Attitude And Practice Of Aseptic Techniques Amidst Health Workers Of Selected Primary Health Care Centers In Abuja

Attitude And Practice Of Aseptic Techniques Amidst Health Workers Of Selected Primary Health Care Centers In Abuja

Abstract

This study was carried out on the attitude and practice of aseptic techniques amidst health workers of selected primary health care centers in Abuja. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of health workers of selected primary health care centers in Abuja. In determining the sample size, the researcher purposefully selected 57 respondents and 50 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using mean scores and frequency tables. The result of the findings reveals that the level of health workers’ knowledge of aseptic practices techniques is to a certain extent low. The study also revealed that the level of healthcare workers knowledge on benefits of aseptic technique is low. Furthermore, the study showed that Health workers do not have a positive attitude towards aseptic techniques. Therefore, it is recommended that administrators in the healthcare system should formulate policies that will include all staffs to be actively involved in infection control programs in their respective hospitals.

Chapter One

Introduction

1.1 Background of the Study

An ancient record shows that antiseptic techniques date far back into history. The ancient Chinese, Persians and Egyptians had methods for water sanitation and antisepsis for wounds.

The ancient Greeks and Romans used silver vessels to restore fresh liquid and wine, settlers in the Australian use silver ware and pioneers of the American west put silver and copper coins in drinking water for the same purpose (Lois, 2013).

The modern concept of asepsis evolved in the 19th century. Ignazsemmelwe is showed that washing the hands prior to delivery reduced puerperal fever in the ward of vienna’s lying-in hospital.

After the suggestion Louis Pasteur, who proved that microorganism caused spoilage and could be transported via the air, placing booth in flasks with long shaped necks, after boiling the booths, observed that no microorganisms grew in the flask, then Joseph Lister began soaking his surgical dressings in carbolic acid (phenol) because he heard that carbolic acid has been used to treat sewage in Carlise and the fields that had been treated were now free of parasitic causing diseases, leading to a dramatic decrease in the number of post operational infections (Mokhoro, 2012).

Joseph Lister introduced the use of carbolic acid as an antiseptic and reduced surgical infection rates especially in 1870 when it saved the lives of many Prussian soldiers. Some countries like England and America were still in opposition to his germ theory though.

The turning point for Lister came on October 26, 1877 when he had the opportunity to perform a simple knee operation (wiring a fracture kneecap, which entailed deliberate conversion of simple fractured into a compound fracture), which often resulted in generalised infection and death.

The success of this operation forced people to accept that this method greatly added to the safety of operative surgery. The culmination of his emphasis on the principle of preventative medicine was the opening of the institute in 1981. These are a few of the reasons why Joseph Lister is often referred to as the ‘father of antiseptic surgery’ (Elana, 2012).

Furthermore, Pittet (2012) stated that Lawson Tait went from antisepsis to asepsis by introducing principles and the iconic statutes that have remained valid to this day.

He also identified Ernst Von Bergmann as the person who introduced the autoclave, a device used for practice of steam sterilization of surgical instruments under pressure.

He equally explained how the Arabian physicians in the middle ages used Mercury chloride to prevent sepsis in wounds by introducing hypochlorite and iodine as a treatment for open wounds in 1825 and 1839 respectively.

1.2 Statement of Problem

The operating room complex environment, including the nursing personnel, may play a role in the transmission of nosocomial infections; and therefore (DeLaune and Ladner 2008) state that nosocomial infections may be transmitted to the patient by the nursing personnel who fail to practise or carry out the sterile technique principles.

It is necessary to give careful attention to the creation and maintenance of a safe and acceptable therapeutic operating room complex environment in order to prevent the potential development of nosocomial infections, because the integrity of the patient’s skin is compromised during a surgical procedure.

The body’s largest and most important organ is the skin and its functional components are the cutaneous layer that includes the epithelium and the connective tissue.

