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患上感染，有时是由于卫生贫困而受到致命后果的影响。这项研究将调查培训“清洁冠军”以教育医院清洁剂最佳实践方法是否可以改善三家坦桑尼亚医院的产妇和新生儿的环境卫生。它还将衡量这样做是否会导致冠军和清洁工的知识，信念，技能和行为的变化。从这项研究中学到的经验教训将有助于告知一项更大的试验，以调查我们的干预措施是否真的减少了母亲和婴儿的感染。我们以前在坦桑尼亚两个地区的研究发现，大多数产妇床已被污染，并且大多数清洁工在去年没有接受过培训。在这项研究中，我们将首先确定每个医院的员工（例如，护士/助产士，病房经理或经验丰富的清洁工），他们可以成为“清洁冠军”。接下来，冠军将获得有关如何对清洁工进行孕妇和新生单位的培训。我们将适应并使用现有的培训套餐，其中包括一组最佳清洁技术的课程（例如，在干净的区域开始，在肮脏的区域结束；穿上个人防护设备）；以及清洁如何破坏感染的“传播链”。包括实际的演示（例如，使用滑石粉来显示隐形细菌的传播是如何传播的），这是鼓励积极参与的方法 - 一种对成人学习者（尤其是识字率较低的人）比传统教学方法更好的方法。对清洁冠军的培训将由经验丰富的当地组织（例如Muhimbili Health University of Health and Allied Sciences的护理学院）进行。我们将使用“质量改进”（QI）方法来确定这些需求，并在当地清洁冠军培训清洁工作人员的绩效。这些冠军将在四个月内的定期监督会议中获得培训的组织的定期监督会议。为了确定是否有任何积极的变化，我们将在培训冠军和清洁工培训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。我们还将秘密地将荧光标签贴在相关位置，例如床，只能通过彻底清洁来删除，并且监视这些标签将帮助我们知道环境是否变得更加干净。 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.

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

Additional file 2 of Birth attendants' hand hygiene compliance in healthcare facilities in low and middle-income countries: a systematic review

低收入和中等收入国家医疗机构中助产士手部卫生合规情况的附加文件 2：系统评价

• DOI: 10.6084/m9.figshare.13323941
• 发表时间: 2020
• 作者: Gon G