Healthcare workers’ compliance with the catheter associated urinary tract infection prevention guidelines: an observational study in Yemen

Khaled Mohammed Al-Sayaghi, Talal Ali Hussein Alqalah, Sameer Abdulmalik Alkubati, Sultan Abdulwadoud Alshoabi, Mohammed Alsabri, Gamil Ghaleb Alrubaiee, Mokhtar Abdo Almoliky, Khalil A. Saleh, Anas Khaled Al-Sayaghi, Rami A. Elshatarat, Zyad T. Saleh, Ahmad Mahmoud Saleh, Hassanat Ramadan Abdel-Aziz
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Abstract

Catheter-associated urinary tract infection is a global problem but it can be prevented with the appropriate implementation of evidence-based guidelines. This study was conducted to assess the level of compliance of healthcare workers with the catheter-associated urinary tract infection prevention guidelines during the insertion of a urinary catheter. An observational study using a descriptive cross-sectional design was conducted at Sana’a City hospitals, Yemen. All the nurses and physicians from the governmental, teaching, and private hospitals were eligible to participate in the study. The data collection was performed through convenience sampling from March 2020 to December 2020, using a structured observational checklist prepared specifically for this study. The majority of the urinary catheter insertions were performed by nurses. There were no written policy or procedures for an urinary catheter insertion and no in-service education or training departments in the majority of the hospitals. The overall mean score of compliance was 7.31 of 10. About 71% of the healthcare workers had a high or acceptable level of compliance and 29% had an unsafe level of compliance. Compliance was low for maintaining aseptic technique throughout the insertion procedure, using a single use packet of lubricant jelly, performing hand hygiene immediately before insertion, and securing the urinary catheter once inserted. Factors affecting the healthcare workers compliance were gender, the working ward/unit of the healthcare workers, the availability of a written policy/procedure and a department or unit for in-service education. Yemeni healthcare workers’ overall compliance was acceptable but it was unsafe in several critical measures. There is an urgent need for developing, implementing, and monitoring national guidelines and institutional policy and procedures for catheter-associated urinary tract infection prevention. Periodical in-service education and training programs and adequate access to the necessary materials and supplies are paramount.
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医护人员遵守导尿管相关尿路感染预防指南的情况:也门的一项观察研究
导尿管相关性尿路感染是一个全球性问题,但只要适当执行以证据为基础的指南,就可以预防导尿管相关性尿路感染。本研究旨在评估医护人员在插入导尿管时遵守导尿管相关尿路感染预防指南的程度。这项观察性研究在也门萨那市的医院进行,采用了描述性横断面设计。来自政府医院、教学医院和私立医院的所有护士和医生都有资格参与这项研究。2020 年 3 月至 2020 年 12 月期间,通过方便抽样的方式收集数据,并使用专门为本研究准备的结构化观察清单。插入导尿管的工作大多由护士完成。大多数医院都没有关于插入导尿管的书面政策或程序,也没有在职教育或培训部门。医护人员遵守规定的总体平均得分为 7.31(满分为 10 分)。约 71% 的医护人员在遵守规定方面达到了较高或可接受的水平,29% 的医护人员在遵守规定方面达到了不安全的水平。在插入导尿管的整个过程中保持无菌技术、使用一次性润滑果冻包、插入导尿管前立即进行手部卫生以及插入导尿管后固定导尿管等方面的依从性较低。影响医护人员遵守规定的因素包括性别、医护人员的工作病房/单位、是否有书面政策/程序以及是否有部门或单位提供在职教育。也门医护人员的总体依从性尚可,但在几项关键措施上不安全。亟需制定、实施和监督预防导尿管相关尿路感染的国家指导方针、机构政策和程序。最重要的是定期开展在职教育和培训计划,并提供充足的必要材料和用品。
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