Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study
# Background The rise in multi-drug resistant tuberculosis (MDR-TB) cases indicates that it is being transmitted as a primary infection in the general population and has been linked to the health care environment. Studies in resource-limited countries have shown that even simple control measures to...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Inishmore Laser Scientific Publishing Ltd
2020-08-01
|
| Series: | Journal of Global Health Reports |
| Online Access: | https://doi.org/10.29392/001c.14140 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850100871819427840 |
|---|---|
| author | Kinley Gyem Riris A Ahmad Yodi Mahendradhata |
| author_facet | Kinley Gyem Riris A Ahmad Yodi Mahendradhata |
| author_sort | Kinley Gyem |
| collection | DOAJ |
| description | # Background
The rise in multi-drug resistant tuberculosis (MDR-TB) cases indicates that it is being transmitted as a primary infection in the general population and has been linked to the health care environment. Studies in resource-limited countries have shown that even simple control measures to prevent TB (tuberculosis) infection appear to be inadequately implemented. This study aimed to assess implementation fidelity with a major focus on adherence, knowledge, and responsiveness to TB infection and prevention control (IPC) practices by exploring its barriers and enablers.
# Methods
This research was an implementation research using a mixed-method explanatory sequential design. We conducted a descriptive cross-sectional study of health care workers (HCWs) working in TB and TB patients enrolled in the three hospitals with the highest notified TB cases in Bhutan from May to August 2019 to assess the implementation fidelity of TB IPC practices. Structured questionnaires and a non-participatory observation checklist were used to assess adherence, knowledge, and responsiveness of the participants. We carried out descriptive statistical analysis for quantitative data and thematic analysis for qualitative data.
# Results
The overall adherence proportion of the participants was poor, with a poor adherence score of 82.6% by the healthcare workers and 93.1% by the patients. HCWs were judged to have overall good knowledge. Most patients strongly agree to the perceptions about TB transmissible through air and visitors wearing masks when they visit the facility; however, the overall response rate score was only 33%. Two overarching themes, “_poor administrative policy_” and “_behavior and attitude_” are identified as key barriers and enablers to the implementation of the TB IPC.
# Conclusions
There was inadequate IPC practice among healthcare workers and patients. The overall good knowledge of the HCWs did not appear to have a positive influence on adherence. Hence, there is a need for continuous improvement and mandatory training, surveillance, awareness, and sensitization. |
| format | Article |
| id | doaj-art-e455fa0ed0ed496697f68ca662114cb9 |
| institution | DOAJ |
| issn | 2399-1623 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | Inishmore Laser Scientific Publishing Ltd |
| record_format | Article |
| series | Journal of Global Health Reports |
| spelling | doaj-art-e455fa0ed0ed496697f68ca662114cb92025-08-20T02:40:11ZengInishmore Laser Scientific Publishing LtdJournal of Global Health Reports2399-16232020-08-01410.29392/001c.14140Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method studyKinley GyemRiris A AhmadYodi Mahendradhata# Background The rise in multi-drug resistant tuberculosis (MDR-TB) cases indicates that it is being transmitted as a primary infection in the general population and has been linked to the health care environment. Studies in resource-limited countries have shown that even simple control measures to prevent TB (tuberculosis) infection appear to be inadequately implemented. This study aimed to assess implementation fidelity with a major focus on adherence, knowledge, and responsiveness to TB infection and prevention control (IPC) practices by exploring its barriers and enablers. # Methods This research was an implementation research using a mixed-method explanatory sequential design. We conducted a descriptive cross-sectional study of health care workers (HCWs) working in TB and TB patients enrolled in the three hospitals with the highest notified TB cases in Bhutan from May to August 2019 to assess the implementation fidelity of TB IPC practices. Structured questionnaires and a non-participatory observation checklist were used to assess adherence, knowledge, and responsiveness of the participants. We carried out descriptive statistical analysis for quantitative data and thematic analysis for qualitative data. # Results The overall adherence proportion of the participants was poor, with a poor adherence score of 82.6% by the healthcare workers and 93.1% by the patients. HCWs were judged to have overall good knowledge. Most patients strongly agree to the perceptions about TB transmissible through air and visitors wearing masks when they visit the facility; however, the overall response rate score was only 33%. Two overarching themes, “_poor administrative policy_” and “_behavior and attitude_” are identified as key barriers and enablers to the implementation of the TB IPC. # Conclusions There was inadequate IPC practice among healthcare workers and patients. The overall good knowledge of the HCWs did not appear to have a positive influence on adherence. Hence, there is a need for continuous improvement and mandatory training, surveillance, awareness, and sensitization.https://doi.org/10.29392/001c.14140 |
| spellingShingle | Kinley Gyem Riris A Ahmad Yodi Mahendradhata Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study Journal of Global Health Reports |
| title | Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study |
| title_full | Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study |
| title_fullStr | Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study |
| title_full_unstemmed | Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study |
| title_short | Implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in Bhutan: a mixed method study |
| title_sort | implementation fidelity of tuberculosis infection prevention and control practices in three hospitals with the highest notified tuberculosis cases in bhutan a mixed method study |
| url | https://doi.org/10.29392/001c.14140 |
| work_keys_str_mv | AT kinleygyem implementationfidelityoftuberculosisinfectionpreventionandcontrolpracticesinthreehospitalswiththehighestnotifiedtuberculosiscasesinbhutanamixedmethodstudy AT ririsaahmad implementationfidelityoftuberculosisinfectionpreventionandcontrolpracticesinthreehospitalswiththehighestnotifiedtuberculosiscasesinbhutanamixedmethodstudy AT yodimahendradhata implementationfidelityoftuberculosisinfectionpreventionandcontrolpracticesinthreehospitalswiththehighestnotifiedtuberculosiscasesinbhutanamixedmethodstudy |