Identifying sterilization practice gaps at five early implementation hospitals in Cambodia: An observational study - 20/02/26
, Sunida Preechawong, PhD, Dip.ACNP b, Daravy Ear, RN a, Sano Phal, MD c, Srun Sok, MD a, Marianne Coffey, RN d, John CS Murray, MD, MPH dRésumé |
Background |
Effective sterilization of devices used for medical procedures is essential for reducing the risk of healthcare-associated infections. Limited data are available from lower-middle-income countries on the quality of sterilization processing practices or strategies for improving quality. This study developed an approach to collecting and using data on sterilization processing practices as part of the first phase of improving sterilization quality in Cambodia.
Methods |
Five early implementation national, provincial, and district hospitals were selected. Evidence-based data collection tools and methods that assessed the proportion of sterilization practice standards met were adapted for local use. Multistakeholder hospital teams assessed environments and practices in sterilization processing areas, calculated indicators, interpreted data, identified gaps and barriers, and developed action plans. Team-based problem-solving was used to guide bottom-up engagement, communication, and staff motivation to implement change.
Results |
Across 5 hospitals, practice gaps were identified for instrument washing (0/24 [0%] cold water pre-rinse, 18/64 [28%] manual washing, 7/32 [22%] manual rinsing, and 0/24 [0%] drying standards met); inspection and packing (11/39 [28%] inspection and function testing, 21/71 [30%] packing, 21/30 [70%] wrapping, and 7/35 [20%] labeling standards met); sterilization (10/59 [17%] sterilizer loading, 10/28 [36%] sterilizer unloading, and 7/63 [11%] recording standards met); and sterile storage (71/130 [55%] sterile storage and 21/62 [34%] sterile-stock management standards met). Environments had limited one-way workflow, separation from patient care, and availability of handwashing resources. Hospital teams used data to develop short-term action plans to improve sterilization practice quality using local experience and resources.
Conclusions |
New evidence-based tools and indicators proved practical and effective for assessing sterilization processing practices in hospitals. Collection and use of local data enabled multistakeholder hospital teams to prioritize problems and work on solutions to problems tailored to the local context. This approach has potential applicability to other hospitals in Cambodia and elsewhere as the foundation of an approach to improve the quality of sterilization practices.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Effective sterilization is essential for limiting the risk of healthcare-associated infections. |
• | This study piloted evidence-based checklists to review sterilization practices in Cambodia. |
• | The study found practice gaps in washing, inspection, sterilization, and storage. |
• | Hospital teams used data to create action plans for practice changes with local resources. |
Key Words : Sterilization practices, Quality improvement, Hospital-acquired infection, Evidence-based checklists, Kotter model
Plan
| Funding/support: This project received funding from the World Health Organization, Western Pacific Regional Office, for hospital data collection. |
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| Conflicts of interest: All authors have completed the ICMJE uniform disclosure form at coi_disclosure.pdf and declare no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. |
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| Ethics approval and consent to participate: This study was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University, Chongqing, China (K2023-19). This project has been registered in Clinicaltrial.gov (ClinicalTrials.gov ID: NCT06733779). This study adhered to the Declaration of Helsinki and respect for all participants and protects their health and rights. |
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| Disclaimer: The authors alone are responsible for the views expressed in this article, and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. |
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| Data sharing statement: Data sharing for pure research purposes is available upon request. |
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| Critical revisions for important intellectual content: All authors. VK is the guarantor of the paper. |
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| Patient and public involvement: This research was done without patient involvement. Patients were not invited to comment on the study design and were not consulted to develop patient-relevant outcomes or interpret the results. Patients were not invited to contribute to the writing or editing of this document for readability or accuracy. |
Vol 54 - N° 3
P. 325-334 - mars 2026 Retour au numéro
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