Compliance to intraoperative basic hygiene and patient safety culture in Maputo, Mozambique. : An observational study

Background: Surgical site infections are commonly occuring within healthcare, especially in Africa. Good hygiene is the most effective way in which to reduce and prevent infection, compliance however is often low or insufficient. Aim: The Aim of the study was to observe intraoperative compliance to basic hand hygiene in the operating theatre, the secondary aim was to investigate the surgical teams views on patient safety by using a survey on patient safety culture. Method: The design is a quantitative observational study. Through participant observation information was gathered on compliance to basic intraoperative hygiene routines in operating theatres in Mozambique. Operating personnel were then asked to complete a survey on patient safety culture. Result: None of the work elements were performed in complete compliance to WHO’s guidelines at all times. The operating theatre personnel’s views on Patient Safety Culture showed the highest percentage of positive responses was the dimensions “Teamwork Within Hospital Units” and “Organisational Learning- Continous improvement”. The dimensions with the least positive response was “Nonpunitive Response To Error” and “Staffing”. When comparing compliance to basic hygiene and the results of the patient safety culture survey a medium relation was found, where the staff who gave the most positive response to the survey also complied better to the WHO’s hygiene guidelines. Conclusions: Compliance to basic hygiene during the intraoperative phase in the operating theatre in Mozambique, Maputo was often insufficient. There was a medium strong relation between the staffs views on patient safety and their compliance to basic hygiene. This implies that working with the staff’s attitudes concerning patient safety could improve hygiene compliance resulting in reduced number of surgical site infections