Healthcare Personnel Opinion and their Implementation Obstacles

Abstract

Context: Hemodialysis HD patients, as well as the dialysis staff, are vulnerable to contracting health-care-associated infections (HAIs) due to frequent and prolonged exposure to many possible contaminants in the dialysis environment.

Aim: Assess healthcare personnel's HCP opinion and their implementation obstacles regarding standard precautions (SPs) in the hemodialysis unit.

Methods: The study was conducted at the hemodialysis unit at Al Mouwasat University Hospital, Alexandria, Egypt. A descriptive research design was used to collect data for this study. All healthcare personnel working in the setting mentioned above were included. Two tools were used. The first tool is a standard precautions practices in hemodialysis observational checklist: The second tool is a structured interview questionnaire to assess the opinion of healthcare personnel regarding the applicability of standard precautions in the hemodialysis unit and their implementation obstacles.

Results: The standard precautions practice score showed unsatisfactory practice among HCP. Regarding their opinion, the majority of HCP disagreed to follow the five moments and reported that the WHO technique of hand hygiene is so sophisticated and time-consuming; they disagreed with changing gloves between patients and considering gloves as a substitute to hand hygiene. The majority recap the needle by two hand techniques disagreed with following respiratory hygiene, and color-coding was accepted only by nurses. Also, it was found that there was a positive correlation between years of experience, infection control training programs, and the level of SPs practice score.

Conclusion: Unsatisfactory SPs practices showed a high percentage of HCP. Healthcare personnel tends to agree to certain infection control practices over other practices. Availability and accessibility of equipment and supplies that interfere with the application of SPs practices and lack of knowledge concerning infection prevention and control were considered as implementation obstacles of SPs practices. Education and training of HCP on SPs, together with consistent and robust management support, are recommended. In addition to the development of national precautions after conducting researches that confirm its effectiveness.