Assessment of Aseptic Protocol Compliance in a Trauma Department: A Mixed-Methods Study in Algeria
Document Type : Original Article
Authors
- 1 Laboratory for the Sustainable Management of Natural Resources in Arid and Semi-Arid Zones, University of Salhi Ahmed, Naama, Algeria and Department of Epidemiology and Preventive Medicine, University of Salhi Ahmed, Naama, Algeria
- 2 Department of Trauma,Public Hospital Institution in Naama, Algeria
Abstract
Background: Healthcare-Associated Infections (HAIs), particularly Surgical Site Infections (SSIs), are a significant concern in trauma departments due to invasive operations and open wounds.
Methods: A convergent parallel mixed-methods design was implemented. The observational arm used a standardized checklist (based on WHO/CDC guidelines) to track 15 healthcare workers (total population sampling) across ten important hygiene categories. Simultaneously, a retrospective case-control investigation examined 50 patient records (25 infected cases and 25 non-infected controls) obtained through consecutive sampling over a 45-day period.
Results: Observational data revealed a clear dichotomy in compliance: whereas hand cleanliness and catheter care had good adherence, there were significant gaps in the provision of specified Personal Protective Equipment (PPE), particularly masks and goggles. The most common self-reported impediments were material resource limitations (40%) and work overload (26.7%). Notably, 53.3% of respondents saw medical staff (physicians) as the "weakest link" in the aseptic chain. In the clinical study, individuals with open fractures had an Odds Ratio (OR) of 2.38 (95% CI: 0.70–8.07) for infection compared to closed fractures. However, due to the small sample size, this association was not statistically significant (p=0.135).
Conclusion: Compliance is hampered mostly by logistical shortcomings rather than a lack of theoretical knowledge. The findings imply that written protocols are insufficient in the absence of a secure supply chain for protective equipment. To improve patient safety, a multi-modal strategy that focuses on logistical security, required physician interaction, and active post-operative care surveillance is advised.
Methods: A convergent parallel mixed-methods design was implemented. The observational arm used a standardized checklist (based on WHO/CDC guidelines) to track 15 healthcare workers (total population sampling) across ten important hygiene categories. Simultaneously, a retrospective case-control investigation examined 50 patient records (25 infected cases and 25 non-infected controls) obtained through consecutive sampling over a 45-day period.
Results: Observational data revealed a clear dichotomy in compliance: whereas hand cleanliness and catheter care had good adherence, there were significant gaps in the provision of specified Personal Protective Equipment (PPE), particularly masks and goggles. The most common self-reported impediments were material resource limitations (40%) and work overload (26.7%). Notably, 53.3% of respondents saw medical staff (physicians) as the "weakest link" in the aseptic chain. In the clinical study, individuals with open fractures had an Odds Ratio (OR) of 2.38 (95% CI: 0.70–8.07) for infection compared to closed fractures. However, due to the small sample size, this association was not statistically significant (p=0.135).
Conclusion: Compliance is hampered mostly by logistical shortcomings rather than a lack of theoretical knowledge. The findings imply that written protocols are insufficient in the absence of a secure supply chain for protective equipment. To improve patient safety, a multi-modal strategy that focuses on logistical security, required physician interaction, and active post-operative care surveillance is advised.