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. 2020 Oct 30;15(10):e0241176.
doi: 10.1371/journal.pone.0241176. eCollection 2020.

Improving injection safety practices of Cambodian healthcare workers through training

Udhayashankar Kanagasabai  1 , Adarshpal Singh  2 , Ray W Shiraishi  3 , Vanthy Ly  4 , Chhaily Hy  4 , Sou Sanith  5 , Sok Srun  5 , Sim Sansam  5 , S Teak SopHeap  6 , Yuliang Liu  3 , Gerald Jones  7 , Ugonna C Ijeoma  3 , Naomi Bock  3 , Irene Benech  3 , Dejana Selenic  3 , Bakary Drammah  3 , Renuka Gadde  2 , Fatima D Mili  3
Affiliations

Improving injection safety practices of Cambodian healthcare workers through training

Udhayashankar Kanagasabai et al. PLoS One. .

Abstract

Background: This study evaluated the impact of a safe injection safety training on healthcare worker (HCW) practice and knowledge following an HIV outbreak in Roka commune, Cambodia.

Methods: Surveys were conducted at baseline (September 2016) and seven months after a training intervention (March 2018) using the World Health Organization standardized injection practices assessment tool. HCWs were sampled at 15 purposively government health facilities in two provinces. HCWs were observed during injection practices and interviewed by trained experts from Becton-Dickinson and the Ministry of Health Cambodia. The Rao-Scott chi square test was used test for differences between baseline and follow-up.

Results: We completed 115 observations of practice at baseline and 206 at post-training follow-up. The proportion of patients whose identification was confirmed by HCWs prior to procedure being performed increased from 40.4% to 98% (p <0.0001). The proportion of HCWs who practiced correct hand hygiene increased from 22.0% to 80.6% (p = 0.056) [therapeutic observations] and 17.2% to 63.4% (p = 0.0012) [diagnostic observations]. Immediate disposal of sharps by HCWs decreased from 96.5% to 92.5% (p = 0.0030).

Conclusions: We found significant improvements in the practice of patient identity confirmation and hand hygiene but not in the immediate disposal of sharps in the post-training intervention. However, findings are not representative of all HCWs in the country. Further pre-service and in-service training and monitoring are necessary to ensure sustained behavior change.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.The commercial affiliation of Becton-Dickinson was limited to that of expertise provided for the training intervention and salary for co-authors. They were not involved in the design or other aspects of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Combined pre and post training assessment of safe injection practices affecting patients (Diagnostic observation).
Fig 2
Fig 2. Combined pre- and post-training assessment of safe injection practices affecting patients (Therapeutic observations).
See this image and copyright information in PMC

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