Infrastructure and Contamination of the Physical Environment in Three Bangladeshi Hospitals: Putting Infection Control into Context

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Rimi, Nadia Ali ; Sultana, Rebeca ; Luby, Stephen P. ; Islam, Mohammed Saiful ; Uddin, Main ; Hossain, Mohammad Jahangir ; Zaman, Rashid Uz ; Nahar, Nazmun ; Gurley, Emily S.
• Description:
  Objective
  
  This paper describes the physical structure and environmental contamination in selected hospital wards in three government hospitals in Bangladesh.
  
  Methods
  
  The qualitative research team conducted 48 hours of observation in six wards from three Bangladeshi tertiary hospitals in 2007. They recorded environmental contamination with body secretions and excretions and medical waste and observed ward occupant handwashing and use of personal protective equipment. They recorded number of persons, number of open doors and windows, and use of fans. They measured the ward area and informally observed waste disposal outside the wards. They conducted nine focus group discussions with doctors, nurses and support staff.
  
  Results
  
  A median of 3.7 persons were present per 10 m2 of floor space in the wards. A median of 4.9 uncovered coughs or sneezes were recorded per 10 m2 per hour per ward. Floors in the wards were soiled with saliva, spit, mucous, vomitus, feces and blood 125 times in 48 hours. Only two of the 12 patient handwashing stations had running water and none had soap. No disinfection was observed before or after using medical instruments. Used medical supplies were often discarded in open containers under the beds. Handwashing with soap was observed in only 32 of 3,373 handwashing opportunities noted during 48 hours. Mosquitoes and feral cats were commonly observed in the wards.
  
  Conclusions
  
  The physical structure and environment of our study hospitals are conducive to the spread of infection to people in the wards. Low-cost interventions on hand hygiene and cleaning procedures for rooms and medical equipment should be developed and evaluated for their practicality and effectiveness.
  
  
• Subjects:
  Adult Child Cross Infection Equipment Contamination Hand Hygiene Hospital Design And Construction Hospitals Humans Infection Control Medical Staff, Hospital Population Density Research Article Sanitation

  More +
• Source:
  PLoS One. 2014; 9(2).
• Document Type:
  Journal Article
• Funding:
  I-U01-C1000298/PHS HHS/United States
• Place as Subject:
  Bangladesh
• Volume:
  9
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1231c2732548f90462c2ff2d6cce752252f4ab32b08745a216a4cdeae2b640d5
• Download URL:
  https://stacks.cdc.gov/view/cdc/27828/cdc_27828_DS1.pdf
• File Type:
  [PDF - 265.13 KB ]