Study

Primary Care Study

IMPROVEMENTS IN INFECTION CONTROL IN

PRIVATE RESIDENTIAL CARE HOMES FOR THE ELDERLY

IN NEW TERRITORIES (EAST) REGION OF HONG KONG

A YEAR AFTER SARS OUTBREAK

Man-yu CHAN   Marianna YIP   Doreen CHEUNG   Sannie CHAN

(Nursing Officers and Senior Nursing Officers)

Elderly Health Services, Department of Health, HKSAR

Background

After the SARS outbreak in 2003, the Visiting Health Teams of the Elderly Health Services initiated a series of infection control training programmes for the staff of all private residential care homes for the elderly (PHs) in Hong Kong. In addition to conducting comprehensive training workshops, practical guidelines were issued.  Follow-up visits were paid to all PHs for assessing the progress after training. On-site supervision and training were provided as required and recommendations were made as appropriate. Progress notes were written during each visit to monitor the improvement of practice.

Objective

To study PH staff's knowledge gain and behavioral change in infection control practice in as a result of training.

Methods

A retrospective study was conducted in 72 PHs in New Territories (East) region.  Staff's knowledge gain was determined through pre- and post-tests of the training workshops.  Their behavioral change was assessed by reviewing the progress notes made during the 2 on-site visit-cum-training occasions in the fall of 2003 and spring of 2004 respectively.

Results

The results of the study on the training workshops showed that the range of baseline scores on infection control knowledge among PH staff was large, however, there was significant gain in knowledge after the training [Pretest median (range): 10 (2 to 16); posttest median (range): 12 (3 to 18); p<0.001 by Mann-Whitney U Test].  After the follow up visits and on-site supervision and training, improvements were noted in the areas of isolation arrangement, hand washing, gowning up of personal-protective-equipment (PPE), and food hygiene. Nevertheless, only slight improvement was observed in the area of de-gowning of PPE as well as in the management of disinfectants and rubbish.

Conclusion

Infection control standards maintained by PH staff were rather varied.  Structured training programmes were found to be effective in enhancing their knowledge.  On-site training not only provided opportunities for PH staff to have more detailed and focused discussion with the nursing staff of the Visiting Health Team with respect to the specific settings of the PHs, it also facilitated them to change their behaviours for improvement.  Future programmes tailored to PH staff with different educational background and qualifications focusing on the most needed learning areas are indicated.

(Please click to see a poster presentation of the study which had been displayed at the 'International Conference of Infection Control - A Golden Age of Infection Control: Resurgence or Reaction?' organized by the Hong Kong Infection Control Nurses' Association during the period 11 - 12 September 2004, in Hong Kong.)

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