Infection Prevention and Control Preparedness Level and Associated Determinants in 56 Acute Healthcare Facilities in Ghana

Figures & data

Table 1 Characteristics of the 56 Included Healthcare Facilities Stratified by Region

Region	No. of Included Hospitals	Management Type		Average Bed Capacity
		Government	Private
Greater Accra	15	9	6	66
Ashanti	29	13	16	78
Western	5	3	2	55
Eastern	5	3	2	55
Bono	2	1	1	50

Table 2 A Presentation of the Availability of IPC Guidelines in the 56 Surveyed Facilities

Guidelines	Yes		No
	n	%	n	%
Standard precautions	39	69.6%	17	30.4%
Injection safety	42	75%	14	25%
Transmission-based precautions	42	75%	14	25%
Prevention of surgical site infections	38	67.9%	18	32.1%
Hand hygiene	50	89.3%	6	10.7%
Outbreak management and preparedness	37	66.1%	19	33.9%
Prevention of vascular catheter-associated bloodstream infections?	24	42.9%	32	57.1%
Prevention of hospital acquired pneumonia	31	55.4%	25	44.6%
Transmission of multidrug-resistant pathogens	30	53.6%	26	46.4%
Catheter-associated urinary tract infections	33	58.9%	23	41.1%
Disinfection and sterilization	41	73.1%	15	26.8%
Healthcare worker protection and safety	42	75%	14	25%
Waste management	42	75%	14	25%
Antibiotic stewardship	22	39.3%	34	60.7%

Table 3 A Representation of Employee Education and Training on IPC in 56 Healthcare Facilities

Questions	Answers
	New Employee Orientation and Regular Mandatory IPC Training for All Health Care Workers	New Employee Orientation, at Least Annual IPC Training, but Attendance not Compulsory/for Selected Workers	New Employee Orientation Only for Health Care Workers	Never/Rarely
How frequently do health care workers receive training regarding IPC in your facility?	n= 17	n= 16	n=16	n= 7
How frequently do cleaners and other personnel directly involved in patient care receive training regarding IPC in your facility?	n= 16	n= 16	n= 16	n= 8

Table 4 A Representation of Review of Ward Design and Bed Occupancy in 56 Facilities

Question	Answers	Number of Facilities	%
Is the design of wards in your facility in accordance with international standards regarding bed capacity?	Yes, in all departments	14	25%
	Only in certain departments	23	41.1%
	No	19	33.9%
Is bed occupancy in your facility kept to one patient per bed?	Yes, in all departments	32	57.1%
	Only in certain departments	24	42.9%
Are patients in your facility placed in beds standing in the corridor outside of the room (including beds in the emergency department)	Yes, more frequently than twice a week	17	30.4%
	Yes, less frequently than twice a week	23	41.1%
	No, not at all	16	28.6%
Is adequate spacing of at least 1 meter between patient beds ensured in your facility?	Yes, for all departments	24	42.9%
	Yes, but only in certain departments	28	50%
	No, spaces are smaller	4	7.1%
Is a system in place in your facility to assess and respond when adequate bed capacity is exceeded?	Yes, this is the responsibility of the hospital administration/management	20	35.7%
	Yes, this is the responsibility of the head of department	24	42.9%
	No	12	21.4%

Table 5 Assessment of the Availability of Built Environment, Materials and Equipment for IPC in 56 Facilities

Question	Answers	No. of Facilities	%
Are water services available at all times and of sufficient quantity for all uses (hand washing, drinking, personal hygiene, medical activities, sterilization, decontamination, cleaning and laundry)?	Yes, every day and of sufficient quantity	24	42.9%
	Available on average ≥ 5 days per week or every day but not of sufficient quantity or flow	20	35.7%
	Available on average less than 5 days per week/or mostly on and off	12	21.4%
Is a reliable safe drinking water station present and accessible for staff, patients and families at all times and in all locations/wards	Yes, accessible at all times and for all wards/groups	24	42.9%
	Sometimes, or only in some places or not available for all users	25	44.6%
	No, not available	7	12.5%
Do you have quality running water, soap and single-use towels in all wards and at all points of care for hand hygiene practices?	Yes, present to all with reliable supplies available all the time	19	33.9%
	Yes, stations present to all, but supplies are not available all the time	17	30.4%
	Yes, present to only staff	18	32.1%
	No, not present	2	3.6%
Do you have alcohol-based hand-rub solution available at all point of care for hand hygiene practices?	Yes, present to only staff	24	42.9%
	Yes, stations present to all, but supplies are not available all the time	28	50%
	No, not present	4	7.1%
Are there enough toilet facilities or improved latrines in this facility? ≥ 4 toilets for outpatient settings ≥ 1 per 20 users for inpatient settings?	Sufficient number present and all functioning	23	41.1%
	Sufficient number present but not all functioning	29	51.8%
	Less than required number available and functioning	4	7.1%
Is there sufficient power supply in your facility day and night for all purposes such as pumping and boiling water, sterilization and decontamination, lighting in toilet, etc	Yes, always and in all areas	23	41.1%
	Yes, but sometimes/periodic offs	30	53.6%
	No	3	5.4%
Is functioning environmental ventilation available in patient care areas?	Yes	46	82.1%
	No	10	17.9%
Do you have accessible records for the cleaning of floors and walls, signed by cleaners each day?	Yes, records completed and signed daily exist that you can check	21	37.5%
	Record exists, but is not completed and signed daily or is outdated	29	51.8%
	There are no such records	6	10.7%
Are appropriate and well-maintained materials (like detergent, mops, buckets, etc) for cleaning available?	Sufficiently available and well maintained	15	26.8%
	Available but not enough/maintained	41	73.2%
Do you have isolation rooms in this facility?	Yes, isolation rooms are available	19	33.9%
	We make room when needed	37	66.1%
Do you have single patient rooms or rooms for cohorting patients with similar pathogens if the number of isolation rooms is insufficient (for example, TB, measles, cholera, Ebola, SARS)?	Yes, single rooms are available	17	30.4%
	No single rooms but rooms suitable for patient cohorting available.	34	60.7%
	No	5	8.9%
Is PPE available at all times and in sufficient quantity for all uses for all health care workers?	Yes, continuously available in sufficient quantities	19	33.9%
	Yes, but not continuously available in sufficient quantities	33	58.9%
	No	4	7.1%
Do you reliably have sterile and disinfected equipment ready for use?	Yes, available every day and of sufficient quantity	23	40.1%
	Yes, available on average ≥ five days per week or every day, but not of sufficient quantity	28	50%
	No. Available on the average < 5 days per week	5	8.9%
Are disposable items available when necessary? (For example, injection safety devices, examination gloves, etc.)	Yes, continuously available	25	44.6%
	Yes, but only sometimes available	31	55.4%