IPC activities (AOR, 15.5; 95% CI, 10.27–23.42). Conclusions: Knowledge of safe practices and having a favorable attitude toward IPC are key components of a successful IPC program. Significant improvements are required among all levels of HCWs in Bangladesh tertiary-care hospitals, especially cleaning staff. Educational interventions to train on IPC guidelines, plus monitoring, could improve HCW safe practices.Disclosures: None

Knowledge and Compliance on Infection Prevention and Control Among Healthcare Professionals in Teaching Hospital, Pahang Malaysia During Pandemic Covid-19: A Cross Sectional Study

Introduction: The European Centre for Disease and Prevention Control and World Health Organization (WHO) had established the guidelines for infection prevention and control (IPC) in managing possible and confirm cases of COVID-19. WHO has enforced an interim guideline for public and healthcare services for COVID-19 to be used together with the existing core component of IPC. Objective: To investigate the level of knowledge on COVID-19 and IPC and its compliance among healthcare providers (HCPs) in one of teaching hospitals, Sultan Ahmad Shah Medical Centre (SASMEC@IIUM).Methods: A quantitative cross-sectional study with convenience sampling was conducted among 114 HCPs by using self-reported questionnaire from May 2021 to July 2021. Descriptive and correlation statistical analysis were employed in this study. The data was analysed using IBM SPSS Statistic version 20. Results: Majority of the respondents (N=114) reported have good knowledge and 84.2% have good compliance on COVID-19, IPC There is a moderate positive correlation between level of knowledge on COVID-19 and knowledge on IPC, respectively (r=0.616, r=0.601), but fair correlation between knowledge on COVID-19 and compliance on IPC (r=0.374). There is a moderate positive correlation between knowledge on IPC and IPC compliance (r=0.601). Conclusion: HCPs in SASMEC@IIUM have good knowledge on COVID-19 and IPC as well as good compliance on IPC. This indicates regular training on IPC among HCPs provide great impact to the teaching hospital.

Building a safety culture for infection prevention and control adherence at Howard Springs: A workplace survey.

Building a safety culture is essential to facilitate infection prevention and control (IPC) adherence in workplaces. We aimed to explore perceptions, barriers and facilitators to IPC procedures by the Australian Medical Assistance Team (AUSMAT) at Howard Springs International Quarantine Facility (HSIQF). We performed a descriptive analysis of a cross-sectional survey administered to the AUSMAT employed at HSQIF from October 2020 to April 2021. We described motivation, training and compliance to IPC adherence and Likert scales described the level of agreement to the success of IPC procedures across the domains of communication, risk, trust, safety and environment, from the individual, team and organisational perspective. There were 101 participants (response rate 59%, 101/170) and 70% (71/101) were clinical. There was strong agreement to the success of IPC procedures, with a median 4 (agree) or 5 (strongly agree) across each domain and perspective of the 67 Likert items. Clinical staff reported slightly higher agreement than non-clinical staff across Likert items. To improve IPC compliance, most reported that daily training should be provided (77/97, 79%) and daily training was very or extremely effective (91/97, 93%). Participants were motivated by protecting self, friends, family and the community rather than workplace pressures. Barriers to IPC compliance were the ambient environment and fatigue. A safety culture was successfully built at HSQIF to optimise IPC adherence whilst managing multiple hazards including prevention of COVID-19 transmission. Strategies implemented by AUSMAT at the quarantine facility may inform the development of safety culture in other settings.

Exploring factors influencing the compliance of patients and family carers with infection prevention and control recommendations across Bangladesh, Indonesia, and South Korea.

