Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110713

Martha Ndhlovu, RM, MSc, JHPIEGO Zambia, Prevention of Medical Transmission Program, PO Box 36873, 8 Ngumbo Road, Lusaka, Zambia, Christopher Mazimba, Mmed(ob/gyn), Prevention of medical transmission of HIV program, JHPIEGO Corporation, PO Box 32481, Lusaka, Zambia, PO Box 32481, Lusaka, Zambia, Richard S. Hughes, MA, Zambia Country Office, JHPIEGO Corporation, 1615 Thames Street, Baltimore, MD 21231, 011-260-1-254555, rhughes@jhpiego.org, Kuhu Maitra, MD, DCH, MBBS, International Health Group, Chemonics International, 1133, 20th Street, NW, Washington, DC, Washington, DC, DC 20036, Answell Chipukuma, Higher Diploma, Manoff Group inc., Prevention of medical transmission of HIV program, P.O Box 36873, Ngumbo Road, LongAcres, Lusaka, Zambia, Matildah Matipa Zyambo, mcips, Zambia Injection Safety, Chemonics International, P.O. Box 36873, Lusaka, Zambia, and Michael N. Favin, MA, MPH, CHANGE Project, The Manoff Group, 2001 S Street, NW, Washington, DC 20009.

BACKGROUND: Infection prevention (IP) is a critical component of quality health services and is regarded by the Ministry of Health (MOH) as the corner stone of quality health care in Zambia. Hand washing is the single most important procedure for preventing cross contamination (person to person). But the practice was found to be poor at 10% during the initial TIPs visit by the IS team. Most health providers said it was cumbersome to keep walking back and forth to wash hands in between patient care.

DESIGN/METHODS: The IS team believed that hand hygiene practices could be improved through the introduction of waterless hand rub, which could be either purchased or prepared using the locally available alcohol and glycerine.

Applying an approach called “Trials of Improved Practices” (TIPS), the team used the baseline assessment to identify a set of practices, which included hand hygiene that could be improved to close performance gaps. They observed hand hygiene practices among 44 providers in two districts, discussed their observations with the providers, and negotiated agreements to try to improve their performance and the use of waterless hand rub was introduced.

RESULTS/OUTCOME: Noticeable improvements in provider performance were observed during the follow-up visit. Hand washing increased from 10% to 66%, and the increase was attributable to the introduction of the hand rub.

CONCLUSIONS: The results demonstrate that rapid improvements in provider practices are achievable even in a low resource setting, using a simple and straightforward methodology.

Learning Objectives: