Group  5  M.  E  Moea  

M.R  Morake  N.F  Jacobs  

S.E  Mmutle  

Background  and  Ra-onale   Tuberculosis  is  an  airborne  disease  and  is  highly  communicable.    

  It  affects  people  of  all  ages,  especially  those  in  the  most  economically  productive  years  of  their  lives.  

 TB  transmission  from  patients  to  health  care  workers  and  among  health  care  workers  is  a  serious  problem  in  health  care  facilities  

 TB  imposes  great  cost  on  employers  due  to  disruption  of  work,  reduced  productivity,  etc.  

Se1ng   Our  study  was  conducted  at  Pelonomi  Hospital  Medical  Out  Patient  Department  (OPD).    

  In  Pelonomi  Hospital,  about  60  new  TB  patients  are  registered  per  month  of  which  most  pass  through  Out  Patient  Department    and  thus  increasing  exposure  to  the  staff  members.  

Research  Ques-ons  1.  What  are  the  gaps  in  knowledge  and  self  reported  

infection  control  practices  of  all  personnel  working  in  Medical  OPD?  

2.  What  are  the  environmental  and  administrative  hazards  and  best  practices  related  to  TB  infection  control  in  Medical  OPD?  

Objec-ves   T0  make  recommendations  to  mangement  regarding  TB  infection  control  practices  at  medical  outpatient  department  in  Pelonomi  Hospital  based  on  knowledge  and  practice  questionnaires  and  observations.  

Research  Methods    Ethics  approval  was  obtained.    Infection  control  policies  and  literature  to  inform  the  development  of  questionnaire  and  checklist  were  reviewed.  

  Self-­‐administered  questionnaires  were  piloted   Questionnaire  and  environmental  and  administrative  audit  checklist  was  used  to:    Determine  knowledge  and  self-­‐reported  practice    Observe  infection  control  practices  in  the  department  

 Questionnaire  analysis  was  done  using  SPSS  (frequencies  and  statistically  significant  correlations  between  knowledge  and  practice)  

Descrip-ve  Results  Questionnaire  Respondents  (n=21)   Response  rate  was  very  high  (91%)   Most  respondents  were:  

  Between  40  and  59  (65%)    Female  (71%)   Nursing  staff  (33%)  

  Other  groups  included  were:    Doctors,  Technicians,  Psychologists  and  Social  Workers,  Messengers,  Cleaners,  and  Administrators  

Ques-onnaire  Results:  Screening  

0  

10  

20  

30  

40  

50  

60  

70  

80  

90  

100  

Yes   No   Yes   No  

Per

cent

 of  R

espo

nden

ts  

Pre-­‐examination  upon  employment                                                                          Yearly  screening  for  TB  

Ques-onnaire  Results:  Knowledge  summary  

Knowledge  Questions  Grouped  by  Category   %  Correct  

Personal  Protective  Equipment  (respiratory)   47  

Controlling  at  the  Source   78  

Hand  Hygiene     33  

Other  PPE  (gloves  and  eyewear)   19  

Knowledge  and  Self-­‐  reported  Prac-ce    

Knowledge  Questions   %  Correct  

I  should  wear  an  N95  respirator…   47  

Practice  Questions  %  of  

Respondents  

I  wear  and  N95  when  I  care  for  a  pt  with  suspected  TB  

Never:  10  Some:  45  Most:  45  

Knowledge  and  Self-­‐  reported  Prac-ce    

Knowledge  Questions   %  Correct  

The  safest  way  to  collect  a  sputum…   35  

Practice  Questions  %  of  

Respondents  

I  wear  a  mask/resp  when  I  obtain  sputum  samples  

Never:  15  Some:  25  Most:  50  

Knowledge  and  Self-­‐  reported  Prac-ce    

Knowledge  Questions   %  Correct  

Respiratory  cough  etiquette  involves…   80  

Practice  Questions  %  of  

Respondents  

I  ask  coughing  patients  to  practice  respiratory  etiquette  

Never:  0  Some:  15.8  Most:  84.2  

Knowledge  and  Self-­‐  reported  Prac-ce    

Knowledge  Questions   %  Correct  

Hand  hygiene  is  the  most  important  way  to  

reduce  the  spread  of  infections  38  

Practice  Questions  %  of  

Respondents  

I  clean  my  hands  before  caring  for  my  patients  

Never:  0  Some:  16.7  Most:  83.3  

Infec-on  Control  Observa-ons  Most  observations  were  positive!!  Model  practices  are  listed  below:    Signage  for  cough  etiquette  is  displayed  

  A  tracking  system  for  all  TB  suspects  and  their  sputum  results  is  in  place  

  Patients  who  are  coughing  are  separated  and  “fast-­‐tracked”  

  Sputum  samples  are  collected  in  a  designated  area  away  from  others  

  Direction  of  airflow  in  consulting  rooms  facilitates  protection  

Infec-on  Control  Observa-ons  Hazards  identified:   Sputum  collection  area  is  difficult  access  and  is  not  “user-­‐friendly”   Uncapped  needles  lying  on  doctor’s  trolleys   Non-­‐latex  gloves  not  available   Spirometry  room  is  also  used  as  an  office   No  UVG  lights  in  spirometry  room  

Conclusions  and  Recommenda-ons  

 Training  is  necessary  for  OPD  staff  on  personal  protective  equipment  and  hand  hygiene  to  improve  low  knowledge.  

 Model  infection  control  practices  observed  in  OPD  should  be  applauded  and  replicated  in  other  areas.  

 Environmental  control  measures  should  be  implemented  to  improve  sputum  collection  area  and  the  spirometry  room  

 More  research  is  necessary  to  determine  why  yearly  screening  for  TB  is  so  low.  

Thank  You!  

Questions?