Poor compliance with infection prevention and control (IPC) measures has been a longstanding issue globally. To date, healthcare workers (HCWs) have been the primary target for policy and strategy revisions. Recent studies exploring the contributing factors to the spread of COVID-19 across countries in Asia have suggested that the scope of focus should be extended to family carers who provide patient care activities. This study aimed to explore factors affecting patients' and their family carers' IPC compliance in hospitals in Bangladesh, Indonesia, and South Korea. A qualitative study incorporating 57 semi-structured interviews was conducted in five tertiary-level hospitals across the three focus countries between July 2019 and February 2020. Interviews were undertaken with: (1) patients, family carers and private carers; and (2) healthcare workers, including nurses, doctors, and hospital managers. Drawing upon the principles of grounded theory, data were inductively analyzed using thematic analysis. A total of three main themes and eight subthemes are identified. Key themes focused on the assumptions made by healthcare workers regarding the family/private carers' level of understanding about IPC and training received; uncertainty and miscommunication regarding the roles of family/private carers; variations in carer knowledge toward IPC and healthcare-associated infections, and the impact of cultural values and social norms. This exploratory study offers novel findings regarding the factors influencing IPC compliance among patients and their family/private carers across various cultural settings, irrespective of resource availability. The role of cultural values and social norms and their impact on IPC compliance must be acknowledged when updating or revising IPC policies and guidelines.

COVID-19 preventive practices and associated factors among high school and preparatory school students in Dessie City, Ethiopia.

As the COVID-19 pandemic continues to ravage the world, the most pretentious sector besides the economy is the education system. Ethiopia is not equipped with the infrastructure and facilities to provide online classes for students at all levels. Hence, all institutions were re-opened with mandatory infection prevention and control (IPC) protocols such as the use of face masks, physical distancing, shifts in classes, and routine hand washing practices with soap and water to restrict the spread of the virus. Nevertheless, there has been no monitoring and follow- up and there is no data on IPC compliance among school children in the country. The purpose of this study was to examine the COVID-19 preventive practices and their associated factors among high and preparatory school students in Dessie City, Ethiopia. A cross-sectional study was carried out by using a pre-tested face-to-face applied structured questionnaire and direct observations from March 8 to March 20, 2021, in five high and preparatory schools in Dessie City. The sample size was proportionally allocated in each school based on the students' total number registered in the first academic semester, then stratified by grade level, and proportionally allocated to each grade and section. Finally, a simple random sampling method was used to select study participants. Variables with p-values < 0.25 in the bivariate logistic regression analysis were entered into the multivariate logistic regression model. This study involved 422 students with a response rate of 98.8%. The level of good preventive practices was 43.7%. After adjusting for covariates, female, positive attitudes, received IPC training and clear accessible sharing of information and feedback with parents, students and teachers were identified as predictors of good precaution practices. The prevalence of good prevention practices for COVID-19 among students was relatively very low. Therefore, the Department of Health and Education of Dessie City and each school should implement environmental health programs and promote prevention practices in high schools and preparatory schools.

Exploring behavioural factors influencing COVID-19-specific infection prevention and control measures in Finland: a mixed-methods study, December 2020 to March 2021.

BackgroundCompliance with infection prevention and control (IPC) measures is critical to preventing COVID-19 transmission in healthcare settings.AimTo identify and explain factors influencing compliance with COVID-19-specific IPC measures among healthcare workers (HCWs) in long-term care facilities (LTCF) in Finland.MethodsThe study included a web-based survey and qualitative study based on the Theoretical Domains Framework (TDF). The link to the anonymous survey was distributed via email to LTCFs through regional IPC experts in December 2020. Outcome was modelled using ordinary logistic regression and penalised ridge logistic regression using regrouped explanatory variables and an original, more correlated set of explanatory variables, respectively. In-depth interviews were conducted among survey participants who volunteered during January–March 2021. Data were analysed thematically using qualitative data analysis software (NVIVO12).ResultsA total of 422 HCWs from 17/20 regions responded to the survey. Three TDF domains were identified that negatively influenced IPC compliance: environmental context and resources, reinforcement and beliefs about capabilities. Twenty HCWs participated in interviews, which resulted in identification of several themes: changes in professional duties and lack of staff planning for emergencies (domain: environmental context and resources); management culture and physical absence of management (domain: reinforcement), knowledge of applying IPC measures, nature of tasks and infrastructure that supports implementation (domain: beliefs about capabilities), that explained how the domains negatively influenced their IPC behaviour.ConclusionsThis study provides insights into behavioural domains that can be used in developing evidence-based behaviour change interventions to support HCW compliance with pandemic-specific IPC measures in LTCFs.

