Knowledge Of Risk Factors And Prevention Of Nosocomial Infections Among Nurses And Patient In Nnamdi Azikiwe Teaching Hospital Nnewi

Project and Seminar Material for Nursing (Science)

Knowledge Of Risk Factors And Prevention Of Nosocomial Infections Among Nurses And Patient In Nnamdi Azikiwe Teaching Hospital Nnewi (Charles)


Abstract


This study was carried out to examine the knowledge of risk factors and prevention of nosocomial infections among nurses and patient in Nnamdi Azikiwe teaching hospital Nnewi. The study was carried out to assess the knowledge of nurses and patients on the risk factors associated with nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi, assess the knowledge of nurses and patients on the measures for preventing nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi, and assess the knowledge of nurses and patients on the need for maintaining healthy preventive practices towards nosocomial infection among health care workers in Nnamdi Azikiwe teaching hospital Nnewi. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprised of nurses and patient in Nnamdi Azikiwe teaching hospital Nnewi. In determining the sample size, the researcher purposefully selected 147 respondents and 141 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses was tested Chi-square statistical tool. The result of the findings reveals that the risk factors associated with nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi includes: excessive or improper use of broad-spectrum antibiotics, age, use of H2 receptor antagonists, and acute physiology and chronic health evaluation. Furthermore, the study revealed that there is need for maintaining healthy preventive practices towards nosocomial infection among health care workers in Nnamdi Azikiwe teaching hospital Nnewi because it prevent viral transmission of diseases within health facilities, it prevent transmission of pathogenic microorganisms, it decreases Patient susceptibility, it eliminates Patient susceptibility, and it contributes to health status of medical practitioners. Therefore, it is recommended that the minister of health to lobby for sufficient funds from the government so that the permanent secretary can allocate enough resources specifically for infection prevention and control. To mention but few.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background of the Study

Hospital-acquired infection (HAI) is one of the common problems and difficulties faced by hospitals in all countries around the world. The fact that health is wealth does not exclude health workers even though they are professionally shouldered with the responsibilities of providing health care to the people. Adequate knowledge of health-care associated infections and some measures to curb the festering of such ailments among health workers and patients will surely bring to the fore the professional acumen and improve the efficacy of health administration and better the lots of the society (Reinhart, Daniels, Kissoon, Machado, Schachter, & Finfer, (2017).

Nosocomial infections are a major public health problem globally and are on the increase despite efforts in hospital infection control measures and contribute significantly to morbidity and mortality (Mbim et al.., 2016). Hospital-acquired infections are also known as nosocomial infections (Khan, Ahmad, & Mehboob, 2015).

According to World Health Organization (2010), Hospital acquired infection is defined as an infection occurring in a patient during the process of care within a health care facility that was not present or incubating at the time of admission. These infections are those acquired after 48 hours of patient’s admission (Alrubaiee et al., 2017). Invasive devices such as catheters and ventilators employed in modern health care are associated with these infections (Centers for Disease Control and Prevention, 2016).

Risk factors include lack of proper health care facilities such as isolation units, sinks and bed space; inappropriate waste management, contaminated equipment, inappropriate use of antibiotics and transmission of infection from the hands of healthcare workers and family caretakers due to inadequate hand hygiene practice (Shahida et al., 2016).

In hospitals, health workers are responsible for and perform procedures like medication administration, wound dressing, sterilization and disinfection. They are more involved in more contact with patients than other health care workers. Therefore, they are more exposed to various nosocomial infections (Shinde & Mohite, 2014). Hence, nurses play a vital role in transmitting nosocomial infections, and their compliance with infection control measures seems to be necessary for preventing and controlling nosocomial infections (Sarani et al., 2015).

Accordingly, the nurses and other health care workers as well as the patients should be aware of how to prevent transmission of nosocomial infections and be knowledgeable of its potential risk to patients, family members and the community at large (Chan-Yeung, 2004).

