The Clean Study

清洁研究

• 批准号: MR/R019274/1
• 负责人: Alexander Aiken
• 金额: $ 19.21万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FR019274%2F1
• 关键词: Clean; Study

Every year, thousands of mothers and babies suffer from infections acquired during a hospital stay, sometimes from poor hygiene and sometimes with fatal consequences. This study will investigate whether training 'cleaning champions' to educate hospital cleaners in best practice methods improves environmental hygiene in maternity and newborn units in three Tanzanian hospitals. It will also measure whether doing this leads to changes in the knowledge, beliefs, skills and behaviour of champions and cleaners. The lessons learnt from this study will help inform a bigger trial to investigate whether our intervention actually reduces infections in mothers and babies. Our previous research in two regions of Tanzania found most maternity beds to be contaminated, and that most cleaners had not received training in the last year. In this study we will start by identifying staff (for example, nurse/midwives, ward managers, or experienced cleaners) in each hospital who can become 'cleaning champions'. Next, the champions will receive training on how to educate cleaners on the maternity and newborn units. We will adapt and use an existing training package which includes a set of lessons on best cleaning techniques (e.g. start in a clean area, and end in a dirty area; wear personal protective equipment); and also on how cleaning breaks the 'chain of transmission' of infection. Practical demonstrations are included (e.g. using talcum powder to show how invisible germs are spread) which encourage active participation - an approach which is better for adult learners, especially those with lower literacy, than traditional teaching methods. The training of the cleaning champions will be undertaken by an experienced local organisation (e.g. School of Nursing at Muhimbili University of Health and Allied Sciences).However, training alone will not necessarily improve environmental hygiene, rather other improvements need to occur too (e.g. ensuring mops and disinfectant are always provided when they run out). We will use 'Quality Improvement' (QI) methods to identify these needs and to monitor performance of cleaning staff after they have been trained by their local cleaning champion. These champions will be supported in their role by regular supervisory meetings over a four-month period from the organization who trained them. To determine if there have been any positive changes we will do assessments both before and after the training of the champions and the cleaners. This includes measuring their knowledge and beliefs using questionnaires. We will also secretly stick fluorescent tags on relevant places, like beds, which can only be removed by thorough cleaning, and monitoring these tags will help us to know if the environment has become cleaner. This will enable us to decide upon the methods to be used in the bigger follow-on trial, which will also include measuring hygiene levels using microbiology, and measuring infections in newborns using the same clinical methods a doctor would employ, such as recording temperature and blood pressure.We will share the findings of this preliminary research both in Tanzania and internationally, through published papers, local workshops, conference presentations and relevant websites.

每年，成千上万的母亲和婴儿在住院期间遭受感染，有时是由于卫生条件差，有时是致命的后果。这项研究将调查培训“清洁冠军”以教育医院清洁工采用最佳实践方法是否可以改善坦桑尼亚三所医院妇产科和新生儿科室的环境卫生。它还将衡量这样做是否会导致拥护者和清洁工的知识、信仰、技能和行为发生变化。从这项研究中吸取的经验教训将有助于为更大规模的试验提供信息，以调查我们的干预措施是否真正减少了母亲和婴儿的感染。我们之前对坦桑尼亚两个地区的研究发现，大多数产床都受到污染，而且大多数清洁工去年没有接受过培训。在本研究中，我们将首先确定每家医院中可以成为“清洁冠军”的员工（例如护士/助产士、病房经理或经验丰富的清洁工）。接下来，冠军们将接受如何对妇产科和新生儿科清洁工进行培训的培训。我们将调整和使用现有的培训包，其中包括一系列有关最佳清洁技术的课程（例如，从清洁区域开始，到肮脏区域结束；穿戴个人防护装备）；以及清洁如何打破感染的“传播链”。其中包括鼓励积极参与的实际演示（例如使用滑石粉来展示看不见的细菌如何传播），这种方法比传统教学方法更适合成人学习者，尤其是识字率较低的学习者。清洁冠军的培训将由经验丰富的当地组织（例如穆希姆比利健康与联合科学大学护理学院）进行。但是，仅靠培训不一定能改善环境卫生，还需要进行其他改进（例如确保拖把和消毒剂用完后总是会提供）。我们将使用“质量改进”（QI）方法来识别这些需求，并在清洁人员接受当地清​​洁冠军的培训后监控他们的表现。这些冠军将得到培训他们的组织为期四个月的定期监督会议的支持。为了确定是否有任何积极的变化，我们将在冠军和清洁工训练之前和之后进行评估。这包括使用问卷来衡量他们的知识和信念。我们还会偷偷地在相关地方贴上荧光标签，比如床，只有彻底清洁才能去除，监测这些标签将帮助我们了解环境是否变得更清洁。这将使我们能够决定在更大规模的后续试验中使用的方法，其中还包括使用微生物学测量卫生水平，以及使用医生使用的相同临床方法测量新生儿的感染情况，例如记录体温和体温。我们将通过发表的论文、当地研讨会、会议演讲和相关网站，在坦桑尼亚和国际上分享这项初步研究的结果。

项目成果

Additional file 1 of The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

The Clean 试点研究的附加文件 1：对坦桑尼亚三家医院的环境卫生干预措施的评估

• DOI: 10.6084/m9.figshare.13544900
• 发表时间: 2021
• 作者: Gon G

Additional file 7 of The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

The Clean 试点研究的附加文件 7：对坦桑尼亚三家医院的环境卫生干预措施的评估

• DOI: 10.6084/m9.figshare.13544921
• 发表时间: 2021
• 作者: Gon G

Additional file 4 of The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

The Clean 试点研究的附加文件 4：对坦桑尼亚三家医院的环境卫生干预措施的评估

• DOI: 10.6084/m9.figshare.13544909
• 发表时间: 2021
• 作者: Gon G

Additional file 9 of The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

The Clean 试点研究的附加文件 9：对坦桑尼亚三家医院的环境卫生干预措施的评估

• DOI: 10.6084/m9.figshare.13544927
• 发表时间: 2021
• 作者: Gon G

Birth attendants' hand hygiene compliance in healthcare facilities in low and middle-income countries: a systematic review.

• DOI: 10.1186/s12913-020-05925-9
• 发表时间: 2020-12-03
• 期刊: BMC health services research
• 影响因子: 2.8
• 作者: Gon G;de Barra M;Dansero L;Nash S;Campbell OMR
• 通讯作者: Campbell OMR