卢旺达基加利费萨尔国王医院感染预防和控制措施的障碍和促进因素。

Jakob Weiss, Sandrine Berwa, Gladys Momanyi, Richard Nduwayezu, Dawd Siraj, Daniel Shirley
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引用次数: 0

摘要

目的:利用患者安全系统工程倡议(SEIPS)模型,确定卢旺达基加利费萨尔国王医院(KFH)感染预防和控制(IPC)实践的障碍和促进因素。设计:包括半结构化访谈的定性研究。地点:费萨尔国王医院,卢旺达基加利的三级保健设施。参与者:参与感染控制实践的不同角色的25名医院工作人员的目的样本。方法:采用SEIPS框架进行半结构化访谈,该框架包括人员、环境、任务、组织、工具和过程领域。对访谈进行转录、编码和分析,以确定与IPC障碍和促进因素相关的反复出现的主题。结果:主要障碍包括过度拥挤、缺乏隔离室以及与工作人员相关的重要因素,如新工作人员的态度、培训不频繁和监测不一致。促进预防感染措施的措施包括提供足够的洗手液、肥皂、水和个人防护装备,以及医院管理部门制定强有力的预防感染政策。确定的一个系统性障碍是消费者在没有处方的情况下获得抗生素,这引起了对不当使用和抗生素耐药性的担忧。结论:为加强IPC实践,建议采取诸如增加IPC培训和监测等干预措施。长期解决方案可能包括扩建医院和为每个单元建立隔离室。此外,立法行动限制消费者在没有医生处方的情况下获得抗生素,可以减轻社区和医院层面的抗生素耐药性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Barriers and facilitators to infection prevention and control practices at King Faisal Hospital, Kigali, Rwanda.

Objective: To identify barriers and facilitators of infection prevention and control (IPC) practices at King Faisal Hospital (KFH) in Kigali, Rwanda, using the Systems Engineering Initiative for Patient Safety (SEIPS) model.

Design: Qualitative study involving semi-structured interviews.

Setting: King Faisal Hospital, a tertiary healthcare facility in Kigali, Rwanda.

Participants: A purposive sample of 25 hospital staff members from various roles involved in infection control practices.

Methods: Semi-structured interviews were conducted, guided by the SEIPS framework which includes domains of person, environment, tasks, organization, tools, and process. Interviews were transcribed, coded, and analyzed to identify recurring themes related to IPC barriers and facilitators.

Results: Key barriers included overcrowding, lack of isolation rooms, and significant staff-related factors, such as new staff attitudes, infrequent training, and inconsistent monitoring. Facilitators of IPC practices included adequate availability of hand sanitizer, soap, water, and personal protective equipment, as well as strong IPC policies from hospital administration. A systemic barrier identified was consumer access to antibiotics without a prescription, raising concerns about inappropriate use and antibiotic resistance.

Conclusions: To enhance IPC practices, interventions such as increased IPC training and monitoring are recommended. Long-term solutions may include hospital expansion and isolation room creation for each unit. Additionally, legislative action limiting consumer access to antibiotics without a physician's prescription could mitigate antibiotic resistance at the community and hospital levels.

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