Biosecurity in Angola`s Hospitals Prevention Strategie

Background: After 27 years of civil war, Angola has begun a reconstruction process in 2002. The health system is being reorganized with the reform of hospitals, purchase of equipment and hiring/training of professionals. As part of this process, it was decided to implement biosecurity standards in hospitals.

Objective:  

Report the implementation of an effective and permanent Biosecurity National Program in the sanitary units (provincial hospitals, maternities and sanatoriums) aiming at five basic actions: hand washing, drill-cutting disposal, N95 mask implementation, healthcare workers (HCW) vaccination against hepatitis B and implantation of a kit for occupational exposure to reduce the risk and promote a safe work environment.

Methods:  

Team work: 3 biomedical ones, 5 nurses (1 coordinator), a scientific coordinating doctor (Brazilians) and 3 national nurses. Initially nominated the National Biosecurity Technical Committee (CTBN) for regulations standard. First action: assessment diagnosis in sanitary units (structure, water existence, workflow and occupational risk) followed by education in Biosecurity Basic Norms, creation of the local Biosecurity Technical Committee (CTBI), effective implementation of the adequacies in the most critical work sections: surgical center, emergency room, laboratory, childbirth rooms and internments, with hand washing training, drill-cutting disposal, correct use of N95 mask, HCW first atendence, follow up and vaccination against hepatitis B. Monitoring carried through by means of auditorships of the implanted actions, meetings and continuing education to the CTBI.

Results:  

The Biosecurity Program, from January 2008 to July 2010, effectively was implanted in 49 sanitary units of the country having obeyed each province organizational structure. 1146 HCW had been enabled in Biosecurity Basic Norms, 29 CTBIs formed, being a national one. 10160 HCW were immunized to hepatitis B, 394 points were set up for hand washing, N95 mask implementation in 6 hospitals, 13200 puncture-resistant containers and 148 Kits for occupational exposure were placed in the hospitals for the beginning of the actions.

Conclusions:

After 31 months of intense work accomplished in 11 provinces and 49 sanitary units was concluded that education in Biosecurity Basic Norms motivated HCW to undertake changes in its work environment. On the other hand the maintenance of these changes only occurred in the units where the leadership became present and if it involved in the actions fulfilment, therefore it is possible to establish safe work conditions in hospitals with deficient structures by involving continuing education, team work and physical structure adequacy. Considering that the program has less than 3 years of existence it can be said that had been created the provocations in relation the basic actions for a mannering change that still is far from being concluded.