背景:有效的感染预防和控制计划可以积极影响护理质量,增加患者安全,并保护医疗保健提供者。氯,一种广泛使用和有效的化学消毒剂,建议在医疗保健环境中预防和控制感染。然而,缺乏一致的氯可用性限制了它的使用。电解氯气发生器可以解决有限的氯气供应和缺货问题,使现场生产易于使用的,高品质的氯成本有效。我们报告可行性(即,性能,可接受性,氯的可用性,和成本)的电解流消毒剂发生器(AquaResearch,新墨西哥州,美国)乌干达初级卫生保健设施中用于预防和控制感染的装置。
方法:我们在乌干达中部和西部的10个初级卫生保健设施中安装了STREAM设备。在每个设施中审查商业氯库存记录(库存卡)以计算每月接收和使用的氯的平均升。将这些值与研究期间的实际STREAM氯产量进行比较,以确定其对氯可用性的影响。我们从设备用户的目的样本中收集了可接受性数据(n=16),医院管理人员(n=10),和直接参与STREAM设备的操作或监督的地区卫生官员(n=6)。我们描述性地分析了用户组的可接受性数据,并使用主题方法手动评估了定性响应。对成本数据进行归一化和建模,以确定五年期间(STREAM设备的最低预期寿命)的收支平衡和成本节约分析。
结果:在评估期间,氯始终可用,没有任何报告缺货。与商业氯相比,流氯生产在五年内节省了36.9%的成本。STREAM设备的用户接受度在STREAM运营商中很高,医院管理员,和地区卫生官员,所有受访者都报告STREAM适度或显着改善了医疗机构的感染预防和控制措施。总的来说,88%的设备用户和100%的医院管理人员希望继续使用STREAM设备而不是商业氯产品。
结论:STREAM装置已显示出在乌干达卫生保健机构加强感染预防和控制实践的巨大潜力。根据初步结果,STREAM设备应该被认为是乌干达和其他地方面临感染预防和控制挑战的地区医院和大型卫生中心的有前途的工具。提供水和电。展望未来,也可以考虑在乌干达和其他地方的小型医疗机构中实施STREAM设备。
BACKGROUND: Effective infection prevention and control programs can positively influence quality of care, increase patient safety, and protect health care providers. Chlorine, a widely used and effective chemical disinfectant, is recommended for infection prevention and control in health care settings. However, lack of consistent chlorine availability limits its use. Electrolytic chlorine generators can address limited chlorine supply and stockouts by enabling onsite production of readily usable, high-quality chlorine cost-effectively. We report the feasibility (i.e., performance, acceptability, chlorine availability, and cost) of the electrolytic STREAM Disinfectant Generator (Aqua Research, New Mexico, USA) device for infection prevention and control in primary health care facilities in Uganda.
METHODS: We installed STREAM devices in 10 primary health care facilities in central and western Uganda. Commercial chlorine inventory records (stock cards) were reviewed in each facility to calculate average liters of chlorine received and used per month. These values were compared with actual STREAM chlorine production volumes over the study period to determine its impact on chlorine availability. We collected acceptability data from a purposive sample of device users (n = 16), hospital administrators (n = 10), and district health officers (n = 6) who had been directly involved in the operation or supervision of the STREAM device. We descriptively analyzed the acceptability data by user group and evaluated qualitative responses manually using a thematic approach. Cost data were normalized and modeled to determine a break-even and cost-savings analysis across a five-year period (the minimum expected lifespan of the STREAM device).
RESULTS: Chlorine was consistently available without any reported stockouts during the evaluation period. STREAM chlorine production resulted in a 36.9 percent cost-savings over a five-year period compared to commercial chlorine. User acceptability of the STREAM device was high among STREAM operators, hospital administrators, and district health officers, with all respondents reporting that STREAM moderately or significantly improved infection prevention and control practices in the health facility. Overall, 88 percent of device users and 100 percent of hospital administrators wished to continue using the STREAM device instead of commercial chlorine products.
CONCLUSIONS: The STREAM device has demonstrated significant potential to strengthen infection prevention and control practices in health care facilities in Uganda. Based on the preliminary results, the STREAM device should be considered a promising tool for district hospitals and large health centers facing infection prevention and control challenges in Uganda and elsewhere, provided water and electricity are available. Going forward, implementation of the STREAM device could also be considered in smaller health care facilities in Uganda and elsewhere.