AN INVESTIGATION ON THE PRACTICES OF ASEPTIC TECHNIQUE ON SURGICAL WOUND DRESSING BY HEALTH CARE PRACTITIONERS IN HEALTH FACILITIES IN MAMFE TOWN

Abstract

Surgical site infections remain increasingly the major cause of nosocomial infections despite improvements in the operating room, sterilization methods, better surgical technique and best efforts of infection prevention. The general objective of the study was to assess the level of knowledge on the practice of aseptic technique on surgical wound dressing by health care practitioners in health facilities in Mamfe Town.

This study was a hospital base study in which a descriptive cross sectional research design method was used. Well-structured questionnaire of open and closed ended questions were used and it was carried out from January to March. A convenient sampling method was used to collect data from four health facilities.

Data collected was analysed both manually and electronically(using Microsoft excel)After data collection from four selected health Institutions in Mamfe Town, findings revealed that 75% of respondents  had adequate knowledge on the practice of Aseptic technique on surgical wound dressing, 25%had knowledge on the practice,65%had adequate knowledge on the factors affecting the practice of aseptic technique during wound dressing. It was concluded that most health care practitioners had adequate knowledge on the practice of aseptic technique.

CHAPTER ONE
INTRODUCTION

1.0 Background Of Study

Despite improvements in operating room practices, instrument sterilization methods, better surgical technique and the best efforts of infection prevention by health practitioners, surgical site infection (SSI) remains increasingly the major cause of nosocomial (hospital acquired) infections globally.(Owolabi, 2015).

Infections are a major source of morbidity and cause of mortality during the postoperative phase for patients. Wound infections are the second most commonly encountered type of nosocomial (hospital acquired infection) in the United states (Nicholas,2017) knowing the fact that wound infection may be induced by not practicing enough infection control measures and sterile techniques in the operating theatre, it is essential to implement infection control principles and apply sterile technique principles. From this, we understand that aseptic technique is a prime importance in the operating theatre which includes mainly hand hygiene, gowning and gloving.

Mangram et al (1999) suggests that adherence to the sterile technique principles by sterile surgical team members such as the anesthetist, must be observed as it is the foundation of the prevention of nosocomial infection and contamination of wounds by potentially pathogenic micro-organisms.

Fry and Fry claimed that preoperative nurses play an important role as the patient’s Infection control advocate.

Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes; previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses (Shuying et al., 2017).

Aseptic technique is any procedure performed under sterile conditions which protects the patient from the impact of associated health care infections (delayedrecovery,longer hospitalization, increased pain and increased morbidity.(Ayliffe et al 2000).

1.1 Statement Of The Problem

It is estimated that 4.5 to 5.7 billion people are affected with surgical site infection(SSI) per year due to lack of aseptic technique practices in the hospital (Infection control and Hospital Epidemiology 2013)Journal of Chicago. Approximately 9% of Indian Hospital patients acquire health care associated infections especially postoperative infections and as a result,5000-15000 die every year. It also recommended the importance of improving the knowledge  and practice of aseptic technique amount  theatre nurses.

National Surveillance service (2002)conducted a survey for health care workers in the UK reported 2351 cases of wounds infection. Out of these,44%of infections occur due to lack of knowledge on aseptic procedures,29% due to lack of time and 28% due to shortage of staffs.

According to Centers for disease control and Prevention (CDC), about 500000 surgical site Infections occur annually and account for 3%of surgical mortality, prolonged lengths of hospital stay and increased medical cost (Diaz and Newman, 2015).

Poor adherence to aseptic techniques(AT) results in Considerable morbidity and mortality. Even in countries with well-established infection control programs, Hospital Acquired Infections(HAI)related to poor Compliance with aseptic techniques is an important Public health Problem.

Data on surgical site infection is not available in Cameroon, however, infection Control is a very Challenging problem to the public health sector with corresponding hospital acquired infections(HAIs)10 to 20% from a Cameroon Public health report in September 2008.Moreover,an important aspect of nursing care is to improve on patient care by minimizing infection and ensuring patient’s wellbeing and this can be achieved by applying the principles of aseptic techniques during nursing procedures.

According to the American Journal of health, (2016), data for SSI in Africa is sparse and incidence is estimated to range from 2.5 to 30.9%. During one of my internships in a health institution in Mamfe town, observed a nurse dressing a surgical wound with bare hands and no hand washing, I was baffled as to why he could taken such a risk. Consequently, I was eager to know more about AT and to find out nurses knowledge on the practice of AT in mamfe town health facilities. It is therefore against this backdrop

that the researcher writes on “An Investigation on the practice of Aseptic technique on surgical wound dressing by health care practitioners in Mamfe Town Health Institutions” So to reiterate on the fact that aseptic technique needs to be properly practiced in order to reduce the occurrence of SSIs.

 1.2 Hypothesis.

Health care Practitioners with knowledge on the practice of aseptic technique will better prevent wound infection.

1.3 Objectives

1.3.1 General Objective.

To assess the level of knowledge on the practice of aseptic technique on surgical wound dressing by health care practitioners in Mamfe Town Health Institutions.

1.3.2 Specific Objectives.

1. To assess nurse’s knowledge on the practice of aseptic technique on surgical wound dressing.
2. To identify the factors that affects the practice of aseptic technique during wound dressing by health care practitioners in Mamfe Town.