Are healthcare workers safe? Facility assessment of airborne infection control measures in public hospitals of Kerala

Authors

  • Anjali Krishnan R. State Health Systems Resource Centre, Kerala, India
  • Kamarudeen M. Hamad Medical Corporation, Doha, Qatar
  • Rekha Ravindran M. State Health Systems Resource Centre, Kerala, India
  • Shinu K. S. State Health Systems Resource Centre, Kerala, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20203005

Keywords:

Nosocomial, Occupation induced, Secondary care hospitals, Tuberculosis

Abstract

Background: Nosocomial transmission of airborne infection is a major peril to health care providing community and has been linked to poor adherence to airborne infection control practices. The present study was conducted to assess the gaps in health care facilities and practices for prevention and control of transmission of air borne infections among healthcare workers in government district level hospitals of Kerala.

Methods: A cross sectional survey including observation was done in 24 facilities. The tool for the survey and the check list for observation were developed based on national airborne infection control guidelines and assessment tool for prevention and control of infection by centre for disease control. The data were analysed using IBM SPSS version 23.

Results: The functioning of airborne infection control system was found to be suboptimal in most of the institutions. Implementation of environmental control measures was poor when compared to administrative control and personal protection measures. Adequate ventilation was not present in more than half of the institutions (60%). All institutions had infection control committees in place but were not functioning well. Personal protective equipment’s were not available at point of use in more than half of the institutions (62.5%). Out of the 16 self-reported hospital acquired respiratory infections among the staff, pulmonary tuberculosis was predominant.

Conclusions: Several barriers were identified at different levels for prevention and control of airborne infections among healthcare workers. The findings reinforce the need to implement strict guidelines to prevent occupation induced airborne infections among health workers in public health system.

Author Biography

Anjali Krishnan R., State Health Systems Resource Centre, Kerala, India

Resaerch Officer, Public Health

References

Eames I, Tang JW, Li Y, Wilson P. Airborne transmission of disease in hospitals. JR Soc Interface. 2009;6:697-702.

Blachere FM, Lindsley WG, Pearce TA, Anderson SE, Fisher M, Khakoo R, et al. Measurement of airborne influenza virus in a hospital emergency department. Clin Infect Dis. 2009;48:438-40.

Vashishtha VM, Yadav S, Dabas A, Bansal CP, Agarwal RC, Yewale VN, et al. IAP position paper on burden of mumps in India and vaccination strategies. Indian Pediatr. 2015;52:505-14.

Shrivastava SR, Shrivastava PS, Ramasamy J. Airborne infection control in healthcare settings. Infect Ecol Epidemiol. 2013;3:103-402.

James PT, Kunoor A, Rakesh PS. Awareness of health care workers, patients and visitors regarding air borne infection control a descriptive study from a tertiary care centre in Kerala, Southern India. Indian J Tuberc. 2018;65:168-71.

Pai M, Kalantri S, Aggarwal AN, Menzies D, Blumberg HM. Nosocomial tuberculosis in India. Emerg Infect Dis. 2006;12:1311-8.

Chughtai AA, Seale H, MacIntyre CR. Availability, consistency and evidence-base of policies and guidelines on the use of mask and respirator to protect hospital health care workers: a global analysis. BMC Res Notes. 2013;6:216.

World Health Organization regional office for South-East Asia, Nipah virus. Available at https:// www.who.int/news-room/fact-sheets/detail/nipah-virus. Accessed on 20 September 2018.

Directorate of Health Services, Kerala. Nipah donetails. Available at https:// www. Nhp .gov.in/ NHPfiles/adph_06062019.pdf. Accessed on 26 June 2018.

Ministry of Health and Family Welfare. New Delhi: Ministry of Health and Family Welfare; 2010. Guidelines on airborne infection control in healthcare and other settings. Available at http://www.tbcindia.nic.in/pdfs/Guidelines_on_Airborne_Infection_Control_April2010Provisional.pdf. Accessed on 29 August 2019.

Tuberculosis infection control in the era of expanding HIV care and treatment. Available at https://apps.who.int/iris/bitstream/handle/10665/66400/WHO_TB_99.269_ADD_eng.pdf;jsessionid=63FFFD6B5F1A24C0E6C6630CE107AF48?sequence=2. Accessed on 12 December 2019.

Centres for Disease Control and Prevention (CDC). Department of health and human services; 2016. Infection prevention and control assessment tool. Available at https://www.cdc.gov/infection control/pdf/icar/hospital.pdf. Accessed on 24 July 2019.

