ABSTRACT
South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient-centered care.
ABSTRACT
BACKGROUND: Audiologists have a clinical and ethical responsibility to create a working environment, designed to reduce the potential for cross-contamination or transmission of infections. OBJECTIVES: To describe the infection prevention and control (IPC) measures utilised and the opinions of audiologists and speech therapists, and audiologists (A/STAs) towards IPC in public healthcare facilities in KwaZulu-Natal province, South Africa. METHOD: A quantitative, descriptive survey was utilised and entailed completing an online questionnaire. The Cronbach's alpha (0.82) indicated good internal consistency of the tool. Forty-nine A/STAs from 29 public healthcare facilities responded. RESULTS: Most participants (82%) followed a generic Department of Health policy on IPC, while 67% alluded to a discipline-specific policy. Participants had received training in infection control but indicated that further instruction was required for audiology-specific infection control procedures. Only 57% indicated that they 'sometimes' wore gloves with every patient during direct clinical contact. An association between the healthcare facility level and the wearing of gloves was found to be statistically significant (p = 0.025). Participants at regional and tertiary levels contended that gloves should be worn during most procedures versus those at district levels of care. While 96% washed their hands after each patient, only 76% washed their hands before each patient. Twenty-nine per cent indicated that they only 'sometimes' wore masks when in contact with patients with communicable diseases. Approximately one-third disinfected touch surfaces and toys, based on the clinician's discretion. The majority (86%) of participants, however, always followed the correct protocol for medical waste disposal. Despite training and the availability of policies, some practitioners displayed poor IPC practices in terms of universal precautions, personal protective equipment, handwashing and sterilisation. CONCLUSION: Further education, training and awareness related to appropriate IPC measures are recommended for audiologists. It is envisaged that this will lead to more effective IPC measures in audiology practice thereby reducing the risk of infection transmission.
