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. 2023 Oct 27;8(11):486.
doi: 10.3390/tropicalmed8110486.

Hand Hygiene Practices and Promotion in Public Hospitals in Western Sierra Leone: Changes Following Operational Research in 2021

Matilda N Kamara  1 , Sulaiman Lakoh  1   2 , Christiana Kallon  2 , Joseph Sam Kanu  1   2 , Rugiatu Z Kamara  3 , Ibrahim Franklyn Kamara  4 , Matilda Mattu Moiwo  5 , Satta S T K Kpagoi  2 , Olukemi Adekanmbi  6   7 , Marcel Manzi  8 , Bobson Derrick Fofanah  4 , Hemant Deepak Shewade  9
Affiliations

Hand Hygiene Practices and Promotion in Public Hospitals in Western Sierra Leone: Changes Following Operational Research in 2021

Matilda N Kamara et al. Trop Med Infect Dis. .

Abstract

Hand hygiene is the most important intervention for preventing healthcare-associated infections and can reduce preventable morbidity and mortality. We described the changes in hand hygiene practices and promotion in 13 public hospitals (six secondary and seven tertiary) in the Western Area of Sierra Leone following the implementation of recommendations from an operational research study. This was a "before and after" observational study involving two routine cross-sectional assessments using the WHO hand hygiene self-assessment framework (HHSAF) tool. The overall mean HHSAF score changed from 273 in May 2021 to 278 in April 2023; it decreased from 278 to 250 for secondary hospitals but increased from 263 to 303 for tertiary hospitals. The overall mean HHSAF score and that of the tertiary hospitals remained at the "intermediate" level, while secondary hospitals declined from "intermediate" to "basic" level. The mean score increased for the "system change" and "institutional safety climate" domains, decreased for "training and education" and "reminders in the workplace" domains, and remained the same for the "evaluation and feedback" domain. Limited resources for hand hygiene promotion, lack of budgetary support, and formalized patient engagement programs are the persistent gaps that should be addressed to improve hand hygiene practices and promotion.

Keywords: IPC in hospital; Structured Operational Research Training Initiative (SORT IT); hand hygiene self-assessment framework (HHSAF); hand hygiene training; healthcare-associated infections (HAIs); infection prevention and control (IPC).

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
“Information-Dissemination-Decisions-Action-Change” cycle. OR—operational research; SORT IT—Structured Operational Research and Training Initiative.
Figure 2
Figure 2
The mean HHSAF score of 13 public hospitals in the Western Area of Sierra Leone before (May 2021) and after (April 2023) the implementation of the recommendations from operational research [13].
See this image and copyright information in PMC

References

    1. World Health Organization . Report on the Burden of Endemic Health Care-Associated Infection Worldwide Clean Care Is Safer Care. World Health Organization; Geneva, Switzerland: 2011.
    1. Nejad S.B., Allegranzi B., Syed S.B., Ellisc B., Pittetd D. Health-Care-Associated Infection in Africa: A Systematic Review. Bull. World Health Organ. 2011;89:757–765. doi: 10.2471/BLT.11.088179. - DOI - PMC - PubMed
    1. Jia H., Li L., Li W., Hou T., Ma H., Yang Y., Wu A., Liu Y., Wen J., Yang H., et al. Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China. BioMed Res. Int. 2019;2019:2590563. doi: 10.1155/2019/2590563. - DOI - PMC - PubMed
    1. Serra-Burriel M., Keys M., Campillo-Artero C., Agodi A., Barchitta M., Gikas A., Palos C., López-Casasnovas G. Impact of Multi-Drug Resistant Bacteria on Economic and Clinical Outcomes of Healthcare-Associated Infections in Adults: Systematic Review and Meta-Analysis. PLoS ONE. 2020;15:e0227139. doi: 10.1371/journal.pone.0227139. - DOI - PMC - PubMed
    1. Alp E., Damani N. Healthcare-Associated Infections in Intensive Care Units: Epidemiology and Infection Control in Low-to-Middle Income Countries. J. Infect. Dev. Ctries. 2015;9:1040–1045. doi: 10.3855/jidc.6832. - DOI - PubMed

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