Knowledge of Health Care Providers of a Tertiary Hospital Regarding Post-Operative Infection

Background: Infection is a very common post-operative complication. Now a day the knowledge about infection among healthcare provider is very essential. The study was aimed to determine the knowledge health care provider regarding the management of infection in postoperative ward. Methods: The cross-sectional study was conducted among 90 respondents (60 doctors, 50 nurses & 40 supporting staff) from January 2015 to December 2015 in Dhaka Medical College and Hospital. A semi structured questionnaire was used to obtain socio-demographic data and infection management related information from the respondents through face to face interview. In-depth interviews were taken from director of DMCH, head of the department of surgery and nurse in-charge in post-operative ward for qualitative data. After collection data were complied, summarized and analyzed. The study was approved by ethical committee of National institute of Preventive and Social Medicine. Before collection of data, written permission was taken from the director of the selected hospital & take consent from the respondents. Results: Among 150 respondents, 58% were female with 26-30 years age group. Most doctors were post-graduate & nurses were diploma in nursing. Most of doctors had knowledge about infections- 83.3% told bacterial as a type, 80% told devices as a source and 94% told diabetes as a risk factor. Both doctors and nurses had knowledge about the causes and mode of transmission of infection (90% doctors & 93.2% nurses told unsterile instrument), complication due to infection (100% doctors told sepsis & 86.7% nurses told wound become red & swelling), prevention (100% doctors &92% nurses told proper sterilization of instrument). Doctors (95% and nurse (74%) known about infection control guideline and. Doctors (47.5%) and nurses (68%) received training about infection management Among 40 staff 80% were known about infection and they knew from their colleague. 82.5% staffs known about sterilization. Conclusion: This finding had great impact for management of infection and it will be beneficial for all HCW to receive formal and periodic refresher trainings. JOPSOM 2021; 40(1): 43-50

Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study: protocol of a pragmatic clinical effectiveness study to improve birth outcomes in Ethiopia

IntroductionThe WHO Nutrition Target aims to reduce the global prevalence of low birth weight by 30% by the year 2025. The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study will test the impact of packages of pregnancy interventions to enhance maternal nutrition and infection management on birth outcomes in rural Ethiopia.Methods and analysisENAT is a pragmatic, open-label, 2×2 factorial, randomised clinical effectiveness study implemented in 12 rural health centres in Amhara, Ethiopia. Eligible pregnant women presenting at antenatal care (ANC) visits at <24 weeks gestation are enrolled (n=2400). ANC quality is strengthened across all centres. Health centres are randomised to receive an enhanced nutrition package (ENP) or standard nutrition care, and within each health centre, individual women are randomised to receive an enhanced infection management package (EIMP) or standard infection care. At ENP centres, women receive a regular supply of adequately iodised salt and iron–folate (IFA), enhanced nutrition counselling and those with mid-upper arm circumference of <23 cm receive a micronutrient fortified balanced energy protein supplement (corn soya blend) until delivery. In standard nutrition centres, women receive routine counselling and IFA. EIMP women have additional screening/treatment for urinary and sexual/reproductive tract infections and intensive deworming. Non-EIMP women are managed syndromically per Ministry of Health Guidelines. Participants are followed until 1-month post partum, and a subset until 6 months. The primary study outcomes are newborn weight and length measured at <72 hours of age. Secondary outcomes include preterm birth, low birth weight and stillbirth rates; newborn head circumference; infant weight and length for age z-scores at birth; maternal anaemia; and weight gain during pregnancy.Ethics and disseminationENAT is approved by the Institutional Review Boards of Addis Continental Institute of Public Health (001-A1-2019) and Mass General Brigham (2018P002479). Results will be disseminated to local and international stakeholders.Registration numberISRCTN15116516.

The Effect of Educational Training on Surgical Site Infection Management for Operating Room Nursing Staff

Purpose: This study tested the effectiveness of brochure- and video-based education on managing surgical site infections by operating room health personnel.Methods: From April 20 to May 4, 2021, 34 operating room health personnel were subjected to training on surgical site infection management using brochures and educational videos. A survey was then conducted on knowledge, perception, and adherence regarding surgical site infection management.Results: After receiving training on surgical site infection management, the knowledge score increased significantly (15.15±2.09 vs.19.70±1.96, p<.001). However, the perception and adherence scores were already near perfect before the intervention and did not further increase after the intervention.Conclusion: It is necessary to develop and utilize continuous and substantive educational programs to improve perception and adherence of surgical site infection management.

136. Attitudes and Practices of Antimicrobial Resistance and Antimicrobial Stewardship at the Uganda Cancer Institute

Background As access to cancer treatment has increased in sub-Saharan Africa (sSA), infection-related complications are a growing concern. Little is known about infection management practices in this setting. Understanding the unique challenges to diagnosing and treating infections can inform the development of targeted strategies to improve infection management for cancer treatment programs throughout sSA. Methods We conducted a cross-sectional survey of doctors, nurses, and pharmacists at the Uganda Cancer Institute (UCI), a national cancer referral hospital in Kampala, Uganda. The 25-item survey was designed to assess staff knowledge of antimicrobial resistance and antimicrobial stewardship, investigate antibiotic decision-making practices, and identify barriers to diagnosing and treating infections. Results Of the 61 respondents, 25 (41%) were doctors, 7 (11%) were pharmacists, and 29 (48%) were nurses. In total, 98% (60/61) had heard of the term “antimicrobial resistance” and 84% (51/61) agreed that antimicrobial resistance is an important problem at UCI. Multiple factors were felt to contribute to antimicrobial resistance including the use of too many antibiotics, patient insistence on antibiotics, and poor patient adherence (Fig 1). While 72% (44/61) had heard of the term “antimicrobial stewardship”, only 25% (15/61) knew a lot about what it meant. Numerous factors were considered important to antibiotic decision-making including patient white blood cell count and severity of illness (Fig 2). Perceived barriers to infection diagnosis included the inability to obtain blood cultures and to regularly measure patient temperatures; perceived barriers to obtaining blood cultures included patient cost and availability of supplies (Fig 3). Figure 1. Factors that doctors, pharmacists, and nurses working at the Uganda Cancer Institute (UCI) perceive as contributing to antimicrobial resistance at the UCI. Percentages shown next to bars represent the combined total percentage of respondents reporting that the factor does not or usually does not contribute (left of bars, main chart), occasionally or frequently contributes (right of bars, main chart), or neither contributes nor does not contribute (right of neutral chart). Figure 2. Factors that doctors, pharmacists, and nurses working at the Uganda Cancer Institute consider to be important when choosing antibiotics to treat infections. Percentages shown next to bars represent the combined total percentage of respondents reporting that the factor is somewhat or very unimportant (left of bars, main chart), somewhat or very important (right of bars, main chart), or neither important nor unimportant (right of neutral chart). Figure 3. Factors that doctors, pharmacists, and nurses working at the Uganda Cancer Institute perceive as limiting the ability to diagnose infections and obtain blood cultures. Conclusion While most staff recognized the term “antimicrobial resistance” and identified this as a major local problem, fewer were familiar with the term “antimicrobial stewardship”. We identified numerous perceived barriers to infection diagnosis and treatment, including the ability to consistently measure temperatures and the cost of blood cultures. A multipronged approach is needed to improve staff knowledge of antimicrobial stewardship and to address the systematic barriers to infection management at UCI. Disclosures All Authors: No reported disclosures