Role Of Education And Training In Promoting Infection Control Practices Among Nurses Staff

Introduction

1.1 Background of the Study

Health care professionals are constantly exposed to microorganisms. Many of which can cause serious or even lethal infections (Twitchell, 2003). Nurses in particular are often exposed to various infections during the course of carrying out their nursing activities ( Kosgeroglu, Ayranci, Vardareli, & Dincer, 2004).Hospital-acquired infections (HAIs) are a worldwide problem. These infections are associated with delivery of care in contrast to infections that are present at the time of care and are leading cause of death and morbidity among patients receiving health care.[1] HAI is defined as a localized or systemic infection acquired in a hospital or any other health-care facility by a patient admitted for a reason other than that infection. It may also include an infection acquired in a health-care facility that may manifest 48 h after the patient’s admission into the health-care facility, 3 days after discharge, or 30 days after a surgical operation. The pathogens should not be present or incubating prior to the patient’s admission into health-care facility. HAIs add to functional disability and emotional stress of the patient and may in some cases, lead to disabling conditions that reduce the quality of life.[2] A study conducted at National Health Service hospitals in England estimated that approximately 0.32 million patients per annum acquire one or more HAI which add to a burden of 930.62 million pounds per year.[3] Surveys on the incidence of HAIs have shown that 5%–10% of all hospitalized patients are affected by these infections.[4] In the United States, HAIs were found to be responsible for significant morbidity and nearly 80,000 deaths annually.[5,6] The most common types of hospital-acquired infections are pneumonias, urinary tract infections, respiratory tract infections, surgical site infections, and bloodstream infections.

There are many causes of HAIs, but they are most commonly caused by contaminated hands of health-care workers, contaminated medical devices, and failure of staff to comply with procedures and guidelines. Unfortunately, not all HAIs can be prevented, but with good practice and careful hygiene, the incidence of HAIs can be reduced. Poor compliance with recommended infection control guidelines by health-care personnel is one of the main reasons for the transmission of pathogens.[7] The pathogens may be transmitted from one patient to another by way of health-care workers who have not washed their hands or health-care workers who do not practice hand disinfection, glove use, etc.[8] Although Semmelweis demonstrated more than a century ago that handwashing itself was sufficient in reducing the incidence of health-care-associated infections, compliance of health-care workers with the recommended handwashing practices remains low.[9,10] The spread of multidrug resistant pathogens has not still compelled health-care workers to adopt recommended infection control practices.[11]

Nurses are the largest group in the health-care system. They provide services in hospitals 7 days a week round the clock for the full year and work in close relation to patients. Nurses aim to provide complete nursing care to the patients with respect to promotion of health and well-being, prevention of various diseases, and healing nursing care to the patients in a health-care organization and the community. The nursing professionals are the foundation of any quality-related program in a hospital since they monitor and deliver almost all the health-care activities. Nurses working in different areas of a hospital play an important role in the prevention of HAIs.

Earlier studies have shown poor compliance among nurses regarding infection control practices.[12,13] Hence, a huge emphasis is currently being laid on educating and training health-care workers, especially nurses, to reduce HAIs. The knowledge and attitude of nurses can make a considerable positive difference in the delivery of health care. Studies claim continuing education to have resulted in an improvement in nurses’ professional behavior and knowledge with respect to patient care activities.[14] Continuing education for nurses is also necessary for them to remain up to date with latest practice issues, perform competently, and respond positively to advanced medical and technology changes and this is also necessary for patient safety as well. Thus, keeping in mind the importance of nurses in prevention of HAI as well as importance of educational intervention in influencing the nurses’ behaviour regarding infection control practices, we planned our study.

1.2 Statement of the 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 (Klevens, Edwards, Richards, Horan, Gaynes, Pullock, &Cardo, 2007; Kaye, Anderson, Sioanne, Chen, Choi, Link, Sexton, &Schmader, 2009). A systematic review of published literature on costs attributable to nosocomial infections among only 28 community hospitals in southeastern region of U.S. over a one-year period, revealed that the annual cost associated with nosocomial infections exceeded $26 million (Anderson, Kaye, Chen, Schmader, Choi, Sloan, &Sexton, 2009). These findings are indicative of the enormous economic burden associated with nosocomial infections. Findings from several epidemiological studies reveal that healthcare workers such as physicians, dentists and nurses are implicated in the transmission of nosocomial infections. It has also been reported that transmission frequently occurs during the performance of medical procedures, when these healthcare workers fail to follow aseptic precautions. Thus, noncompliance with recommended guidelines by healthcare workers expose patients to an abundance of pathogens (Racco &Hom, 2009; Eriksen, Saether, Vangen, Hjetland, Lundmark, &Aavitsland, 2009; Costello, Graham, Morrow, Morrow, Potter-Bynoe, Sandora, Pigula, &Lausse, 2010).

1.3 Objectives of the Study

The primary objective of this study is to examine the role of education and training in promoting infection control practices among nurses staff. Specifically but not limited to, other objectives of this study are:

Ascertain the attitude of nurses towards infection control practices.

Determine whether education and training programmes can promote effective infection control practices among nurses.

Find out whether education and training programmes are organized to promote infection control practices among nurses.

Ascertain the effectiveness of the education and training programmes aimed to promote infection control practices among nurses in Federal Medical Centre in Asaba.

1.4 Research Questions

The following research question will guide the study:

What is the attitude of nurses towards infection control practices?

Can education and training programmes promote effective infection control practices among nurses?

Are education and training programmes organized to promote infection control practices among nurses?

How effective of the education and training programmes aimed to promote infection control practices among nurses in Federal Medical Centre in Asaba?

1.5 Research Hypotheses

Ho: The education and training programmes aimed to promote infection control practices among nurses in Federal Medical Centre in Asaba is not effective.

Ha: The education and training programmes aimed to promote infection control practices among nurses in Federal Medical Centre in Asaba is effective.

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 on role of education and training in promoting infection control practices among nurses staff. By extension the study tends to ascertain the attitude of nurses towards infection control practices, determine whether education and training programmes can promote effective infection control practices among nurses, find out whether education and training programmes are organized to promote infection control practices among nurses, and ascertain the effectiveness of the education and training programmes aimed to promote infection control practices among nurses in Federal Medical Centre in Asaba. However The study will be delimited to Federal Medical Centre in Asaba, Delta State.

The respondents for this study will be obtained among nurses in Federal Medical Centre in Asaba, Delta State.

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 Operational Definitions of Terms

Infection

The capability of microorganisms to enter or invade the underlying tissues of the human body and discover conducive conditions that can facilitate its growth, survival and replication.

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.

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.