Understanding the Infection Prevention and Control Landscape at a Tertiary Hospital in Blantyre, Malawi
Introduction: Surgical site infections (SSIs) can be prevented and reduced by following infection prevention and control (IPC) measures. There is little or no information on the implementation of IPC measures in the surgical department at the tertiary hospital in Blantyre, Malawi. Methods: We conduc...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971224008300 |
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| Summary: | Introduction: Surgical site infections (SSIs) can be prevented and reduced by following infection prevention and control (IPC) measures. There is little or no information on the implementation of IPC measures in the surgical department at the tertiary hospital in Blantyre, Malawi. Methods: We conducted mixed methods implementation research to understand the IPC landscape in a surgical department (within general wards and operating theatres) at Queen Elizabeth Central Hospital (QECH) from September 2023 to April 2024. We used four data collection Methods: a survey using the Infection Prevention and Control Assessment Framework tool; a desk review on available IPC documentation; observation of IPC practices using structured tools adapted from the CDC; individual interviews with healthcare workers (HCWs); and focus group discussions with cleaners and patient caregivers/guardians. Findings were triangulated to understand the IPC landscape for SSIs. Results: IPC guidelines are available in the surgical department of QECH, though are not easily accessed by the HCWs. The IPC guidelines recommend use of multimodal strategies to improve IPC. There are no standard operating procedures and visual aids for many IPC practices. There was 80% non-compliance to hand hygiene, 50% improper environmental cleaning between procedures in theatre and poor postoperative wound dressing. Monitoring/audits and feedback is done for 20% of IPC practices. No training is given on wound management and IPC practices to HCWs. There is no orientation on IPC practices for surgical wounds for patients and guardians. Discussion: There is currently limited implementation of IPC measures in the surgical department at QECH, with marked gaps in IPC standard operating procedures and visual aids. In line with recommendations to use multimodal strategies for IPC implementation, having easily accessible IPC guidelines and standard operating procedures, training of HCWs, orientation of patients and their guardians to IPC measures, and monitoring and feedback of IPC activities would support IPC implementation to prevent SSIs. In the next phase of our study, we will use participatory approach and multimodal strategies to improve implementation of IPC measures for the prevention of SSIs in the surgical department at QECH. Conclusion: The study reveals critical gaps in IPC implementation in the surgical department at QECH, including poor accessibility of guidelines, lack of training and insufficient compliance with IPC practices. Addressing these issues using multimodal strategies is essential to improve IPC and prevent SSIs. |
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| ISSN: | 1201-9712 |