ASSESSMENT OF STUDENT NURSE’S KNOWLEDGE ON THE PREVENTION AND CHALLENGES FACED IN THE MANAGEMENT OF NOSOCOMIAL INFECTION AT THE BUEA REGIONAL HOSPITAL

Abstract

Nosocomial Infection is a localized or systemic infection acquired in a hospital or any Other Health care facility by a patient admitted for a reason other than the pathology present during Admission it may also include an infection acquired in a healthcare facility that may manifest 48 Hours after the patient’s admission into the health care facility .

A cross-sectional design amongst nursing students in the Buea. Regional Hospital with a sample population of 100 Students who were recruited through a Simple random sampling technique it has a general objective to assess student Nurses knowledge on the prevention of Nosocomial infection and the challenges faced in the management of Nosocomial infection at Buea Regional Hospital .

The specific objective were To assess nursing students knowledge on Nosocomial infection also To assess nursing students knowledge on the prevention of Nosocomial infection at the Buea Regional Hospital and to assess the challenges faced by the nursing students in the management of Nosocomial infection .

The instrument for data collection was a structured questionnaire which was administrated to 130 nursing students by convent sampling The study realized that with regards to knowledge on nosocomial infection, 98% of the participants had adequate knowledge while 2% had poor knowledge.

This study also shows that 60(60%) of respondents said they always wash hand after contact with patients while 1(1%) said he/she rarely wash hands. Again, 52(52%) said they always wear protective devices when handling linen while 3(3%) said they rarely wear protective devices. Further 54(54%) said they always follow aseptic techniques while 1(1%) said he/she never follows asepsis.

Also, 48(48%) said they wear mask and glasses during invasive procedures while 4(4%) said they never wear mask nor put on glasses during invasive procedures.

This study will go a long way to improve the knowledge of student nurses on Nosocomial infection , It will help advance knowledge through the development of scientific theories, concept and ideas and also this study will help improve the researcher’s skills in research writing and also improve her knowledge on Nosocomial infection.

CHAPTER ONE
INTRODUCTION

1.1 Background of Study

According to W E Scheckler, in the United States, the hospital discipline of infection control response was established in the 1950s in to a nationwide Epidemic of nosocomial Staphylococcus aureus and the recognition of the need for nosocomial infection surveillance.

As a concept, however, the epidemiology and Prevention of infection has its roots in a time prior to the understanding of the germ Theory of disease (W E Scheckler et al. ,2000). In 1846 Semmelweis, a Hungarian physician, noted that the Mortality from childbed fever among women who had babies delivered by midwives Was lower than among mothers with babies delivered by physicians.

After in-depth Analysis of differences between the groups, Semmelweis concluded that the high Rate of childbed fever was caused by cadaverous materials on the hands of medical Students who came to the obstetric clinic directly from the autopsy chamber. A Policy of hand washing in chlorinated lime solution before maternal contact was Instituted, and the mortality rate among mothers cared for by physicians Dropped (Kadar N ., 2019). John Snow, a British physician, applied statistics and epidemiologic Approaches to determine and eradicate the source of a cholera outbreak in 1854 in London.

The scientifically study of nosocomial began in Scotland during the first half of the 18th century and from that time until the start of the bacteriological era(AA FURDER 2007).100 years later in 1950s in Hungary Nosocomial infection and the importance of its prevention was discovered by Dr Ignaz Semmelweis who discovered the effects of hand washing(Heidi Reddevior ,2010). In 1858 Florence nightingale promote the case if hospital cleaning flowed by discovery of Pasteur, Kosh and leister (smith pw et,al 2021).

Nosocomial Infection is a localized or systemic infection acquired in a hospital or any Other Health care facility by a patient admitted for a reason other than the pathology present during Admission it may also include an infection acquired in a healthcare facility that may manifest 48 Hours after the patient’s admission into the health care facility or discharge(W.H.O,2002).

Epidemiological studies report that nosocomial infections are caused by ubiquitous pathogens such as bacteria (Lepelletier et aI., 2005),viruses (De-Oliveira et al.,2005) and Fungi (Trick et aI., 2002).present in air, surfaces or equipment. The pathogens are not present or Incubating prior to the patient’s admission into healthcare facility and are most likely Transmitted by Direct person-to-person contact during invasive medical procedures (Starfield ,2000) .