Knowledge and determinants of infection prevention and control compliance among nurses in Yendi municipality, Ghana.

Knowledge of and compliance to infection prevention and control (IPC) guidelines are crucial to curbing hospital acquired infections (HAIs). Globally, about 7-10% of patients suffer HAIs. However, there is limited evidence on nurses' knowledge and adherence to IPC guidelines. Therefore, this study assessed the knowledge and determinants of IPC compliance among nurses in Yendi Municipality, Northern Ghana. We conducted a quantitative cross-sectional study among 209 nurses of the Yendi Municipal hospital, using an adapted questionnaire. We collected and analysed data using SPSS version 26. Socio-demographics, knowledge level and compliance to IPC guidelines were assessed using descriptive statistics. The minimum scores for knowledge and compliance were 0 each with maximum scores being 10 and 8 respectively. Using binary multivariate logistic regression, the determinants of IPC compliance were analysed and odds ratios reported at 95% confidence intervals. The nurses had high mean and standard deviation scores for knowledge (7.26 ± 1.4) and compliance to IPC guidelines (5.41 ± 1.5). Females (aOR: 0.33; 95%CI: 0.17-0.64; p = 0.001) were significantly less likely to comply to IPC guidelines. Nurses working in Maternity/Labour wards (aOR: 8.31; 95%CI: 2.46-28.15; p = 0.001) and Outpatient Department (OPD)/Psychiatry (aOR: 5.00; 95%CI: 1.42-17.62; p = 0.012) were associated with higher odds of complying to IPC guidelines. Availability of IPC guidelines (aOR: 3.48; 95%CI: 1.13-10.72; p = 0.030) in a working department influenced compliance to IPC measures. The study revealed high knowledge and high compliance regarding IPC among nurses in the Yendi Municipal Hospital. A person's working department and the availability of IPC guidelines were key determinants for high compliance to IPC measures. However, knowledge of IPC did not influence compliance to IPC guidelines. The Municipal and Regional Health directorates, should therefore ensure adequate logistic flow, provision of IPC guidelines and proper supervision to ensure maximum compliance with IPC guidelines, particularly among paediatric, medical and surgical wards nurses as well as degree holding nurses.

Infection Prevention and Control in Three Tertiary Healthcare Facilities in Freetown, Sierra Leone during the COVID-19 Pandemic: More Needs to Be Done!

Infection Prevention and Control (IPC) measures are critical to the reduction in healthcare-associated infections, especially during pandemics, such as that of COVID-19. We conducted a hospital-based cross-sectional study in August 2021 at Connaught Hospital, Princess Christian Maternity Hospital and Ola During Children’s Hospital located in Freetown, Sierra Leone. We used the World Health Organization’s Infection Prevention and Control Assessment Framework Tool to assess the level of IPC compliance at these healthcare facilities. The overall IPC compliance score at Connaught Hospital was 323.5 of 800 points, 313.5 of 800 at Ola During Children’s Hospital, 281 of 800 at Princess Christian Maternity Hospital, implying a ‘Basic’ IPC compliance grade. These facilities had an IPC program, IPC committees and dedicated IPC focal persons. However, there were several challenges, including access to safe and clean water and insufficient quantities of face masks, examination gloves and aprons. Furthermore, there was no dedicated budget or no healthcare-associated infection (HAI) surveillance, and monitoring/audit of IPC practices were weak. These findings are of concern during the COVID-19 era, and there is an urgent need for both financial and technical support to address the gaps and challenges identified.

