背景:医疗保健相关感染(HAIs)是对患者安全和优质护理的主要威胁。然而,通过实施循证感染预防和控制措施,它们是可以避免的。这篇综述评估了感染预防和控制(IPC)干预措施在降低非洲医疗机构HAIs发生率方面的有效性的证据。
方法:我们搜索了几个数据库:CENTRAL,EMBASE,pubmed,CINAHL,WHOIRIS和AJOL的主要研究报告了四种最常见HAIs的发生率:手术部位感染,中线相关血流感染,导管相关尿路感染,呼吸机相关肺炎和手卫生依从性的增加。两名审稿人评估了这些研究,并遵循了PRISMA指南。
结果:在从数据库和其他来源确定的4,624项研究中,15项研究最终纳入综述。大多数研究是测试前和测试后的研究设计。所有研究都实施了干预措施的组合,而不是作为独立的组成部分。在所有纳入的研究中,据报道,至少一项主要结局有所改善.
结论:我们的综述强调了IPC干预措施在减少HAIs和提高非洲医疗机构手部卫生依从性方面的潜力。然而,大多数结局的证据确定性较低.为了将来的研究,我们推荐更实用的研究设计,并改进方法的严谨性。
BACKGROUND: Health care-associated infections (HAIs) are a major threat to patient safety and quality care. However, they are avoidable by implementing evidence-based infection prevention and control (IPC) measures. This review evaluated the evidence of the effectiveness of IPC interventions in reducing rates of HAIs in health care settings in Africa.
METHODS: We searched several databases: CENTRAL, EMBASE, PUBMED, CINAHL, WHO IRIS, and AJOL for primary studies reporting rates of the 4 most frequent HAIs: surgical site infections, central line--associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumoniae, and increase in hand hygiene compliance. Two reviewers appraised the studies and PRISMA guidelines were followed.
RESULTS: Out of 4,624 studies identified from databases and additional sources, 15 studies were finally included in the review. The majority of studies were of pre- and post-test study design. All the studies implemented a combination of interventions and not as stand-alone components. Across all included studies, an improvement was reported in at least 1 primary outcome.
CONCLUSIONS: Our review highlights the potential of IPC interventions in reducing HAIs and improving compliance with hand hygiene in health care facilities in Africa. For future research, we recommend more pragmatic study designs with improved methodological rigor.