Manjula V, Bhaskar A, Sobha A. Surveillance of communicable disease from a tertiary care teaching hospital of central Kerala, India. Int J Med Public Health. 2015;5:317.

Liang SY, Theodoro DL, Schuur JD, Marschall J. Infection prevention in the emergency department. Ann Emerg Med. 2014;64:299-313.

Menzies D, Joshi R, Pai M. Risk of tuberculosis infection and disease associated with work in health care settings. Int J Tuberc Lung Dis. 2007;11:593-605.

Directorate of Health Services Kerala. The health referral system in Kerala. Available at http://www.dme.kerala.gov.in/pdf/notification/planning_meeting_for_referrral_protocols.pdf. Accessed on September 16 2020.

Sehulster L, Raymond YW. Guidelines for environmental infection control in health care facilities, recommendations and reports. MMWR. 2003;52:1-42.

Escombe AR, Oeser CC, Gilman RH, Navincopa M, Ticona E, Pan W, et al. Natural ventilation for the prevention of airborne contagion. PLoS Med. 2007;4:68.

Chandran D, Patni M. Assessment of airborne infection control practices in the pulmonary medicine ward in a tertiary-care hospital of South Gujarat. Int J Med Sci Public Health. 2015;4:1265.

Rao SKM. Designing hospital for better infection control: an experience. MJAFI. 2004;60:63-6.

Directorate General of Health Services Ministry of Health and Family Welfare. Government of India Indian Public Health Standards (IPHS) Guidelines for district hospitals. Directorate general of health services. Available at http:// www. Nrh m manipur.org/wpcontent/uploads/2012/08/District_Hospital.pdf. Accessed on 20 January 2020.

Raj A, Ramakrishnan D, Thomas CR, Mavila AD, Rajiv M, Suseela RP. Assessment of health facilities for airborne infection control practices and adherence to national airborne infection control guidelines: A study from Kerala, Southern India. Indian J Community Med. 2019;44:23-6.

Infection Prevention and Control of Epidemic- and pandemic-prone acute respiratory infections in health care. Geneva: World Health Organization; 2014. Annex E, isolation rooms or areas. Available at https://www.ncbi.nlm.nih.gov/books/NBK21-4341/. Accessed on 29 January 2019.

National Rural Health Mission Kerala. Kerala accreditation standards for hospitals second edition: updated 2013; cited 2020 February 19. Available at http://arogyakeralam.gov.in/docs/Quality/2014/Kerala_Accreditation_Standards_for_Hospitals_Second_Edition.pdf. Accessed on 29 January 2019.

Parmar MM, Sachdeva KS, Rade K, Ghedia M, Bansal A, Nagaraja SB, et al. Airborne infection control in India: baseline assessment of health facilities. Indian J Tuberc. 2015;62:211-7.

Chandran D, Patni M. Assessment of airborne infection control practices in the pulmonary medicine ward in a tertiary-care hospital of South Gujarat. Int J Med Sci Public Health. 2015;4:1265. Available at:

Jain A, Mandelia C, Jayaram S. Perception and practice regarding infection control measures amongst healthcare workers in district government hospitals of Mangalore, India. Int J Health Allied Sci. 2012;1:68-73.

Lewis KL, Thompson JM. Health care professionals’ perceptions and knowledge of infection control practices in a community hospital. Health Care Manag. 2009;28:230-9.

Du J, Pang Y, Ma Y, Mi F, Liu Y, Li L. Prevalence of tuberculosis among health care workers in tuberculosis specialized hospitals in China. J Occup Health. 2017;59(3):292-5.

Wenger P, Otten J. Control of nosocomial transmission of multidrug-resistant mycobacterium tuberculosis among healthcare workers and HIV-infected patients. Lancet. 2018;345(8944):235-40.

Collins AS. Preventing health care–associated infections. Available at: https:// www. ncbi. nlm.nih.gov/books/NBK2683/. Accessed on 29 January 2019.

Downloads

Published

2020-06-26

How to Cite

Krishnan R., A., M., K., Ravindran M., R., & K. S., S. (2020). Are healthcare workers safe? Facility assessment of airborne infection control measures in public hospitals of Kerala. International Journal Of Community Medicine And Public Health, 7(7), 2723–2729. https://doi.org/10.18203/2394-6040.ijcmph20203005

Issue

Section

Original Research Articles