Implementation Science and Research
Background : Esteemed contribution of healthcare workers (HCWs) in ensuring patient safety is often compromised by inadequate knowledge and ineffective infection prevention and control (IPC) practices in developing countries. Diverse healthcare settings (HCS) further intensify the perplexity by impacting HCWs’ fundamental skills and contributing to healthcare-associated infections. Considering multimodal intervention (MMI) as innovative, evidence-based and real-world sustainable solution, our study aimed to compare its role among different HCS first time in Bangladesh to foster HCWs’ IPC principles and practices.
Methods : A pre-post quasi-experimental design was implemented in three phases (pretest, MMI and post-test) in two private, one autonomous and two public hospitals of Bangladesh during 2012 to 2017 for education and training of 1150 HCWs. Data were collected by direct observation through a structured checklist on the outcome variables: hand hygiene (HH), disinfection of reuseable devices (DRUD), segregation of wastes into color-coded bins (SWCB) and personal-protective-equipments (PPE). IPC was compared at 5% significance level using bivariate analysis.
Results : Following MMI, HCWs’ compliance with all variables improved significantly (p < 0.01) in every HCS. HH practices before and after patient contacts enhanced more in private hospitals (55.8% and 58.2%), followed by autonomous (49.0% and 53.4%) and public hospitals (45.4% and 54.6%). Similarly, DRUD and SWCB improved more in private (60.3% and 83.1%) than in autonomous (54.6% and 65.8%) and public (46.7% and 65.1%) hospitals. Compared to autonomous (40.0%) and public (56.1%), private hospitals’ HCWs (65.3%) were more compliant to using PPE.
Conclusions : These scientific research findings suggest that HCWs of private and autonomous settings are more compliant to IPC following MMI, perhaps due to resource availability and accountability to management. However, despite resource constraints, public hospitals only marginally fall behind. Therefore, developing multidisciplinary approaches like MMI can bring behavioral changes, significantly improve HCWs’ IPC practices in different HCS.