الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 158 |  |  |
| | | from | 158 | | |
Abstract
COVID-19 Pandemic, originated and started from Wuhan, China, in December 2019
and was found in the field hospitals with severe chest infection of unknown cause, it has
destroyed the global community, as it negatively affects respiratory tract and all sides of
human lives. The disease is more infectious virus that is high severe in aging people and
people with latent medical conditions. This virus is classified as severe acute respiratory
syndrome and affected more than eight thousand people mainly in China and Hong Kong and
caused more than nine hundred deaths (mortality rate eleven percentage). In Egypt, The
Ministry of Health had announced the first case in the country on February 2020. In the
starting of April 2020, there were more than 800 documented cases, with more than fifty
fatalities, with an accelerated direction towards an increase.
Health care providers are exposed to covid19 risk due to open exposure and working at
different outpatient clinics and dealing with the public, more than working at inpatient wards.
Therefore, practice with infection prevention and control (IPC) protocols is critical to
decrease health care providers’ insecure to this fatal virus. Practicing while following the
WHO protocols is facilitated by training health care providers to IPC, providing of materials
and regular auditing of IPC practices. Generally, IPC strategies in response to more infectious
diseases, such as COVID-19, should contain early recognition, physical distancing, source
control, taking precautions and adequate use of Personal Protective Equipment (PPEs) as
maintain wearing of mask and face shield, water and soap for hand washing , using alcohol
disinfectant for hand disinfection, restriction of movement, environmental cleaning and
disinfection by disinfectants as sodium hypochlorite and hydrogen peroxide.
Aim of the study:
The present study aims to:
Assess health care providers‘ practices of the WHO protocol for infection prevention
and control of COVID-19 in different outpatient settings.
Research question:
What are the health care providers‘ practices toward WHO protocol for infection
prevention and control of COVID-19 virus in different outpatient settings?
Materials and methods:
Materials:
Research Design:
A descriptive exploratory research design was utilized for this study.
Setting:
The present study was conducted at the African Center Of Woman’s Health, Alexandria
and at the Medical Research Institute, Alexandria University as following:
- The African center of woman’s health, is composed of 8 clinics namely a medical
clinic, oncology clinic, obstetric clinic, dental clinic, orthopedic clinic, dermatology
clinic, ophthalmic clinic, and urology clinic. It receives from 15 to 20 clients per day.
Subjects:
A convenience sample of 40 health care providers in the above mentioned settings
were included in the study, 26 in African Center and 14 in Medical Research Institute
will be included in the study.
Assuming the effect size of health care providers’ practice toward WHO protocol for
infection prevention and control to covid19 virus is 0.5, using alpha error of 0.05 and
sample size of 40.
The achieved power is 86.9%.
Power analysis was calculated using G-power.
Minimum sample size is 35 health care providers.
Tools of the study:
Two tools were used for the data collection.
Tool (I): Health Care Providers’ sociodemographic & clinical data.
(Health care providers’ socio-demographic data, health Care Providers’ clinical data).
Tool (II): WHO protocol for infection prevention and Control Practices regarding
covid19: Observational Checklist.
1. Hand Hygiene: (Six Items).
2. Respiratory Hygiene: (Two Items).
3. Use Of Personal Protective Equipment (masks, face shields, gloves, aprons) : (Six
Items).
4. Environmental Cleaning And Disinfection: (Five Items).
5. Isolation or designated waiting area: (Four Items).
6. Screening of clients, and others entering the facility: (Eleven Items).
7. Wastes Management: (Five Items).
8. Environmental Infrastructure: (Five Items).
Scoring System:
Health care providers ’ practices were checked and scored as follows:
Done correctly and completely ”2”.
Done incorrectly or not done”1”.
Total health care providers‘ practice scores were calculated, then converted into mean
percent score and was classified as:
One hundred percentage was considered satisfactory level of practices.
Less than One hundred percentage was considered unsatisfactory level of practices.
Methods:
Approval from the Research Ethics Committee, Faculty of Nursing, Alexandria
University was obtained before starting the study.
Approval from the Graduate studies and Research affairs committee, Faculty of
Nursing, Alexandria University was obtained before starting the study.
An official permission was obtained from responsible authorities of Faculty of
Nursing, Alexandria University to the selected setting to collect the data after
explaining the aim of the study.
An official permission was obtained from the African Center and Medical Research
Institute director and head of different outpatient setting after explanation of the study aim.
Tool I was developed by the researcher after reviewing the related literature. The
developed tool will be translated into Arabic language.
Tool II was adopted by the researcher according to WHO protocol for infection
prevention and control to covid19 virus and it will be used in English language.
Tool I was tested for content validity by 5 experts three in the field of Medical
Surgical Nursing, one from infection control committee of the African Center for
Women Health and one from Medical Research Institute.
Tool II was tested for reliability using appropriate statistical test.
A pilot study was carried out on 10% of health care providers not from outpatient
clinics to test the feasibility and applicability of all tools and the necessary
modification were carried out. Those health care providers were excluded from the
actual study sample.
Tool I was to collect data related socio-demographic data and professional data.
Assessment of health care providers’ practices were carried out using tool (II).
Every health care providers were observed individually for their practice using tool II
via concealed observation technique. The observations were carried out throughout
the work time for approximately 20-30 minutes to collect the needed data for three
times during morning shift (beginning, middle, end of the shift) at three different
shifts in the outpatient clinics by the researcher.
Data were collected and statistically analyzed to identify health care providers‘ practices
toward WHO Protocol for infection Prevention and Control to Covid-19 Virus at different
outpatient settings.
The main results of the study showed that:
1. The present study revealed that all health care providers in both settings had
unsatisfactory level of practice (100%), with no statistical relationship between both
groups. In relation to health care providers practice, it was observed that all health
care providers in the African center group had satisfactory practice of environmental
cleaning, while the majority of them (92.3%) had satisfactory related to respiratory
hygiene, and (45.5%) of them had satisfactory to waste management.
2. The study demonstrated that the health care providers mean practice, it was observed
that all health care providers in both settings had unsatisfactory practice related to
personal protective equipment, isolation, screening of the clients and environmental
infrastructure. Statistical relationships are detected between the two groups in all items
of WHO protocol except use of personal protective equipment as (P<005).
3. The results showed that all health care providers had unsatisfactory performance in
relation to the isolation, screening of the clients and environmental infrastructure.
4. The study revealed that all health care providers had unsatisfactory overall level of
practice. On the other hand, Mean ±SD of nurses practice was (190.4±14.13) while,
physician practice was (165.9±14.34), with a statistical of significant difference between them (X2= NA).
between them (X2= NA).