Browsing by Author "Achmat, Bilqees"

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    Challenges to infection control in early communication intervention : a scoping review
    (AOSIS (Pty) Ltd., 2022-08-03) Achmat, Bilqees; Gerber, Berna
    Background: Personal protective equipment (PPE) and infection prevention and control (IPC) measures are crucial to preventing the spread of coronavirus disease 2019 (COVID-19). This study used a scoping review to investigate the challenges that exist when speech–language therapists (SLTs) use IPC measures for providing early communication intervention (ECI). Objectives: To describe existing, recent literature on PPE and IPC measures used in early intervention through a scoping review (steps 1–5) and to consult local clinicians to investigate how SLTs who provide ECI in South Africa relate to these findings (step 6 of the scoping review). Method: A scoping review was performed which followed the PRISMA-ScR framework. Because of limited literature on PPE and IPC measures used by SLTs in providing ECI, the inclusion criteria were adjusted to include PPE and IPC measures used by healthcare workers (HCWs) who provide early intervention to the population of infants and toddlers up to 3 years old. At the time of the review, articles were not older than 10 years and were published between 2011 and 2020. The scoping review included a consultation with South African SLTs who provide ECI, including during the COVID-19 pandemic. A pilot study was conducted prior to the consultations. Seventeen clinicians were included in total. Data from both the pilot study and main consultation were transcribed and analysed in the results using thematic analysis. Results: Fourteen articles were included in the study. The scoping review of existing literature identified challenges to implementing IPC measures, namely the care and behaviour of young children, infrastructure and system challenges, poor compliance and lack of training and a lack of standard IPC protocols. Clinicians in the consultation phase confirmed these challenges and reported that IPC measures did not consider ECI populations nor the settings in which services were provided. Suggestions from the literature for improved infection control included hand hygiene, improved supplies and infrastructure and education and training. Clinicians in the consultation added practical suggestions for implementing IPC measures within ECI, which included an increase in parent-led intervention as well as cleaning and disinfection strategies. Conclusion: This study identified challenges and recommendations of SLTs who use PPE and IPC measures whilst providing ECI. Understanding these challenges can benefit ECI services and future research efforts focused on improving ECI services whilst maintaining IPC standards.
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    Personal protective equipment and infection prevention and control measures used by healthcare workers for early childhood intervention : a scoping review with specific relevance for speech-language therapists practising in South Africa
    (Stellenbosch : Stellenbosch University, 2024-03) Achmat, Bilqees; Gerber, Berna; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech-Language and Hearing Therapy.
    ENGLISH SUMMARY: Background: Within low-to-middle-income countries (LMICs) such as South Africa, there is an increased risk of children acquiring developmental delays due to the prevalence of infectious diseases and high-risk environments. Early childhood intervention (ECI) can provide long-term benefits to children at risk of developmental delays and has a positive impact on brain maturation, as it takes place during the peak of neural plasticity from birth to three years of age. Since a delay in language acquisition is often the first sign of a developmental delay, speech-language therapists (SLTs) have a key role in developing communication skills through early communication intervention. A delay in the provision of ECI can negatively impact the success of services. During the Covid-19 pandemic, all routine healthcare services were disrupted. One clear strategy to reduce the spread of infectious diseases is the use of personal protective equipment (PPE) and infection prevention and control (IPC) measures. All healthcare workers (HCWs) involved in ECI should be aware of effective PPE and IPC measures to ensure the continuation of services in the event of future infectious disease outbreaks. Research aims: This research study aimed to identify and describe the PPE and IPC measures used by HCWs in ECI as reported in the existing international literature, using a scoping review (steps 1-5). In addition, South African stakeholders were consulted to investigate how SLTs who provide early communication intervention in the local context relate to the research findings (step 6 of the scoping review). Method: A scoping review was conducted in accordance with the PRISMA-ScR framework. A total of 14 studies, none of which were older than 10 years at the time of review, were included in steps 1-5 of the scoping review. Due to limited available literature on PPE and IPC measures used by SLTs in early communication intervention, the researcher included a consultation phase (step 6) which investigated the perceptions of South African SLTs with regard to the research findings. The consultation took the form of focus group discussions. A pilot study and main study were conducted involving altogether 17 clinicians. The data from steps 1-6 were analysed using numerical and thematic analysis. Findings: The scoping review of existing literature highlighted the need for infection control in ECI, as infants and toddlers are highly susceptible to infectious diseases. The main barriers to infection control in ECI included infrastructure and system challenges, poor IPC compliance, and a lack of HCW training. There was little reflection on the nature of care and behaviour of young children which can reduce the effectiveness of IPC measures (e.g., close physical contact, increased exposure to bodily fluids, and the reliance on caregivers). Stakeholders agreed with the research findings and reported additional challenges to using PPE and IPC measures in early communication intervention. These included face masks which reduced the quality of the SLTs’ speech signal and ability to provide visual cues as a therapy technique, as well as a lack of consideration for populations with special needs. There was an evident need for guidance on providing optimal early intervention services without reducing the effectiveness of IPC measures. Conclusion: This study described PPE and IPC measures available to HCWs providing ECI, including early communication intervention. Several challenges were identified which may reduce the effectiveness of early intervention services and/or IPC measures. An awareness and understanding of these challenges can benefit future research efforts which focus on improving ECI services whilst maintaining IPC standards.