A pilot intervention to support improved hand hygiene at QECH TIPS Chatinkha

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Date
2021-02-10
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Kamuzu University of Health Sciences
Abstract
Type of research study: Qualitative research study using In-depth interviews, focus group discussions and participant observation A formative study using a Trial of Improved Practice approach through qualitative research methods (i.e. participant observation, in-depth interviews and focus group discussions) Problem statement Our recent assessment of hand hygiene practices in the Chatinkha neonatal unit identified intermittent availability lack of water, soap, and hand sanitizers as a key barrier for medical staff, patients and guardians to perform these practices effectively. Understanding the barriers and opportunities to the use of hand sanitizers to facilitate proper hand hygiene in this high risk setting will enable an effective roll-out plan to be established across QECH and other health care settings in Malawi. Broad Objective: To determine pilot the level of acceptance, barriers, and opportunities for the long-term use of hand sanitizer for infection prevention and control in Chatinkha neonatal unit at QECH Specific Objectives: 1. To assess the current barriers and attitudes of health care workers, patients and guardians towards hand hygiene practice; 2. Develop a program for the implementation of hand sanitizer use for hand hygiene appropriate for health care workers, patients and guardians 2.3. To determine the level of acceptance, barriers and opportunities for long term use of hand sanitizer among health care workers, patients and guardians 3. Trial the pilot intervention in the Chatinkha neonatal unit. Methodology: The study will use the Trials of Improved Practice approach. TIPs is a formative research technique used to pre-test the actual practices that a future programme may aim to promote. The procedure consists a series of visits in which the interviewer and the participant analyse current practices, discuss what could be improved, and together reach an agreement on one or a few solutions to try. These are then trialed on a small scale as an iterative process with feedback loops from participants to inform future plans. Importantly TIPs focusses on behaviour, what people do, rather than knowledge, or what people know or believe. Trials are the best way to gauge the acceptability of new practices and learn how to promote and support them. Within the TIPS model, we will use qualitative research methodologies, including participant observation, semi-structured qualitative interview and focus group discussions with front-line staff (including ancillary, allied health professional staff and medical and nursing staff), and with caregivers Ethnographic fieldwork involving interviews, focus group discussions and participant observation. However Expected findings: Barriers and opportunities to effective hand hygiene will be identified and it is anticipated that use of hand sanitizers will be accepted by both health care workers and guardians, . as a means of minimizing the risk of infection transmission. It is anticipated that use of hand sanitizers will be accepted by both health care workers and guardians. Further to that, barriers to its use will be identified and further opportunities will be created to provide an alternative solution to hand washing, with the aim of minimizing the risk of infection transmission. Dissemination: Feedback workshops will be held with relevant stake holders including unit staff and guardians. We will then hold wider dissemination of study findings, to Queen Elizabeth Hospital (QECH) management. Results will also be presented at Malawi College of Medicine Research Ethics Committee and disseminated to the Ministry of Health, Malawi. We will consider presenting findings at national and international conferences and aim to publish findings in academic journals.
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Research Subject Categories::MEDICINE
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