The skin also includes structures in the cutaneous layer, such as the sweat and the sebaceous glands, hair and nails.
The cutaneous layer consists of two main layers which are known as the epidermis and the dermis. When a wound occurs, the skin and its components become involved in the healing process in other to restore the integrity of the skin (Mulder, 2012)

The intact skin plays an important role in the prevention of infection or disease because it is part of the body’s first line of defence against infection, involves good health and entails natural biochemical, mechanical as well as anatomic protection (Fortunato, 2009).

The source of pathogens for most wound infections is the endogenous flora of the patient’s skin, mucous membranes or hollow viscera. When the skin or mucous membranes are incised, the exposed tissues are at risk for contamination with endogenous flora (Mangram, 2009).

An aseptic technique must be used during any invasive procedure which breaches the body’s natural defences, for example the skin, mucous membranes, or when one is handling equipment which will enter a normally sterile area (Xavier, 2009).

Infection may also occur from the normal colonisation of the patient’s skin or it may enter the wound from dispersed bacteria in the air of the operating room, hence the rationale for using specialised air-conditioners to reduce potential infection.

Bacteria that are responsible for infections, such as wound infections, are introduced into the wound at the time of the surgical procedure and may only be noticed weeks after the surgical procedure (Fry and Fry, 2007).

In the practical situation, within the operating room, it is important to classify the degree of contamination of the surgical wound in order to determine whether the nosocomial infection was introduced within the operating room complex, because a clean site may become contaminated depending on the type of wound, the pathological findings, the anatomical location or a break in the aseptic technique (Fortunato, 2009).

Patients have a right to be protected from preventable infection and health workers have a duty to safeguard the wellbeing of their patients (King 2008).

An aseptic technique should be implemented during any invasive procedure that bypasses the body’s natural defences, e.g. the skin and mucous membranes, or when handling equipment such as intravenous cannula and urinary catheters that have been used during these procedures.

Whilst it is difficult to maintain sterility, it is important to prevent contamination of sterile equipment. Poor aseptic techniques can lead to contamination. By having the right attitude and high level of practice asepsis can be maintained.

It is observed that a nurses’ attitude towards hand washing compliance worsened when the demand for aseptic technique was high.

There are two significant problems that are found to influence the level of practice of aseptic technique which include poor practice areas with high intravenous therapy workloads, such as theatres and intensive care units, often seemed to demonstrate the poorest aseptic practice.

For instance, hand washing is often found to be poor, intravenous ports are often not cleaned and syringes are often re-used after being placed on the patient’s bed linen.

Secondly, the wrong attitude, included being a chief nursing officer rather that a sister nurse, being male; working in an intensive care unit (ICU); working during weekdays rather than weekends; wearing gowns and gloves; performing activities with high risk for cross infection; and having many opportunities for hand hygiene per hour of patient care.

All these affect the attitude health workers have towards aseptic technique. (Didier 2013)

Despite health workers educational background and training and continuous efforts made in the promotion of the practice of aseptic techniques, many health workers seems not to be performing it. This may be probably due to wrong attitude, inadequate knowledge and so on. It’s based on this submission that the researcher intends to carry out a research on the attitude and practice of health workers towards aseptic techniques.

1.3 Objectives of the Study

The overall aim of this study is to examine attitude and practice of aseptic techniques amidst health workers of selected primary health care centers in Abuja. Hence, the study will be channeled to the following specific objectives;

1. Ascertain the extent of health workers knowledge of aseptic practices techniques.
2. Asses the level of healthcare workers knowledge on benefits of aseptic technique.
3. Determine whether health workers have a positive attitude towards aseptic techniques.
4. Identify the factors affecting the practice of aseptic techniques by health workers.

1.4 Research Questions

The study will be guided by the following questions;

1. What is the level of health workers’ knowledge of aseptic practices techniques?
2. What is the level of healthcare workers knowledge on benefits of aseptic technique?
3. Does health workers have a positive attitude towards aseptic techniques?
4. What are the factors affecting the practice of aseptic techniques by health workers?

