title: Family caregivers in public tertiary care hospitals in Bangladesh: risks and opportunities for infection control.
abstract: BACKGROUND
  Family caregivers are integral to patient care in Bangladeshi public hospitals. This study explored family caregivers' activities and their perceptions and practices related to disease transmission and prevention in public hospitals.
  
  
  METHODS
  Trained qualitative researchers conducted a total of 48 hours of observation in 3 public tertiary care hospitals and 12 in-depth interviews with family caregivers.
  
  
  RESULTS
  Family caregivers provided care 24 hours a day, including bedside nursing, cleaning care, and psychologic support. During observations, family members provided 2,065 episodes of care giving, 75% (1,544) of which involved close contact with patients. We observed family caregivers washing their hands with soap on only 4 occasions. The majority of respondents said diseases are transmitted through physical contact with surfaces and objects that have been contaminated with patient secretions and excretions, and avoiding contact with these contaminated objects would help prevent disease.
  
  
  CONCLUSIONS
  Family caregivers are at risk for hospital-acquired infection from their repeated exposure to infectious agents combined with their inadequate hand hygiene and knowledge about disease transmission. Future research should explore potential strategies to improve family caregivers' knowledge about disease transmission and reduce family caregiver exposures, which may be accomplished by improving care provided by health care workers.
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh. Electronic address: saiful@icddrb.org.
authors.forename: M Saiful
authors.initials: MS
authors.lastname: Islam
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh; Global Disease Detection Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Sultana
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
authors.forename: Nadia Ali
authors.initials: NA
authors.lastname: Rimi
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
authors.forename: Rashid Uz
authors.initials: RU
authors.lastname: Zaman
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
authors.forename: Main
authors.initials: M
authors.lastname: Uddin
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
authors.forename: Nazmun
authors.initials: N
authors.lastname: Nahar
authors.affiliation: Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh.
authors.forename: Mahmudur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
authors.forename: M Jahangir
authors.initials: MJ
authors.lastname: Hossain
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Gurley
mesh_terms: D000328:Adult; D001459:Bangladesh; D017028:Caregivers; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission*; D005260:Female; D063373:Hand Hygiene / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006779:Hospitals, Public; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012308:Risk Management; D062606:Tertiary Care Centers
keywords: Caregiving practice; Hospital-acquired infection; Qualitative research; Socio-cultural