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Knowledge and Practice of Standard Precaution among Nurses (PDF)


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Knowledge and Practice of Standard Precaution among Nurses

Abstract

The practice of standard precautions among Health Care Workers (HCWs) in public health facilities in Akwa Ibom State, Nigeria was evaluated.

A cross-sectional survey of 277 HCWs was conducted using a structured questionnaire. Of 277 participants, 83(29.96%) were doctors; 194(70.04%) were nurses.

Median age (years) of doctors was 34(IQR: 30, 39), while nurses was 39(IQR: 33; 45). Median years of experience for doctors was 7(IQR: 4; 10) while nurses was 15(IQR: 9; 20). 16.61% participants had knowledge of the basic concept of standard precautions. 42.24% knew potential sources of occupational exposure.

The association between the knowledge and area of practice was significant (p=0.011). 97.46% practiced hand washing; 97.83% reported regular use of hand gloves; 88.44% use gown or plastic apron; 68.95% use masks and eye protector.

The major factor reported for non-adherence was non-availability of the materials. Practice of recapping used needle was common among doctors than nurses (p=0.01). 32.53% of doctors and 28.87% of nurses had ≥1 dose of hepatitis-B vaccine; the difference in hepatitis-B immunization status of doctors and nurses was not significant (p=0.556).

The knowledge of standard precautions among HCWs was suboptimal. Except for mask and eye protector, the use of PPE was good.

Non-availability of materials was the major cause of poor compliance. The HCWs hepatitis-B vaccination status was poor. Capacity development of HCWs and a comprehensive infection prevention and control program were recommended.

TABLE OF CONTENTS

CONTENT                                                                PAGES

Title page

Certificate

Abstract

Dedication

Acknowledgement

Table of contents

List of table

List of figures

CHAPTER ONE: INTRODUCTION

1.1    Background of the study

1.2    statement of the problem

1.3    Research question

1.4    Objective of the study

1.5    Significance of the study

1.6    Scope of the study

1.7    Operational definition of terms

CHAPTER TWO: LITERATURE REVIEW

2.1    Conceptual review

2.2    Theoretical review

2.3    Empirical review

2.3.1 To assess the level of knowledge of standard precaution among Nurses

2.3.2 To determine the level of practice of standard precaution among Nurses

2.3.3 To identify the Dangers  Associated with poor practice of standard precaution among Nurses

CHAPTER THREE: METHODOLOGY:

3.1    Research Design

3.2    Research setting

3.4    Sampling size determination

3.5    Sampling technique

3.6    Instruments for data collection

3.7    Validity of instrument

3.8    Reliability of instrument

3.9    Method of date collection

3.10  Method of data analysis

3.11  Ethical consideration

CHAPTER FOUR: DATA ANALYSIS (RESULT) 

INTRODUCTION

1.1 Background of the study

According to Hauswirth (2010) standard precautions are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids non-intact skin (including rashes) and mucus membranes.

Standard precautions are employed to minimize the spread of infection in the clinical setting. As stated by Stephen (2008). Standard precautions represent the last line of defense for patient from micro-organisms during clinical procedures.

The goal of standard precautions is to protect patient who is potentially vulnerable to infection due to their low resistant status.

Standard precautions is a set of specific practices and procedures performed under carefully controlled conditions with the goal of minimizing contamination by pathogens (Alexander, 2008) (Smith, 2009) stated that the relationship between Nursing and infection control was first identified by florence nightingale during the Crimean war when she served in a millitany hospital in scutary in Italy.

Typically, situations that call for standard precautionary measure include; surgery and the insertion of intravenous lines, passing of catheters, insertion of drains and wound dressing and delivery of babies in labour rooms.

The concept of standard precautions can be applied to any clinical setting as pathogens may introduce infection to the patient through contact with the environment, personnel or equipments.

In a study carried out by Arenas (2009), on the level of knowledge of standard precautions among nurses in New Zealand.

The researcher observed that a total of 977 opportunities of applying standard precautions such as hand washing and wearing  of gloves following  Patients oriented activity and 1,902 opportunities to wash hands before such an activity.

While gloves were actually used on 92.9% of these accessions hands were washed on 35.6% of the time after patient contacts and only 13.8% of the time before patient contact the researcher found that personnel’s knowledge status did not modify their adherence to hand hygiene practice.

According to Wirkin and Maxwell (2012) from centres for disease control and prevention (COC) estimate that over 27 million surgical procedures are performed yearly.

Surgical site infections and are responsible for longer hospital stays and increased costs to the patient and hospital.

Standard  precautions is vital in reducing morbidity and mortality associated with surgical infections. Knowledge and practice of standard precaution applied by nurses in ward is a dramatic reduction in the spread of pathogenic infection among patient in the hospital.

According to Kristeen (2013), standard precaution is a measures used by medical staff to prevent the spread of infection.

The goals is to reach asepsis environment which means an environment that is free from harmful micro-organism. Each health care setting has its own set of practice for achieving asepsis.

Common example are surgery rooms, clinic and out patient care centres. It is commonly used in nursing procedure, vaginal delivery, intravenous lines, urinary catheters and others.

The concepts of standard precaution can be applied to any clinical setting as pathogens may introduce infection to the patient through contacts with the environment, personnel or equipments.

The environment posses potential hazard that may spread pathogens through movement and touch, intervention such as restricting traffic in the ward during wound dressing, isolation of patient in order to prevent airborne diseases thereafter minimizing environmental  hazards.

Standard precaution as performed in the united kingdom (UK) examines the nature of evidence based procedures. These findings have identified gloves wearing culture and continuing hand hygiene practices.

This alternative clean technique is also adopted widely in clinical practice in  our health institutions

The aim of the study is therefore to assess the level of knowledge and practice of standard precautions among nurses in  St. Luke’s Hospital, Anua, Uyo, Akwa Ibom State, Nigeria.

CSN Team.

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