In-Person Training Plus E-learning Video on Dressing Change in Orthopedic Ward: A Before-After Observational Study

Abstract Introduction : Infection prevention and control (IPC) training can prevent healthcare-associated infections. To assess healthcare worker compliance with dressing change (DC) guidelines before and after different training modalities. Methods : Observational study has performed in orthopedic department in a Vietnamese hospital. Forty-five nurses were trained for DC practices over three training sessions and 26 nurses were trained on hand hygiene (HH) in two training sessions. DC practices were assessed from November 2019 (ADC1: assessment dressing change 1) to May 2022 (ADC2). The evaluation concerned: HH opportunities and glove removal; patient and equipment installation; and the installation steps of the dressing set and antisepsis. Between ADC1 and ADC2, training courses were performed and a short (<6 min) e-learning video was available, explaining the DC. Twenty-two and 27 DC were assessed in ADC1 and in ADC2, respectively. Results : Dressing changes were mainly performed after orthopedic surgeries such as osteosynthesis or hip prosthesis. The grip mode for DC was mainly clamps without sterile gloves. Wounds were systematically disinfected by an antiseptic. The principle of cleanest to dirtiest was respected in 45% cases in ADC1, rising significantly to 100% for ADC2. The bandage used was sterile compresses with strip. Overall compliance increased significantly from 50% to 89.5% from ADC1 to ADC2, particularly for glove removal, the patient and equipment installation and the installation steps of the dressing set. HH compliance increased significantlyfrom 44.8% to 74.1%. Conclusions : IC learning significantly improved the IPC practices in the DC. Healthcare worker education is crucial when targeting interventions for IPC.