| Autor: |
Tantum LK; School of Medicine, Stanford University, Stanford, CA 94305, USA., Gilstad JR; School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Bolay FK; National Public Health Institute of Liberia, Monrovia 1000, Liberia., Horng LM; School of Medicine, Stanford University, Stanford, CA 94305, USA., Simpson AD; Q&A, Inc., Monrovia 1000, Liberia., Letizia AG; Naval Medical Research Center, Silver Spring, MD 29010, USA., Styczynski AR; School of Medicine, Stanford University, Stanford, CA 94305, USA., Luby SP; School of Medicine, Stanford University, Stanford, CA 94305, USA., Arthur RF; School of Medicine, Stanford University, Stanford, CA 94305, USA. |
| Abstrakt: |
Hand hygiene is central to hospital infection control. During the 2014-2016 West Africa Ebola virus disease epidemic in Liberia, gaps in hand hygiene infrastructure and health worker training contributed to hospital-based Ebola transmission. Hand hygiene interventions were undertaken post-Ebola, but many improvements were not sustainable. This study characterizes barriers to, and facilitators of, hand hygiene in rural Liberian hospitals and evaluates readiness for sustainable, locally derived interventions to improve hand hygiene. Research enumerators collected data at all hospitals in Bong and Lofa counties, Liberia, in the period March-May 2020. Enumerators performed standardized spot checks of hand hygiene infrastructure and supplies, structured observations of hand hygiene behavior, and semi-structured key informant interviews for thematic analysis. During spot checks, hospital staff reported that handwashing container water was always available in 89% ( n = 42) of hospital wards, piped running water in 23% ( n = 11), and soap in 62% ( n = 29). Enumerators observed 5% of wall-mounted hand sanitizer dispensers ( n = 8) and 95% of pocket-size dispensers ( n = 53) to be working. In interviews, hospital staff described willingness to purchase personal hand sanitizer dispensers when hospital-provided supplies were unavailable. Low-cost, sustainable interventions should address supply and infrastructure-related obstacles to hospital hand hygiene improvement. |