Inadequate knowledge and poor infection prevention and control practices among health workers and patients may increase the rates of hospital-acquired infections (Shahida, Islam, Dey, Islam, Venkatesh, & Goodman (2016). In clinical practice, the researchers observed cases where health workers handle contaminated linen with bare hands, put needles in the patient’s mattress after giving injections, do not clean the stethoscope after each patient contact and do not wash hands regularly in the clinical environment.


1.2 Statement of the Problem

Regardless of the advances in public health and hospital care, infections continue to emerge in hospitalized patients, threatening the quality and outcomes of health care delivery. According to Adjugah & Ordinioha (2018), little information and inadequate infection prevention and control techniques among health personnel has raised the prevalence of hospital-acquired infections. Mbim, Mboto, & Agbo (2016) averred that although Hand hygiene is the single most critical intervention for preventing illness transmission and should be a quality standard in all health care facilities, there are numerous situations in clinical practise when health personnel handle contaminated linen with bare hands, place needles in the patient’s mattress after providing injections, do not clean the stethoscope after each patient interaction, and do not wash hands on a regular basis. Melaku, Temesgen & Nega et’al (2018) submits that antibiotic abuse is on the rise in hospitals and overuse antibiotics has allowed multi-drug-resistant organisms to thrive, which can transmit Health Care Acquired Infections (HCAIs). Therefore to combat this threat, infection control measures must be implemented in order to minimize morbidity and mortality associated with HCAIs, standard guidelines based on evidence-based care have been developed to establish worldwide standards for effective infection control among healthcare workers (WHO 2019).

Conversely, many studies have revealed disparities in infection awareness, prevention, and control. Various studies have demonstrated that the benefits of successful infection control techniques range from improved morbidity and mortality to disease prevention and cost-effective healthcare(Saidu, Habu, & et’al. 2015).

Despite the abundance of research on Hospital Acquired Infections, impoverished nations such as Nigeria have been estimated to have up to 20 times the risk of obtaining a nosocomial infection when compared to wealthy countries (World Health Organization 2019). Thus, spread of infection serves as a major source of worry for health care practice, particularly in developing countries where the health care system is already overstretched. Therefore, this study seek to assess the knowledge of risk factors and prevention of nosocomial infections among nurses and patient in Nnamdi Azikiwe teaching hospital Nnewi.


1.3 Objective of the Study

The overall aim of this study is to critically assess the knowledge of risk factors and prevention of nosocomial infections among nurses and patient in Nnamdi Azikiwe teaching hospital Nnewi. Hence, the study will be channeled to the following specific objectives;

  1. Assess the knowledge of nurses and patients on the risk factors associated with nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi.
  2. Assess the knowledge of nurses and patients on the measures for preventing nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi.
  3. Assess the knowledge of nurses and patients on the need for maintaining healthy preventive practices towards nosocomial infection among health care workers in Nnamdi Azikiwe teaching hospital Nnewi.

1.4 Research Questions

The following research question will guide the study:

  1. What are the risk factors associated with nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi?
  2. What are the measures for preventing nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi?
  3. What are the need for maintaining healthy preventive practices towards nosocomial infection among health care workers in Nnamdi Azikiwe teaching hospital Nnewi?

1.5 Research Hypotheses

  • Ho: The level of knowledge of nosocomial infection among health care workers and patients in Nnamdi Azikiwe teaching hospital Nnewi is low.
  • Ha: The level of knowledge of nosocomial infection among health care workers and patients in Nnamdi Azikiwe teaching hospital Nnewi is high.

1.6 Significance of the Study

Infection-related diseases are still the main cause of morbidity and mortality in tertiary hospitals in Rivers State, Even with regular infection control training in the hospital, gaps have been identified in knowledge and practice of infection control among doctors and nurses. Findings of this study will be of significance to hospitals, other medical facilities, healthcare workers and patients. The study will emphasize on the need for health facilities to prioritize health care delivery as Nurses with inadequate knowledge, bad practices in infection control and prevention, jeopardize the safety of the patient. Furthermore NCDC will benefit from the nosocomial infection study due to the timeliness to be able to contain and issue standard policy guidelines on Hospital Acquired Infections by this therefore preparedness in infection prevention and control measures is strengthened. More so, the study will acquint healthcare workers with efficient knowledge, good attitude and best practices by the nurse in infection prevention and control which in turn contribute to decreasing in infection rate in the hospital. Finally, the study will contribute to empirical body of knowledge on Hospital-acquired infection (HAI) and serve as reference material to student and scholars who wishes to conduct further studies in related field.


