TY - JOUR
T1 - Protecting healthcare workers and patients during the COVID-19 pandemic
T2 - a comparison of baseline and follow-up infection prevention and control needs in Nigerian military healthcare facilities delivering HIV services
AU - Lee, Elizabeth H.
AU - Rashid, Ayesha
AU - Lawal, Ismail
AU - Adekanye, Usman
AU - Adamu, Yakubu
AU - Godfrey, Catherine
AU - Agaba, Patricia A.
AU - Okeji, Nathan
AU - Desai, Priyanka
N1 - Publisher Copyright:
© 2023, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
PY - 2023/12
Y1 - 2023/12
N2 - Background: Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV Research Program, took steps to improve infection prevention and control (IPC) practices among staff working in select PEPFAR-supported Nigerian military health facilities. Methods: We identified a set of IPC activities a priori for implementation at four Nigerian military hospitals in HIV and related departments in early 2021, including continuous medical masking, physical distancing, placement of additional hand washing stations and hand sanitizers throughout facilities, and training. We fine-tuned planned intervention activities through a baseline needs assessment conducted in December 2020 that covered eight IPC components: ‘IPC program structure, funding and leadership engagement’; ‘IPC policies, guidelines and standard operating procedures (SOPs)’; ‘infrastructure’; ‘triage and screening’; ‘training, knowledge and practice’; ‘personal protective equipment (PPE) materials, availability and adequacy’; ‘biosafety and waste management’; and ‘monitoring and remediation’ prior to implementation. Baseline results were compared with those of a follow up assessment administered in August 2021, following intervention implementation. Results: IPC readiness remained high at both baseline and follow-up assessments for ‘IPC guidelines, policies, and SOPs’ (96.7%). The components ‘infrastructure’ and ‘monitoring and remediation’, which needed improvement at baseline, saw modest improvements at follow-up, by 2% and 7.5%, respectively. At follow-up, declines from high scoring at baseline were seen in ‘IPC program structure, funding and leadership engagement’, ‘training, knowledge and practice’, and ‘biosafety and waste management’. ‘PPE materials availability and adequacy’ improved to 88.9% at follow-up. Although unidirectional client flow was newly implemented, the score for ‘triage and screening’ did not change from baseline to follow-up (73%). Conclusion: Variability in IPC component readiness and across facilities highlights the importance of building resilience and employing a quality improvement approach to IPC that includes regular monitoring, re-assessment and re-training at set intervals. Results can be used to encourage solutions-oriented dialogue between staff and leadership, determine needs and implement action plans to protect staff and people with HIV.
AB - Background: Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV Research Program, took steps to improve infection prevention and control (IPC) practices among staff working in select PEPFAR-supported Nigerian military health facilities. Methods: We identified a set of IPC activities a priori for implementation at four Nigerian military hospitals in HIV and related departments in early 2021, including continuous medical masking, physical distancing, placement of additional hand washing stations and hand sanitizers throughout facilities, and training. We fine-tuned planned intervention activities through a baseline needs assessment conducted in December 2020 that covered eight IPC components: ‘IPC program structure, funding and leadership engagement’; ‘IPC policies, guidelines and standard operating procedures (SOPs)’; ‘infrastructure’; ‘triage and screening’; ‘training, knowledge and practice’; ‘personal protective equipment (PPE) materials, availability and adequacy’; ‘biosafety and waste management’; and ‘monitoring and remediation’ prior to implementation. Baseline results were compared with those of a follow up assessment administered in August 2021, following intervention implementation. Results: IPC readiness remained high at both baseline and follow-up assessments for ‘IPC guidelines, policies, and SOPs’ (96.7%). The components ‘infrastructure’ and ‘monitoring and remediation’, which needed improvement at baseline, saw modest improvements at follow-up, by 2% and 7.5%, respectively. At follow-up, declines from high scoring at baseline were seen in ‘IPC program structure, funding and leadership engagement’, ‘training, knowledge and practice’, and ‘biosafety and waste management’. ‘PPE materials availability and adequacy’ improved to 88.9% at follow-up. Although unidirectional client flow was newly implemented, the score for ‘triage and screening’ did not change from baseline to follow-up (73%). Conclusion: Variability in IPC component readiness and across facilities highlights the importance of building resilience and employing a quality improvement approach to IPC that includes regular monitoring, re-assessment and re-training at set intervals. Results can be used to encourage solutions-oriented dialogue between staff and leadership, determine needs and implement action plans to protect staff and people with HIV.
KW - COVID-19
KW - Infection prevention and control
KW - Needs assessment
KW - Pandemic preparedness
UR - http://www.scopus.com/inward/record.url?scp=85176412727&partnerID=8YFLogxK
U2 - 10.1186/s12913-023-10289-x
DO - 10.1186/s12913-023-10289-x
M3 - Article
C2 - 37964245
AN - SCOPUS:85176412727
SN - 1472-6963
VL - 23
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 1254
ER -