According to (Asian pacific journal of tropical biomedicine 5 ,2015 )Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected Individuals, contaminated healthcare personnel’s skin or contact via shared items and surfaces. Journal of Hospital Infection (62 ,2006) stated that As most nosocomial infections are thought to Be transmitted by the hands of healthcare workers, hand washing is considered to be the single Most important intervention to prevent nosocomial infections. However, studies have shown that Hand washing practices are poor, especially among medical personnel.

According to African journal of clinical and experimental microbiology (African journal .2010) stating that Nosocomial infection is a recognized public health problem world-wide with a prevalence rate of 3.0-20.7% and an incidence rate of 5-10%. It has become increasingly obvious that infections acquired in the hospital lead to increased morbidity and mortality which has added noticeably to economic burden.

British Microbiology Research Journal 15 ( 2016) shows that In sub-Saharan Africa 2-49% patients in intensive care units have the highest rate ranging from 21.2-35.6%The prevalence of nosocomial infections have been reported to vary between 1.6%-28.7% in Burkina Faso, United Republic of Tanzania, Ghana, Mali, Cameroon, Gabon, Uganda, Burundi, Democratic republic of Congo and Senegal.

In Nigeria and Ethiopia, the total accruing occurrence in surgical wards has been reported to vary from 5.7%-45.8% with the later having an incidence as high as 45.8% and an incidence density equal 26.7 infections per 1000 patient days in pediatric surgical patients.

In Africa a prospect study was carried out in the Albert Schweitzer Hospital, Lambaréné, Gabon. All patients admitted to the departments of surgery, gynecology/obstetrics and internal medicine were screened daily for signs and symptoms of hospital-acquired infections.

A total of 2925 patients were screened out of which 46 nosocomial infections (1.6%) were diagnosed. These comprised 20 (44%) surgical-site infections, 12 (26%) urinary-tract infections, 9 (20%) bacteraemias and 5 (11%) other infections. High rates of nosocomial infections were found after hysterectomies (12%) and Caesarean sections (6%). Most frequent pathogens were Staphylococcus aureus and Escherichia coli. (Katrin koster et al, abraham Alabi et al,.2014).

In Cameroon a research has been carried out on the prevalence of Nosocomial infection at the Yaoundé university teaching hospital on 307 patients and it was descriptive study targeting hospitalized patients at the intensive care unit, surgical unit and neonatal unit the mortality and incident rate was,19.21% (16.9–21.5) and 28% (16.2–42.5)respectively, septicemia (20.34%), infection of the skin and soft tissues (20.34%)and urinary tract infections(15.25%) were the most frequent type of Nosocomial Infection .(Bonaventure jemea et al., 2016).

The environmental theory of Florence nightingale at the 2nd half of the 19th century in England focused on the fact that a healthy environment was fundamental for healing. That is a nurse or student nurse can reduce Nosocomial infection by making use of their waste management practices and also they can assist with the hand washing procedure by washing their hands before and after attending to a patient

1.2 Statement of problem

Nosocomial infections have been recognized as a problem affecting the quality of health Care and a principal source of adverse healthcare outcomes. It has been documented in the Literature that within the realm of patient safety, these infections have serious impact. Increased hospital stay days, increased costs of healthcare, economic hardship to patients And their families and even deaths, are among the many negative outcomes ( Starfield et aI.,2000 , Angus et aI., 2001).

With respect to my clinical experience at the hospital where I was sent to do a bed bath to a bed ridden patient in comma on carrying out the procedure I noticed She had developed a 3rd degree bed sore which was as a result of her lying on one position for long without changing her position this was due to the fact that her care takers didn’t have adequate knowledge which lead to her death.

Also, I witness a cases where an Indwelling urinary catheter was been set in a man’s penis upon removal of the catheter the Nurse observed that it has been infected causing a serious problem. This made me to carry out this research titled ‘Assessment of student Nurses knowledge on the prevention and challenges faced in the management of Nosocomial infection at the Buea Regional Hospital”.

1.3 Objectives