Background

Nurses are considered as the key to infection prevention as they play a major role in treatment as well as taking care of patients.

Aim

To assess the role of a multi-modal intervention (MMI) in improving nurses' competency and adherence to standard infection control practices in Bangladesh.

Methods

The study adopted a pretest–post-test intervention approach, in three different periods (from 2012 to 2017) in five hospitals (two public, two private, and one autonomous) in Bangladesh. Each study period was divided into three phases: pretest, MMI, and post-test. Data were collected on 642 nurses using direct observation method through a structured checklist.

Findings

After implementing the MMI, overall hand hygiene compliance significantly increased before patient contact (from 1.3% to 50.2%; P < 0.000) and after patient contact (from 2.8% to 59.6%; P < 0.000). Remarkable improvements were also achieved in adherence to use of gloves (from 14.6% to 57.6%; P < 0.000), maintaining sterility of equipment during aseptic techniques (from 34.9% to 86%; P < 0.000), biomedical waste segregation (from 1.8% to 81.3%; P < 0.000) and labelling of procedural sites (from 0% to 85.7%; P < 0.000). Moreover, needlestick injury rate notably decreased (from 6.2% to 0.6%; P < 0.000).

Conclusion

MMI can play a vital role in improving nurses' compliance with the standard infection control practices. Such context-specific interventions, which are crucial for preventing healthcare-associated infections and for decreasing occupational hazards, should be replicated in resource-poor countries for achieving universal health coverage by 2030.

中文翻译：

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将知识转化为实践：多模式，多中心干预措施，旨在提高孟加拉国护士的感染控制能力

背景

护士被认为是预防感染的关键，因为他们在治疗以及照顾患者方面起着重要作用。

目的

评估多模式干预（MMI）在提高孟加拉国护士的能力和遵守标准感染控制措施方面的作用。

方法

该研究在孟加拉国的五家医院（两家公立，两家私营和一家自治医院）的三个不同时期（从2012年至2017年）采用了测试前-测试后干预方法。每个研究阶段分为三个阶段：测试前，MMI和测试后。使用直接观察法通过结构化检查表收集了642名护士的数据。

发现

实施MMI后，患者接触之前（从1.3％到50.2％；P  <0.000）和患者接触之后（从2.8％到59.6％；P  <0.000），总体手部卫生顺从性显着提高。在坚持使用手套方面也取得了显着改善（从14.6％降低到57.6％；P  <0.000），在无菌技术过程中保持了设备的无菌性（从34.9％降低到86％；P  <0.000），生物医学废物隔离（从1.8起） ％到81.3％; P  <0.000）和程序部位标记（从0％到85.7％; P  <0.000）。此外，针刺伤害率显着降低（从6.2％降低至0.6％；P  <0.000）。

结论

MMI在提高护士对标准感染控制措施的依从性方面可以发挥至关重要的作用。此类针对具体情况的干预措施对于预防与卫生保健相关的感染和减少职业危害至关重要，应在资源贫乏的国家推广，以在2030年前实现全民健康覆盖。