EXAMINING THE ROLE OF CLEANERS AND SUPERVISORS IN EFFECTIVE INFECTION PREVENTION AND CONTROL IN SIX CAMBODIAN HOSPITALS 公开
Brown, Dominique (Spring 2020)
Published
Abstract
Global rates of healthcare associated infection (HCAIs) remain high across countries and contexts. The burden of HCAIs and the resulting poor health outcomes have inspired infection prevention and control (IPC) programs around the world in efforts to reduce poor outcomes and improve the health of healthcare facility patients. There are several key components to effective IPC programs in hospitals and a major one is ensuring high levels of environmental hygiene in healthcare facilities. Environmental hygiene may include handwashing, clean water, effective disinfection of facilities, and proper waste handling.
Hospital cleaners play an often overlooked and underrated role in environmental hygiene management. They are frontline workers in providing clean facilities for healthcare staff and patients; but are rarely included in specific infection control trainings and protocols. This is especially true in developing settings such as Cambodia.
The purpose of this thesis was to unpack the experiences of supervisors and cleaning staff in six Cambodian hospitals in four key areas - supplies and products, training, hospital cleanliness and roles of cleaning staff- and explore their role in infection control and achieving optimal environmental cleanliness in the healthcare facilities in which they work.
Embedded in a larger WASH in Health Facilities project by the GE Foundation and the Center for Global Safe WASH at Emory University, this study conducted nine key informant interviews with cleaning supervisors and five focus group discussions with cleaners in six Cambodian hospitals. Analysis of the data revealed five main issues related to cleaners that are inhibiting optimal levels of environmental hygiene in their respective hospitals. They include: a lack of effective supervision, visual assessment of cleaning only, a shortage of cleaners, a lack of knowledge around IPC and a lack of and desire for additional IPC training.
When the data from the study is compared with recommended IPC guidelines from major health organizations such as the World Health Organization, these gaps are concerning. Healthcare facility cleaners and their supervisors play a vital role in effective infection control and prevention. The results from this study warrant greater investment in cleaners, particularly in the areas of supervision and training.
Table of Contents
Abstract………………………………………………………………………………………… 4
Acknowledgements…………………………………………………………….………………. 6
Table of Contents ……………………………………………………………………………... 7
List of Figures and Tables……………………………………………………………….……. 8
Chapter I: Introduction ……………………………………………………………………… 9
Global Burden of Healthcare Associated Infection……………………………………… 9
Environmental Transmission as a Contributor to Healthcare Associated Infection…….. 11
Purpose Statement…………………………………………………………………….. 12
Significance……………………………………………………………………………. 13
Chapter II: Review of Literature ………………………………………………………….. 14
Chapter III: Methodology………………………………………………………………….. 19
Chapter IV: Results……………………………………………………………….………… 31
Key Informant Interviews with Cleaning Supervisors
Theme I: Supervisor Duties- Limited Cleaner Supervision and Monitoring…… 32
Theme II: Supervisor Duties- Visual Assessment of Cleanliness………………… 37
Theme III: Resources: Shortages in Human Resources………………………… 42
Theme IV: Training- Lack of Training/Perceived Need for Additional Training.. 44
Chapter V: Results………………………………………………………………………….…. 48
Focus Group Discussions with Cleaners
Theme I: Visual Assessment of Cleanliness……………………………………. 48
Theme II: Knowledge of Infection Control…………………………………….. 51
Theme III: Desire for Additional Training…………………………………….. 52
Chapter VI: Discussion ………………………………………………………………………… 55
Chapter VII: Conclusion ………………………………………………………………………. 59
Appendix A: Key Informant Interview Guide (Cleaner Supervisors) ………………………….. 61
Appendix B: Focus Group Discussion Guide (Hospital Cleaners) ……………………………… 63
References……………………………………………………………………………………… 66
About this Master's Thesis
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