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Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana

INTRODUCTION: Healthcare-associated infections (HAIs) are a global health challenge, particularly in low- and middle-income countries (LMICs). Infection prevention and control (IPC) remains an important strategy for preventing HAIs and improving the quality of care in hospital wards. The social envi...

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Autores principales: Sunkwa-Mills, Gifty, Senah, Kodjo, Tersbøl, Britt Pinkowski
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328309/
https://www.ncbi.nlm.nih.gov/pubmed/37418459
http://dx.doi.org/10.1371/journal.pone.0283647
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author Sunkwa-Mills, Gifty
Senah, Kodjo
Tersbøl, Britt Pinkowski
author_facet Sunkwa-Mills, Gifty
Senah, Kodjo
Tersbøl, Britt Pinkowski
author_sort Sunkwa-Mills, Gifty
collection PubMed
description INTRODUCTION: Healthcare-associated infections (HAIs) are a global health challenge, particularly in low- and middle-income countries (LMICs). Infection prevention and control (IPC) remains an important strategy for preventing HAIs and improving the quality of care in hospital wards. The social environment and interactions in hospital wards are important in the quest to improve IPC. This study explored care practices and the interactions between healthcare providers and mothers in the neonatal intensive care units (NICU) in two Ghanaian hospitals and discusses the relevance for IPC. METHODOLOGY: This study draws on data from an ethnographic study using in-depth interviews, focus group discussions involving 43 healthcare providers and 72 mothers, and participant observations in the wards between September 2017 and June 2019. The qualitative data were analysed thematically using NVivo 12 to facilitate coding. FINDINGS: Mothers of hospitalized babies faced various challenges in coping with the hospital environment. Mothers received sparse information about their babies’ medical conditions and felt intimidated in the contact with providers. Mothers strategically positioned themselves as learners, guardians, and peers to enable them to navigate the clinical and social environment of the wards. Mothers feared that persistent requests for information might result in their being labelled “difficult mothers” or might impact the care provided to their babies. Healthcare providers also shifted between various positionings as professionals, caregivers, and gatekeepers, with the tendency to exercise power and maintain control over activities on the ward. CONCLUSION: The socio-cultural environment of the wards, with the patterns of interaction and power, reduces priority to IPC as a form of care. Effective promotion and maintenance of hygiene practices require cooperation, and that healthcare providers and mothers find common grounds from which to leverage mutual support and respect, and through this enhance care for mothers and babies, and develop stronger motivation for promoting IPC.
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spelling pubmed-103283092023-07-08 Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana Sunkwa-Mills, Gifty Senah, Kodjo Tersbøl, Britt Pinkowski PLoS One Research Article INTRODUCTION: Healthcare-associated infections (HAIs) are a global health challenge, particularly in low- and middle-income countries (LMICs). Infection prevention and control (IPC) remains an important strategy for preventing HAIs and improving the quality of care in hospital wards. The social environment and interactions in hospital wards are important in the quest to improve IPC. This study explored care practices and the interactions between healthcare providers and mothers in the neonatal intensive care units (NICU) in two Ghanaian hospitals and discusses the relevance for IPC. METHODOLOGY: This study draws on data from an ethnographic study using in-depth interviews, focus group discussions involving 43 healthcare providers and 72 mothers, and participant observations in the wards between September 2017 and June 2019. The qualitative data were analysed thematically using NVivo 12 to facilitate coding. FINDINGS: Mothers of hospitalized babies faced various challenges in coping with the hospital environment. Mothers received sparse information about their babies’ medical conditions and felt intimidated in the contact with providers. Mothers strategically positioned themselves as learners, guardians, and peers to enable them to navigate the clinical and social environment of the wards. Mothers feared that persistent requests for information might result in their being labelled “difficult mothers” or might impact the care provided to their babies. Healthcare providers also shifted between various positionings as professionals, caregivers, and gatekeepers, with the tendency to exercise power and maintain control over activities on the ward. CONCLUSION: The socio-cultural environment of the wards, with the patterns of interaction and power, reduces priority to IPC as a form of care. Effective promotion and maintenance of hygiene practices require cooperation, and that healthcare providers and mothers find common grounds from which to leverage mutual support and respect, and through this enhance care for mothers and babies, and develop stronger motivation for promoting IPC. Public Library of Science 2023-07-07 /pmc/articles/PMC10328309/ /pubmed/37418459 http://dx.doi.org/10.1371/journal.pone.0283647 Text en © 2023 Sunkwa-Mills et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sunkwa-Mills, Gifty
Senah, Kodjo
Tersbøl, Britt Pinkowski
Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana
title Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana
title_full Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana
title_fullStr Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana
title_full_unstemmed Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana
title_short Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana
title_sort infection prevention and control in neonatal units: an ethnographic study of social and clinical interactions among healthcare providers and mothers in ghana
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328309/
https://www.ncbi.nlm.nih.gov/pubmed/37418459
http://dx.doi.org/10.1371/journal.pone.0283647
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