Predicting Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infection Incidence Rates using Canadian Nosocomial Infection Surveillance Program (CNISP)

Methicillin-Resistant Staphylococcus aureus (MRSA) is among the most prevalent nosocomial pathogens globally, causing significant morbidity, mortality, and healthcare costs. MRSA bloodstream infection (BSI) incidence rates in Canadian hospitals have significantly risen by almost 60% and have a mortality of over 20% upon Intensive Care Unit admission. MRSA is believed to be spread through healthcare workers; thus, high hand hygiene compliancy in addition to environmental cleaning are the cornerstone countermeasures to disrupting its transmission. The Public Health Agency of Canada (PHAC), in collaboration with the Canadian Nosocomial Infection Surveillance Program (CNISP), conducts national, sentinel surveillance on healthcare-associated infections like MRSA. As a Student Epidemiologist, I developed a research proposal detailing two study objectives: 1) develop a regression model to predict all incident MRSA BSI rates among acute-care hospitals in Canada using CNISP MRSA BSI incident cases from 2000 to 2019, and 2) create a compartmental (Susceptible-Infected-Recovered-Deceased) model to determine the impact of various Infection Prevention and Control (IPC) measures on the risk of healthcare-associated MRSA BSI transmission specifically. This study hopes to demonstrate that proper IPC compliance is associated with lower incident MRSA BSI rates with the goal being to produce a manuscript draft by 2021. MRSA poses a serious threat to patient safety globally and is becoming a growing national public health concern in Canada; determining which IPC strategy is most effective at disrupting MRSA transmission is essential to reducing incidence and mortality rates.

Gaps in Infection Prevention and Control in Public Health Facilities of Sierra Leone after the 2014-2015 Ebola Outbreak.

Background: High compliance to infection prevention and control (IPC) is vital to prevent health care-associated infections. In the worst 2014–2015 Ebola-affected district in Sierra Leone (Kenema), we assessed (a) average yearly IPC compliance (2016–2018) using a National IPC assessment tool in the district hospital and peripheral health units (PHUs), and (b) gaps in IPC activities, infrastructure and consumables in 2018. Methods: This was a cross-sectional study using secondary program data. Results: At the district hospital, compliance increased from 69% in 2016 to 73% in 2018 (expected minimal threshold = 70%; desired threshold ≥ 85%). Compliance for screening/isolation facilities and decontamination of medical equipment reached 100% in 2018. The two thematic areas with the lowest compliance were sanitation (44%) and sharps safety (56%). In PHUs (2018), the minimal 70% compliance threshold was not achieved in two (of 10 thematic areas) for Community Health Centers, four for Community Health Posts, and five for Maternal and Child Health Units. The lowest compliance was for screening and isolation facilities (range: 33–53%). Conclusion: This baseline assessment is an eye opener of what is working and what is not, and can be used to galvanize political, financial, and material resources to bridge the existing gaps.

Environmental hygiene, knowledge and cleaning practice: a phenomenological study of nurses and midwives during COVID-19

BackgroundEnvironmental cleanliness is a fundamental tenet in nursing and midwifery but often overshadowed in practice. This study explored nurses’ and midwives’ knowledge and experiences of infection prevention and control (IPC) processes and cleaning, and perceptions about workplace risk-management during COVID-19. MethodsSix registered and enrolled nurses (one with dual midwife qualifications) were recruited. In-depth telephone interviews were analyzed using Colaizzi's phenomenological method. ResultsFour major themes were identified: Striving towards environmental cleanliness; Knowledge and learning feeds good practice; There's always doubt in the back of your mind; and COVID has cracked it wide open. These articulate the nurses’ and midwives’ experiences and knowledge of IPC, particularly during COVID-19. DiscussionThe findings emphasize the dynamic, interdependent nature of clinical (time, staff knowledge and compliance, work processes, hospital design) and organizational contexts and environmental cleanliness, which must be constantly maintained. COVID-19 opened up critical insights regarding poor past practices and lack of IPC compliance. ConclusionsCOVID-19 has highlighted the criticality of environmental cleanliness within clinical and community settings. Evidence-based, experiential learning is important for nurses and midwives at all career stages, but provides only one solution. Clinician-led hospital design may also reduce the spread of infection; thus, promoting better patient care.

Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study

Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.