Abstract
Background: The hospital environment is an important reservoir for microorganisms which are responsible for in-patient contamination and healthcare associated infections (HCAIs); with newborn babies admitted in the Neonatal Intensive Care Unit (NICU) being highly susceptible to acquiring HCAIs due to the immaturity of their immune systems. Evidence that healthcare workers’ (HCWs) hand hygiene practices contribute significantly to the transmission and spread of HCAIs has been available for almost two centuries, yet HCWs compliance to hand hygiene continues to be poor and efforts to improve it have mostly been ineffective. The provision of water, sanitation, and hygiene (WASH) facilities in healthcare environments classified as urban areas of third world countries and the role that WASH facilities play in the transmission of HCAIs is not well documented. Objectives: The objectives of the study were to determine and assess WASH factors that contribute to poor handwashing outcomes and the provision of hand hygiene devices, nd to measure the extent of change in the status of WASH facilities. The objectives of this mixed methods study therefore were to determine and assess WASH factors that contribute to poor handwashing outcomes and the provision of hand hygiene devices and to measure the extent of change in the status of WASH facilities. Methodology: Data was collected using inspection checklists to observe WASH facilities and hand hygiene practices of HCWs since the exposure risk of acquiring HCAIs is directly linked to the Infection Prevention and Control (IPC) practices of HCWs and the cleanliness of the hospital environment. A total of n=456 surface, hand and water samples were collected and analyzed through microscopy for the presence of microorganisms, including those classified as World Health Organization’s (WHO) Priority Organisms and Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, pseudomonas aeruginosa and Enterobacter spp., (ESKAPE) microorganisms and retrospective data (laboratory blood results) of neonates n=14 were used to compare whether the microorganisms detected on neonates were similar to those found on HCWs hands and on the environmental swabs. Results: The subjective WASH data results showed handwash basins to have compliance rates of n=81.0%, availability of handwash soap n=94.0%, provision of hand paper towel n=65.0% and the provision of hand sanitizer at n=82.0%. The hygiene status of the NICU was concerningly poor with non-compliance rates of...
M.Tech. (Environmental Health)