STREAM 消毒发生器在乌干达初级卫生保健设施感染预防和控制实践中的性能和可接受性。

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
Adam Drolet, Thomas Mugumya, Shan Hsu, Jonathan Izudi, Martin Ruhweza, Emmanuel Mugisha, Rony Bahatungire, Patricia S Coffey
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引用次数: 0

摘要

背景:有效的感染预防和控制计划可以对医疗质量产生积极影响,提高患者安全,保护医疗服务提供者。氯是一种广泛使用且有效的化学消毒剂,建议用于医疗机构的感染预防和控制。然而,由于缺乏稳定的氯供应,限制了氯的使用。电解法氯气发生器可以通过现场生产随时可用的高质量氯气,经济有效地解决氯气供应有限和库存不足的问题。我们报告了电解 STREAM 消毒剂发生器(Aqua Research,美国新墨西哥州)在乌干达初级卫生保健设施中用于预防和控制感染的可行性(即性能、可接受性、氯的可用性和成本):方法:我们在乌干达中部和西部的 10 家初级卫生保健机构安装了 STREAM 设备。我们查看了每个医疗机构的商用氯库存记录(库存卡),以计算出每月接收和使用氯的平均升数。将这些数值与研究期间 STREAM 的实际氯产量进行比较,以确定其对氯供应的影响。我们从设备用户(16 人)、医院管理人员(10 人)和直接参与 STREAM 设备操作或监督的地区卫生官员(6 人)中收集了可接受性数据。我们按用户群体对可接受性数据进行了描述性分析,并采用专题方法对定性回答进行了人工评估。我们对成本数据进行了归一化处理和建模,以确定五年内(STREAM 设备的最短预期使用寿命)的盈亏平衡和成本节约分析:结果:在评估期间,氯的供应一直稳定,没有任何缺货报告。与商用氯相比,STREAM 生产氯的成本在五年内节省了 36.9%。STREAM 操作员、医院管理人员和地区卫生官员对 STREAM 设备的用户接受度很高,所有受访者都表示 STREAM 在一定程度上或显著改善了卫生机构的感染预防和控制措施。总体而言,88% 的设备用户和 100% 的医院管理人员希望继续使用 STREAM 设备,而不是商用氯产品:结论:STREAM 设备在加强乌干达医疗机构的感染预防和控制措施方面表现出了巨大的潜力。根据初步结果,对于乌干达和其他地区面临感染预防和控制挑战的地区医院和大型医疗中心来说,只要有水和电,STREAM 设备就应该被视为一种很有前途的工具。今后,还可以考虑在乌干达和其他地方的小型医疗机构中使用 STREAM 设备。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Performance and acceptability of the STREAM Disinfectant Generator for infection prevention and control practices in primary health care facilities in Uganda.

Background: Effective infection prevention and control programs can positively influence quality of care, increase patient safety, and protect health care providers. Chlorine, a widely used and effective chemical disinfectant, is recommended for infection prevention and control in health care settings. However, lack of consistent chlorine availability limits its use. Electrolytic chlorine generators can address limited chlorine supply and stockouts by enabling onsite production of readily usable, high-quality chlorine cost-effectively. We report the feasibility (i.e., performance, acceptability, chlorine availability, and cost) of the electrolytic STREAM Disinfectant Generator (Aqua Research, New Mexico, USA) device for infection prevention and control in primary health care facilities in Uganda.

Methods: We installed STREAM devices in 10 primary health care facilities in central and western Uganda. Commercial chlorine inventory records (stock cards) were reviewed in each facility to calculate average liters of chlorine received and used per month. These values were compared with actual STREAM chlorine production volumes over the study period to determine its impact on chlorine availability. We collected acceptability data from a purposive sample of device users (n = 16), hospital administrators (n = 10), and district health officers (n = 6) who had been directly involved in the operation or supervision of the STREAM device. We descriptively analyzed the acceptability data by user group and evaluated qualitative responses manually using a thematic approach. Cost data were normalized and modeled to determine a break-even and cost-savings analysis across a five-year period (the minimum expected lifespan of the STREAM device).

Results: Chlorine was consistently available without any reported stockouts during the evaluation period. STREAM chlorine production resulted in a 36.9 percent cost-savings over a five-year period compared to commercial chlorine. User acceptability of the STREAM device was high among STREAM operators, hospital administrators, and district health officers, with all respondents reporting that STREAM moderately or significantly improved infection prevention and control practices in the health facility. Overall, 88 percent of device users and 100 percent of hospital administrators wished to continue using the STREAM device instead of commercial chlorine products.

Conclusion: The STREAM device has demonstrated significant potential to strengthen infection prevention and control practices in health care facilities in Uganda. Based on the preliminary results, the STREAM device should be considered a promising tool for district hospitals and large health centers facing infection prevention and control challenges in Uganda and elsewhere, provided water and electricity are available. Going forward, implementation of the STREAM device could also be considered in smaller health care facilities in Uganda and elsewhere.

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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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