Table 2.
Proportion of primary health-care (PHC) facilities compliant with measures and each risk rating category in 2011/12 and 2014/15 (N = 60)
| Variable/measure | Baseline (external) audits (2011–2012) Facilities compliant: n (%) |
Follow up (internal) audits (2014–2015) Facilities compliant: n (%) | Difference % (95% CI) |
|---|---|---|---|
| Functional area: clinic/CHC manager | |||
| IPC policy (E checklist)∗ | 18 (30%) | 32 (53%) | 23% (4; 43)† |
| The annual in service education & training plan includes IPC (especially TB and universal precautions) (E) | 26 (43%) | 42 (70%) | 27% (7; 46) |
| There is educational material available for staff on universal precautions: hand washing/respirator use/sharps/PPE/cough etiquette (E) | 44 (73%) | 47 (78%) | 5% (-10; 20) |
| There is educational material available to patients on prevention of the spread of TB (E) | 49 (82%) | 55 (92%) | 10% (-4; 24) |
| Appropriate types of masks and FDA-approved respirators available and at risk staff fit tested (X) | 50 (83%) | 36 (60%) | -23% (-40; -7) |
| Rooms used for patients with infectious TB are separated by adequate physical barriers from non-TB patients (X) | 42 (70%) | 44 (73%) | 3% (-12; 19) |
| Rooms used for accommodation/consultation of patients with respiratory infections have adequate natural or mechanical ventilation (E) | 47 (78%) | 55 (92%) | -14% (-0.2; 27) |
| A comprehensive policy on standard precautions is available (E checklist) | 41 (68%) | 46 (77%) | 9% (-9; 26) |
| Reporting system for needle stick injuries (V) | 50 (83%) | 54 (90%) | 7% (-8; 21) |
| Randomly selected clinical area: sharps safety (V checklist)* | 44 (73%) | 50 (83%) | 10% (-7; 27) |
| Annual hand washing/hygiene campaign/drive held (V) | 21 (35%) | 25 (42%) | 7% (-12; 25) |
| Up-to-date decontamination policy (E checklist)* | 15 (25%) | 23 (38%) | 13% (-3; 29) |
| Staff able to explain used instrument sterilization procedure (E Checklist)* | 31 (52%) | 33 (55%) | 3% (-17; 23) |
| Records show staff with NSI received PEP and have been retested (V) | 24 (40%) | 31 (52%) | 12% (-5; 29) |
| The fire certificate for the facility is available (E) | 7 (12%) | 24 (40%) | 28% (12; 47) |
| There are quarterly emergency drills (E) | 0 | 6 (10%) | 10% (0.7; 19) |
| Pooled mean overall facility score (weighted mean‡, SD) | 66.08% (20.15) | 66.26% (21.60) | 0.18 (-6.50; 6.86)§ |
CHC, Community Health Center; CI, confidence interval; D, developmental; E, essential; FDA, Food and Drug Administration; IPC, infection prevention and control; IQR, interquartile range; NSI, needle stick injuries; PEP, postexposure prophylaxis; PPE, personal protective equipment; SD, standard deviation; TB, tuberculosis; V, vital; X, extreme.
Numerical variable based on checklist. Compliant on Essential measure if numerical score 80% or greater; compliant on Vital measure if 90% or greater.
McNemar test for all binary variable comparisons.
Weighting: X = 40%, V = 30%, E = 20%, D = 10% (none in this study).
Difference between means, paired data.