Table 3 Gaps in the implementation of airborne infection control guidelines as perceived by the health care providers at DR-TB centers, Karnataka, India, 2016-17
Categories | Codes/ Themes | Verbatim quotes |
|---|---|---|
Administrative AIC measures | Lack of AIC guidelines compliant buildings | “There are patients with other illnesses in the same building just separated by few meters and a wall” (male doctor) “The wards are located too closely with the wards housing patients from other departments” (male doctor) |
Lack of visitor restriction | “Usually there will be one attender or sometimes two staying with the patient. Even when we tell about the disease and how it spreads, they tell that it is difficult to stay away.” (female nurse) “As per our hospital policy, all the patients need to have one attender compulsorily with them at all the times.” (female nurse) | |
Poor Hand Hygiene | “When it comes to washing, there are no soaps provided for hand washing. Sinks are put up but no water is available. Running water is required; however, it is not there.” (male nurse) | |
Unsafe sputum disposal | “Actually, each patient has to spit the sputum in the sputum cup prefilled with some water. The contents are poured in to the toilet and flushed.” (female nurse) “There is presently no adequate supply of disinfectants; it may be phenol or even bleaching powder.” (female housekeeping staff) “The patients are told to spit the sputum in the washroom and flush it with adequate water.” (female housekeeping staff) | |
Lack of training on AIC guidelines among staff | “I have not undergone any training. I have joined here just one year back.” (female housekeeping staff) “I have not received any sort of training before getting posted here. Nobody who is posted here receives any sort of training.” (female nurse) “There is attrition among the housekeeping staff and hence, a lot of new people are added to the pool regularly. Educating these people is also a challenge for us.” (male doctor) “Due to administrative policy of the hospital, they [nurses] are relocated to different wards once in 2 months.” (male doctor) | |
Environmental AIC measures | Poor cross ventilation | “Many a times at least during the nights, the windows are closed citing mosquito menace.” (male doctor) |
Personal Protective AIC measures | Lack of N95 masks | “We are trying our best to provide the N95 masks. However, we don’t have supply at all times.” (male doctor) “I don’t feel very safe working in this ward and always have the fear of contracting the infection (because of lack N95 mask).” [female nurse] “I use mask when I am working in this ward and also in other departments of the hospital. This cloth mask!” (female nurse) “I am not using N95 mask as there is no supply. But what to do? They are costly (to be purchased).” (male doctor) |