1.5 Significance of the Study

This study will be useful in correcting nurses’ attitude towards aseptic techniques and also to improve the practice of aseptic technique among health workers. The information provided will help nursing administrators in knowing area to address as continued education and seminars are organized for the nurses.

The result of this study will assist in nursing education as it provides information to guide the development of nursing curriculum and training courses related to attitude and practice of aseptic techniques.

This study will help the government to understand that practise of aseptic technique is of utmost importance hence the need to be involved in the provision of protective devices for all health workers

The important of the study to the nation is that it will help to reduce the high rate of cross infection from resulting into increased mortality rate. The significance of the study is that it will serve as a basis for further study to include all the doctors, nursing personnel and nursing students.

1.6 Scope of the Study

This study is structured to generally examine the attitude and practice of aseptic techniques amidst health workers of selected primary health care centers in Abuja. However, the study will further asses healthcare workers knowledge on benefits of aseptic technique, ascertain the extent of health workers knowledge of aseptic practices techniques, determine whether health workers have a positive attitude towards aseptic techniques, and identify the factors affecting the practice of aseptic techniques by health workers. The respondents for this study will be obtained from two(2) selected primary health care centers in Abuja.

1.7 Limitation of the Study

Like in every human endeavour, the researcher encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. More so, the researcher simultaneously engaged in this study with other academic work. As a result, the amount of time spent on research will be reduced.

1.8 Definition of the Study

Clinical Environment:

A clinical environment is a location where nursing practice takes place which includes direct patient care ranging from preventative care to chronic care to end of life care (Warshawsky & Havens 2011).

Hospital-Acquired Infections (HAIs):

Hospital-acquired infections formerly called nosocomial infections is defined as infections acquired in the hospital within 48 to 72 hours of hospitalization that were neither present nor incubating upon admission. Infections that present within 10 days after hospital discharge are considered as HAIs (Collins 2008:1).

Aseptic Technique:

Aseptic Technique as a set of specific practices and procedures performed under carefully controlled conditions with the goal of reducing microorganism and to protect patient from infection.

Chapter Five

Summary, Conclusion and Recommendation

5.1 Summary

In this study, our focus was on the attitude and practice of aseptic techniques amidst health workers of selected primary health care centers in Abuja. The study is was specifically carried out to asses healthcare workers knowledge on benefits of aseptic technique, ascertain the extent of health workers knowledge of aseptic practices techniques, determine whether health workers have a positive attitude towards aseptic techniques, and identify the factors affecting the practice of aseptic techniques by health workers.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 50 responses were validated from the enrolled participants where all respondent were health workers of selected primary health care centers in Abuja.

5.2 Conclusion

Based on the findings of this study, the researcher concluded that;

1. The level of health workers’ knowledge of aseptic practices techniques is to a certain extent low.
2. The level of healthcare workers knowledge on benefits of aseptic technique is low.
3. Health workers do not have a positive attitude towards aseptic techniques.
4. The factors affecting the practice of aseptic techniques by health workers include; inadequate facilities in the hospital, lack of supervision, lack of adequate man power, lack of knowledge of aseptic technique, lack of skill on the part of the health care provider, and poor attitude of nurses toward the use of aseptic technique.

5.3 Recommendation

Based on the responses obtained, the researcher proffers the following recommendations:

1. Administrators in the healthcare system should formulate policies that will include all staffs to be actively involved in infection control programs in their respective hospitals.
2. Strengthening and integrating universal precaution with routine services through provision of training and introducing health care workers infection prevention standard of practice, protocol, rules, and regulation are recommended. This will help to rise the knowledge of health workers on aseptic practice.

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Frequently Asked Questions

Where is aseptic technique used in healthcare?

Healthcare workers use aseptic technique in surgery rooms, clinics, outpatient care centers, and other health care settings. What is aseptic technique used for? Following aseptic technique helps prevent the spread of pathogens that cause infection. Healthcare professionals commonly use aseptic technique when they’re:

Is there an aseptic approach for Community Practitioners?

Such an approach has been advocated for community practitioners. The performance of an aseptic technique is an under-researched area.

