Infection prevention and control practices and their associated factors among anesthesia service providers at health facilities in central Uganda

Abstract Background The incidence of spinal epidural abscesses, bloodstream infections, surgical site infections, and ventilator-associated pneumonia, all of which are linked to anesthesia care, is increasing. The same is true in the Ugandan context; however, despite being an indication of Infection Prevention and Control (IPC) practice gaps, Ugandan anesthesia provider-IPC practices have not been objectively assessed before. Objective To assess infection prevention and control practices and their associated factors among anesthesia service providers at health facilities in central Uganda. Method This cross-sectional study included 216 anesthesia care service providers in central Uganda. Hospitals and health center IVs in the region were purposively and randomly sampled, respectively, while anesthesia care service providers were consecutively sampled and engaged in structured interviews. Data were analyzed using descriptive statistics and a log-binomial model with 95% confidence and 5% significance. Results The optimal IPC practice level was found to be 12%. Being attached to a facility with a dedicated IPC supervisor (aPR = 3.469), an IPC committee (aPR = 8.588, p = 0.030) that provides dedicated training in IPC for anesthetists (aPR = 2.808), a very strong IPC culture at the facility (aPR = 6.848), and documented standard procedures for IPC during anesthesia care (aPR = 5.805) increased the prevalence of optimal IPC practices. Surprisingly, a history of formal training in IPC reduced optimal IPC practice prevalence (aPR = 0.424). Conclusions The proportion of anesthesia service providers in central Uganda who optimally practice infection prevention and control is low; only one in every 100 does so. Thus, of the reported 670 anesthesia care providers in central Uganda, about 80 provide care in a manner that guarantees patient safety from potentially fatal nosocomial infections. Given the steadily increasing surgical volume in Uganda, there may be an increase in the incidence of anesthesia-related nosocomial infections and perioperative mortality if the status quo is maintained. The IPC practices of anesthesia providers in central Uganda are almost entirely related to institutional characteristics, implying a need to improve work policies on IPC for a wider impact on anesthesia infection prevention and control practices.