IMPLEMENTATION FIDELITY OF INFECTION PREVENTION PRACTICES AT DEBRE TABOR COMPREHENSIVE SPECIALIZED HOSPITAL, NORTHWEST ETHIOPIA

Abstract

Abstract Background: Healthcare-acquired infections are a major problem in the world within the healthcare delivery system. An estimated 5 to 10% and around 25% of hospitalized patients have developed Healthcare Acquired Infections in developed and developing countries respectively. Infection prevention and control programs have proven to be successful in lowering the incidence and spread of infections. Objective: To evaluate the implementation fidelity of infection prevention practices at Debre Tabor comprehensive specialized hospital, Northwest Ethiopia, 2022. Methods: A facility-based cross-sectional design with a concurrent mixed method was used to evaluate the implementation fidelity of infection prevention practices. A total of 36 indicators were used to measure adherence, participant responsiveness, and facilitation strategies dimensions. A total of 423 clients for interview were administered, an inventory checklist, document review, 35 non-participatory observations, and 11 key informant interviews were conducted. A multivariable logistic regression analysis was used to identify factors significantly associated with the satisfaction of clients. The findings were presented using descriptions, tables, and graphs. Result: The overall implementation fidelity of the IPPs (Infection prevention practices) was 61.8%. The dimensions of adherence to IPC guidelines was 71.4%, participant responsiveness was 60.6% and facilitation strategy was 48%. In multivariable analysis, Ward admitted and educational level had a p-value of below 0.05 and was significantly associated with the satisfaction of clients on infection prevention practices at the hospital. The major themes that emerged in qualitative data analysis were healthcare workers-related factors, management-related factors, and patient and visitor-related factors. Conclusion: the evaluation result of this study concluded that the overall implementation fidelity of IPPs was judged as a medium and it needs improvement. It comprised dimensions adherence and participant responsiveness were judged as a medium and facilitation strategy was judged as a low. Enablers and barriers factors were thematized into factors related to healthcare providers, management-related, intuitional-related, and patient and visitor-related. Keywords: Implementation fidelity, infection prevention practices, Debre Tabor comprehensive hospital, Ethiopia.