What percentage of aseptic procedures are preventable?

Aseptic technique outcome The outcome of aseptic technique depends on whether all healthcare professionals thoroughly follow all procedures. According to the Journal of the American Medical Association (JAMA) Internal Medicine, 50 percent of HAIs are preventable. Healthcare professionals are responsible for following clean and aseptic techniques.

Are nurses involved in the aseptic technique in operation theatre?

This person is not on ResearchGate, or hasn’t claimed this research yet. Introduction: The nurses are involved in major part of patient care; they are thus important target population to determine their level of knowledge and practice of aseptic technique in the operation theatre.

Which safe practice is part of using aseptic technique?

Which safe practice is part of using aseptic technique? using a safety shower to wash chemicals off skin and clothing wearing protective gloves when transferring bacteria and fungi to slides folding and tying up the electric cord of a microscope before carrying it using tongs and a hot mitt to remove a beaker of hot water from a hot plate

Are practitioners expected to solve the aseptic technique’s problems?

In particular, practitioners were just expected to develop their own solutions to the problems presented by the performance of the aseptic technique within a community setting.

Should community practitioners maintain the principles of asepsis in wound care?

Background: Maintaining the principles of asepsis when performing wound care and other invasive procedures is one of the fundamental approaches of preventing healthcare-acquired infection. Such an approach has been advocated for community practitioners. Literature: The performance of an aseptic technique is an under-researched area.

Do community nurses have a fatalistic view of the aseptic technique?

This study has highlighted that some community nurses do not have a fatalistic view about the performance of the aseptic technique in a community setting. However, while staff are aware of the principles of asepsis, contamination of the sterile field and gloves during the procedure is commonplace.

Are there solutions to performing asepsis in a community setting?

The community nurses in this study had developed solutions to performing the technique in a community setting. Although many of these solutions demonstrated adherence to the principles of asepsis, there was a risk that practice could become idiosyncratic in nature.

Why do hospitals use aseptic technique?

To protect patients from harmful bacteria and other pathogens during medical procedures, healthcare providers use aseptic technique. Aseptic technique means using practices and procedures to prevent contamination from pathogens. It involves applying the strictest rules to minimize the risk of infection.

What are the 4 types of aseptic techniques?

Aseptic technique types According to The Joint Commission, there are four chief aspects of the aseptic technique: barriers, patient equipment and preparation, environmental controls, and contact guidelines. Each plays an important role in infection prevention during a medical procedure.

What is the difference between sterile technique and aseptic technique?

The strictest form of aseptic technique, sterile technique is intended to provide a space that has no germs whatsoever. Sterile technique is used in surgeries and other large, invasive procedures where infection could be the most dangerous. It requires a sterile room, gloves, gowns, caps tools, and masks, along with handwashing and aseptic fields.

Should ORS adopt principles of aseptic technique?

As one person noted, “All OR personnel and physicians should adhere meticulously to the principles of aseptic technique. Get back to the basics spelled out in the AORN standards.”

Why do hospitals use aseptic technique?

To protect patients from harmful bacteria and other pathogens during medical procedures, healthcare providers use aseptic technique. Aseptic technique means using practices and procedures to prevent contamination from pathogens. It involves applying the strictest rules to minimize the risk of infection.

What is the level of knowledge on aseptic technique?

Conclusion: The level of knowledge on aseptic technique is statistically significant (p=0.031) with the age and educational qualification of the respondents. Content may be subject to copyright. !

How is asepsis maintained in the operating room?

Asepsis in the operating room or for other invasive procedures is also maintained by creating sterile surgical fields with drapes. terile drapes are sterilized linens placed on the patient or around the field to delineate sterile areas.

What are the four aseptic techniques used in catheterization?

When healthcare providers insert a catheter, they demonstrate all four aseptic techniques in action: Barriers: They wear sterile gloves. Patient and equipment preparation: They open sterile packaging that contains the sterile catheter. They prepare the patient’s skin with a special solution.