Infection control study Immpact
27th April 2009
NEEDS ASSESSMENT FOR OBSERVATION
Using the observation tool: The questions are divided according to the ward you are in.
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After the interview, ask to walk around the facility, and if any procedure is happening, ask if you can observe.
Observe using the checklist in part A.
Go to the delivery ward and observe procedures. If you are going to observe a procedure, fill in the checklist
in part A.
If you cannot observe a delivery, go to the operation theatre, is there a C- section going on? If yes, fill in the
checklist in part A.
If there is no C-section occurring, then proceed to the labour ward.
Walk around the labour ward read the guide in Part A – “Walk-through”.
When you arrive in the ward ask if you can observe quietly.
Fill in the checklist in part A.
To each of the list items the items must be present or the action must be done in order to answer “yes”. If an
item in the list is not present or an action is not done then answer “no” to the entire question. Leave a blank
when an item is missing.
Part A – Walk-through
The following are the areas that require a room-by-room walk-through to determine if they following rooms are ready
for the client in terms of equipment, drugs, supplies, and infrastructure:
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Facility in general
Emergency-evaluation area (any area where emergency evaluation is performed (e.g., an emergency room, a
room in the labour and delivery ward, a treatment room)
Labor and delivery rooms
Operating room
Female/maternity ward
Change/scrub room
Instrument-processing and autoclave room
Part A: Walk through checklist
Q.
no.
Questions and filters
Response categories
Available
Yes - 1
No - 2
Remarks
In the Labour/Delivery Room
1
Surgical
gloves?
2
Surgical
gloves: Washed?
3
Surgical
gloves: Reused?
4
Surgical
gloves: Autoclave?
Immpact infection control study: Needs assessment for observation
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Q.
no.
Questions and filters
Response categories
Available
Yes - 1
No - 2
Remarks
5
24-hour
running water
6
Wash
basin with elbow or knee tap
(aseptic)
7
Scrub
brushes
8
Soap
9
Antiseptics
for skin preparation
1
Thermometer
0
1
Sterile
gloves
1
1
Sterile
gowns
2
1
Sterile
gauze
3
1
Sterile
linen packs
4
1
Sterile
delivery packs
5
1
Disposable
delivery kit
6
Operation Theatre
1
24-hour
running water
7
8
1
Wash
basin with elbow or knee tap
(aseptic)
1
Scrub
brushes
9
2
Soap
0
2
Antiseptics
for skin preparation
1
2
Thermometer
2
2
Sterile
gloves
3
2
Sterile
gowns
4
2
Sterile
gauze
5
2
Sterile
linen packs
6
2
Sterile
laparotomy packs
7
2
Surgical
gloves: Washed?
8
2
Surgical
gloves: Reused?
9
3
Surgical
gloves: Autoclave?
0
3
Automatic
door closure in OT
1
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Q.
no.
2
Questions and filters
Response categories
Available
Yes - 1
No - 2
Remarks
Instrument-processing, autoclave
room or equipment storage area
3
Autoclave
machine with temperature
and pressure
3
Supply
of indicator paper
3
4
5
3
Reliable
and safe electric connection or
supply of kerosene oil/gas
3
Table
with marked areas indicating
sterile and non sterile areas
3
Supply
of clean water
6
3
Back-up
for water supply
7
3 utility sink
Deep
8
3
Brushes
for cleaning equipment
9
4
Detergent
for cleaning equipment
0
1
4
Chlorine
or antiseptic for cleaning
equipment
4
Basins
to soak instruments
2
[Adapted from Gill et al. 2005 International Journal of Gynecology & Obstetrics]
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Part B: Observation Table – Labour ward / Labour Room.
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Q.
no.
1
In the labour ward talk to either the midwife /maternity nurse and ask to be shown around. If you cannot
observe in the labour ward ask to be shown around the ante-natal ward.
Ask her if you can sit quietly somewhere to take notes
While you are sitting observe quietly and fill in the form below.
Questions and filters
Response categories
Look at all the posters and charts on
the wall – are any relevant to
infection control?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
Skips
Describe them or take a photo
2
Is there a thermometer available on
the ward?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
3
Look at the patients charts – is
temperature recorded regularly?
How often?
Yes………………………………1
Every ……………………minutes
No………….………………….…2
Don’t know………………………3
4
Where are the hand-washing
facilities? How many?
Yes………………………………1
……………hand-washing
facilities
No………….………………….…2
Don’t know………………………3
5
Is there soap (or any other
antiseptic) available?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
6
Did you see any staff member
washing their hands?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
7
Do they wash hands before
examining the patient?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
8
Do they wash their hands after
examining the patient?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
9
Do they wash their hands before
putting on gloves?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
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Q.
no.
10
Questions and filters
Response categories
Do they wash their hands after
taking gloves off?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
11
Do they wash their hands after
exposure to mucous membranes,
blood and body fluids and soiled
instruments?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
12
If possible, observe a procedure
(injection, insertion IV line, delivery,
operation) – did you see the
nurse/doctor wash their hands before
starting the procedure?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
13
If you cannot observe a procedure,
invite the staff member escorting you
to wash their hands as if they are
about to examine a patient and
observe how and where they do it,
filling in the questions below:
14
Where is the sink, inside the ward?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
15
Where is the sink, outside the ward?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
16
Do they use soap?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
17
Do they use aseptic practices when
switching off tap – use of elbow?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
18
Did they use aseptic techniques to
dry their hands?
Yes………………………………1
No………….………………….…2
Don’t know………………………3
19
20
Ask to see where drugs are kept on
ward
Are there any antibiotics?
21
What are they? ( List names )
Skips
Yes………………………………1
No………….………………….…2
Don’t know………………………3
[Table adapted from Immpact CBCA http://www.abdn.ac.uk/immpact/cbca/whatcbca.htm]
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NOTES AND OBSERVATIONS:
Elaborate on the specific items that are provided in the checklist OR any other
event/occurrence . fNote details of general cleanliness of OT,Labour room etc & specifically
condition of furniture , equipments , observation about hygiene of patients & staff .
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