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Kamara MN, Lakoh S, Kallon C, Kanu JS, Kamara RZ, Kamara IF, Moiwo MM, Kpagoi SSTK, Adekanmbi O, Manzi M, Fofanah BD, Shewade HD. Hand Hygiene Practices and Promotion in Public Hospitals in Western Sierra Leone: Changes Following Operational Research in 2021. Trop Med Infect Dis 2023; 8:486. [PMID: 37999605 PMCID: PMC10674222 DOI: 10.3390/tropicalmed8110486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/09/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
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.
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Affiliation(s)
- Matilda N Kamara
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
| | - Sulaiman Lakoh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Christiana Kallon
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Joseph Sam Kanu
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Rugiatu Z Kamara
- US Center for Disease Control and Prevention, Freetown 00232, Sierra Leone
| | | | - Matilda Mattu Moiwo
- Republic of Sierra Leone Armed Forces, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Satta S T K Kpagoi
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown 00232, Sierra Leone
| | - Olukemi Adekanmbi
- Department of Medicine, University of Ibadan, Ibadan 200005, Nigeria
- Department of Medicine, University College Hospital, Ibadan 200005, Nigeria
| | | | | | - Hemant Deepak Shewade
- Division of Health Systems Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India
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Kamara RZ, Kamara IF, Moses F, Kanu JS, Kallon C, Kabba M, Moffett DB, Fofanah BD, Margao S, Kamara MN, Moiwo MM, Kpagoi SSTK, Tweya HM, Kumar AMV, Terry RF. Improvement in Infection Prevention and Control Compliance at the Three Tertiary Hospitals of Sierra Leone following an Operational Research Study. Trop Med Infect Dis 2023; 8:378. [PMID: 37505674 PMCID: PMC10385074 DOI: 10.3390/tropicalmed8070378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Abstract
Implementing infection prevention and control (IPC) programmes in line with the World Health Organization's (WHO) eight core components has been challenging in Sierra Leone. In 2021, a baseline study found that IPC compliance in three tertiary hospitals was sub-optimal. We aimed to measure the change in IPC compliance and describe recommended actions at these hospitals in 2023. This was a 'before and after' observational study using two routine cross-sectional assessments of IPC compliance using the WHO IPC Assessment Framework tool. IPC compliance was graded as inadequate (0-200), basic (201-400), intermediate (401-600), and advanced (601-800). The overall compliance scores for each hospital showed an improvement from 'Basic' in 2021 to 'Intermediate' in 2023, with a percentage increase in scores of 16.9%, 18.7%, and 26.9% in these hospitals. There was improved compliance in all core components, with the majority in the 'Intermediate' level for each hospital IPC programme. Recommended actions including the training of healthcare workers and revision of IPC guidelines were undertaken, but a dedicated IPC budget and healthcare-associated infection surveillance remained as gaps in 2023. Operational research is valuable in monitoring and improving IPC programme implementation. To reach the 'Advanced' level, these hospitals should establish a dedicated IPC budget and develop long-term implementation plans.
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Affiliation(s)
- Rugiatu Z. Kamara
- United States Centers for Disease Control and Prevention Country Office, Emergency Operation Centre, Wilkinson Road, Freetown 00232, Sierra Leone;
| | - Ibrahim Franklyn Kamara
- World Health Organization Country Office, 21 A-B Riverside Drive, Off Kingharman Road, Freetown 00232, Sierra Leone; (I.F.K.); (B.D.F.)
| | - Francis Moses
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Joseph Sam Kanu
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
- College of Medicine and Allied Health Science, University of Sierra Leone, Freetown 00232, Sierra Leone
| | - Christiana Kallon
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Mustapha Kabba
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Daphne B. Moffett
- United States Centers for Disease Control and Prevention Country Office, Emergency Operation Centre, Wilkinson Road, Freetown 00232, Sierra Leone;
| | - Bobson Derrick Fofanah
- World Health Organization Country Office, 21 A-B Riverside Drive, Off Kingharman Road, Freetown 00232, Sierra Leone; (I.F.K.); (B.D.F.)
| | - Senesie Margao
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Matilda N. Kamara
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Matilda Mattu Moiwo
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Freetown 00232, Sierra Leone;
| | - Satta S. T. K. Kpagoi
- Ministry of Health and Sanitation, Fourth Floor, Youyi Building, Freetown 00232, Sierra Leone; (F.M.); (J.S.K.); (C.K.); (M.K.); (S.M.); (M.N.K.); (S.S.T.K.K.)
| | - Hannock M. Tweya
- Department of Global Health, University of Washington, Seattle, WA 98195, USA;
- International Training and Education for Health, Lilongwe P.O. Box 30369, Malawi
| | - Ajay M. V. Kumar
- International Union against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France;
- International Union against Tuberculosis and Lung Disease, South-East Asia Office, C-6, Qutub Institutional Area, New Delhi 110016, India
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to Be University), University Road, Deralakatte 75018, India
| | - Robert F. Terry
- The Special Program for Research and Training in Tropical Diseases (TDR), World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland;
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