1.7 Scope of the Study

The scope of this study borders the knowledge of risk factors and prevention of nosocomial infections among nurses and patient. The study will be delimited to Nnamdi Azikiwe teaching hospital Nnewil.


1.8 Limitation of the Study

As every human endeavor is once faced with a constraint, the same was tenable during the period of this study. In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed.  More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other tertiary institutions in other , states, and other countries in the world.


1.9 Definitions of Terms

Nosocomial Infection:

Nosocomial infection is an infection or toxin that exists in a certain location such as a hospital, now Nosocomial infections is use interchangeably with the terms health-care associated infections and hospital-acquired infections.

Prevention:

Prevention is an action taken to decrease the chance of getting a disease or condition. For Nosocomial infection it includes fully disinfecting skin and equipment, washing hands regularly, wearing protective equipment like face masks and gloves. regularly changing urinary catheters, and removing them as soon as possible, removing hair near a surgical area and prescribing antibiotics only when needed.

Control:

In health care and public health practice settings, infection control includes various measures that prevent and contain the spread of infectious disease. For nasocomail infection this includes maintaining a safe, clean, hygienic hospital environment, screening and categorizing patients into cohorts, public health surveillance and following patient safety guidelines.


1.10 Organizations of the Study

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.


Chapter Five


Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the knowledge of risk factors and prevention of nosocomial infections among nurses and patient in Nnamdi Azikiwe teaching hospital Nnewi. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was to examine the knowledge of risk factors and prevention of nosocomial infections among nurses and patient in Nnamdi Azikiwe teaching hospital Nnewi. The study specifically was aimed to assess the knowledge of nurses and patients on the risk factors associated with nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi, assess the knowledge of nurses and patients on the measures for preventing nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi, and assess the knowledge of nurses and patients on the need for maintaining healthy preventive practices towards nosocomial infection among health care workers in Nnamdi Azikiwe teaching hospital Nnewi.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondents are nurses and patient in Nnamdi Azikiwe teaching hospital Nnewi.


5.3 Conclusions

Based on the findings of this study, the researcher made the following conclusion.

  1. The risk factors associated with nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi includes: excessive or improper use of broad-spectrum antibiotics, age, use of H2 receptor antagonists, and acute physiology and chronic health evaluation.
  2. The measures for preventing nosocomial infection in Nnamdi Azikiwe teaching hospital Nnewi includes: washing of hands before and after direct contact with the patients, putting on a mask and glasses when performing invasive and body fluid procedures, recapping needles after use and before disposal, following aseptic techniques strictly, and screening patients to detect colonization even if no evidence of infection.
  3. There is need for maintaining healthy preventive practices towards nosocomial infection among health care workers in Nnamdi Azikiwe teaching hospital Nnewi because it prevent viral transmission of diseases within health facilities, it prevent transmission of pathogenic microorganisms, it decreases Patient susceptibility, it eliminates Patient susceptibility, and it contributes to health status of medical practitioners.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

  1. The Minister of Health to lobby for sufficient funds from the government so that the Permanent Secretary can allocate enough resources specifically for Infection Prevention and Control.
  2. Resources should be allocated for Infection prevention and control conferences locally and internationally.
  3. Nursing schools should emphasize the importance of infection prevention and control (Hospital acquired infections) in the syllabus.
  4. The General Nursing Council of Nigeria should continue to emphasize on the introduced a Continuous Professional Development Booklet for Nurses.
  5. Training on infection prevention and control be mandatory yearly and that it should be a requirement for yearly nursing registration.

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