Adherence to infection control standards among surgical senior house officers in operating rooms of Mulago Hospital, Uganda

Abstract

Background: Hospital acquired infections (HAI) are on the rise and pose a serious concern for patients, attendants, and health workers. Studies show that 5% to 10% of hospitalized patients in developed countries and 25% in developing countries suffer from hospital acquired infections. In Uganda, control of hospital infections is far from ideal. The most effective and appropriate way to prevent HAI is to follow standard precautions. Aim: The aim of the study was to evaluate the adherence to infection control standards and the associated factors among surgical senior house officers operating in Mulago Hospital. Methods and materials: The study adopted a quantitative cross-sectional design. Two observation checklists at 5 operating rooms of Mulago National Referral Hospital were used to collect data on adherence to infection control standards and operating room design and protocols. Self-administered structured questionnaire was used to collect data from 159 senior house officers on knowledge of infection control standards. The data were analysed using STATA version 14. Modified Poisson Regression analysis was used to determine the factors associated with adherence to infection control standards using. The study protocol was approved by the School of Health Sciences Research and Ethics Committee. Study results: The study comprised of 159 senior house officers with mean age of 30.8 (range 25 to 47) years. Majority of the participants were males (57.2%), operating in the casualty theatre (35.8%) and were pursuing general surgery (35.2%). Most participants (62.9%) had experience in surgeries for at least 7 years before this study was conducted. Overall, the prevalence of adherence among the surgical senior house officers was 67.3% (95% CI: 58.9 – 73.6), while the overall prevalence of knowledge in infection control was 88.7% (95% CI: 82.7 – 92.8). The prevalence of infection control standards varied widely among the senior house officers (32.7% - 100%) and the operating rooms (42.1 – 97.7%). Adherence to the infection control standards was significantly associated with senior house officers operating in the casualty theatre (PR=0.58, 95% CI: 0.36 – 0.99) and the main theatre (PR=0.49, 95% CI: 0.24 – 0.95) whereas there was no significant association with the level of knowledge regarding infection control and the rest of the socio-demographics. Conclusion: The prevalence of adherence to infection control standards in the present study was low while the overall prevalence of knowledge in infection control was high. Adherence varied across the domains of the infection control standards among the senior house officers as well as in operating rooms. Adherence was significantly associated with operating in the casualty and the main theatres implying that there is a need to focus our interventions on the operating rooms. However, there were neither significant associations between the level of adherence, nor knowledge and the socio-demographic factors among the senior house officers on infection control standards. This implies there should be a focus on other broader factors or theories such as behavioral change practices.