THE ROLE OF NURSES IN PREVENTION OF SURGICAL SITE INFECTIONS AT THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ITUKU/OZALLA, ENUGU

Abstract

The study assessed the knowledge and practice of post-operative wound infection   prevention among nurses in the Surgical Units of University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu. The objectives of the study included to ascertain what nurses know about post-operative wound infections, assess nurses’ knowledge of factors  responsible for post operative wound infections and determine post operative wound  infection prevention practices adopted by nurses. Literature related to the study was  reviewed and the study anchored on Dorothy Orem’s self-care deficit theory. Cross-section descriptive survey research design was adopted with researcher designed questionnaire consisting of close-ended and response items in modified four point Likert  scale format used as instrument for data collection. The study population consisted of  174 nurses working at the Surgical Unit of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu which was also used as the sample size of the  study. Data collected were analysed descriptively and presented in tables and charts. Findings revealed that  100% of the subjects have adequate knowledge about surgical site infections which majority, 87.1% rightly described as an infection that occurs after surgery in the part of the body where the surgery took place. Results further showed that majority of respondents identified age patients’ nutritional status is responsible for the development  of surgical site infection, cigarette smoking, prolonged hospitalization, medical underlying conditions, pre-operative shaving, transient micro-organisms, lengthy  operation and sterilization of instrument as factors responsible for the development of surgical site infections. It was also revealed that most of the respondents always clean their hands often with an alcohol-based products and perform appropriate surgical hand    scrubs, always perform surgical skin antisepsis using an appropriate technique and antiseptic, wear clean, facility laundered scrub attire, minimize operating room traffic, follow environmental cleaning, engage with a patient who has experienced a surgical site infection to develop prevention strategies, follow a surgical safety checklist, implement team training to promote a team-based approach to surgical site infection prevention, maximize use of steam sterilization, clean instruments thoroughly before sterilizing or  disinfecting as well as speak up whenever a break in sterile technique is witnessed and correct the break as soon as possible. Based on the findings, it was recommended that surgical team members should be encouraged to emphasize the importance of following latest evidence-based practices of infection control in continuing education / training programs.

BARRIERS TO IMPLEMENTATION OF PREOPERATIVE VISITS AMONG PERI-OPERATIVE NURSES AT THE FEDERAL TEACHING HOSPITAL ABAKALIKI

This study assessed the Barriers to the Implementation of Pre-operative Visits among Perioperative Nurses at the Federal Teaching Hospital, Abakaliki Ebonyi State. The specific objectives of the study were to identify what nurses know as the benefits of pre-operative visits, determine the personal barriers to the implementation of pre-operative visits as well as to ascertain institution-related barriers to the implementation of pre-operative visits by peri-operative nurses at the Federal Teaching Hospital (FETHA), Abakaliki. Literature review was conducted under conceptual, theoretical and empirical reviews. The study was anchored on Dorothy Johnson’s and Peplaus’s theory of interpersonal relationships. Descriptive survey design was adopted and the study population and sample size consisted of fifty-six (56) nurses working in the various theatres of the Federal Teaching Hospital, Abakaliki. Self-designed questionnaire was used as instrument for data collection. The questionnaire contained close-ended questions as well as response items on modified four (4) point Likert scale. Data was analysed using descriptive statistics and presented in tables and charts indicating frequencies, simple percentages and mean scores. Findings from the study revealed that 91.1% of respondents stated that pre-visit helps patients to become involved in their care, 94.6% stated that it gives them time to voice any fears they may have, 98.2% stated that it enables the nurse to assess the patient’s needs and to formulate a plan of care while 96.4% said that it improves interactions, information and instruction compliance by the patients. Personal barriers to the implementation of previsits were identified as fear of passing wrong information to patients (Mean=3.1), fear of passing too much information to patients (Mean=3.0) and linguistic barrier (Mean=2.9). Additionally, not having enough time to engage in preoperative visits (Mean2.9), high patient to nurses’ ratio (Mean=3.0), lack of support from immediate supervisors (Mean=2.9), non implementation of findings from previous pre-visits (Mean=2.8)and reluctance to embark on pre-visits alone (Mean=2.9)were identified as institutional barriers to the implementation of pre-operative visits among nurses. Based on the findings of the study, it was recommended among other things that adequate time should be set out during which the healthcare team including the peri-operative nurses should embark on peri-operative visits.

KNOWLEDGE, ATTITUDE AND PRACTICE OF SAFE WASTE DISPOSAL AMONG NURSES IN SURGICAL UNITS OF UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ITUKU/OZALLA, ENUGU

The primary goal of any waste management system is to safeguard the health of the  citizens and protect the environment. This is achieved by ensuring proper collection,  transportation, treatment and, finally, safe disposal of waste. The study assessed the Knowledge, Attitude and Practice of Safe Waste Disposal among Nurses in the Surgical nits of University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu. The objectives of the study included to understand what nurses know about over safe waste disposal,  determine the attitude of the nurses towards waste disposal and to establish the extent to which the Nurses in the Surgical Units of UNTH, Enugu practice safe waste disposal.            Literature related to the study was reviewed and the study anchored on the health belief model propounded by Janz and Becker in 1984. Descriptive survey research design was adopted with researcher designed questionnaire consisting of close-ended and response items in modified four point Likert scale format used as instrument for data collection.  The study population consisted of 174 nurses working at the Surgical Unit of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. Data collected were  analysed descriptively and presented in tables. Findings revealed that nurses agreed that hospital hygiene training is important to ensure health workers, know how to handle wastes properly and realize the effect of poor waste disposal in the hospital. It was also  found that majority of the respondents agreed that safe disposal is of utmost importance to prevent contamination, should be priority at the hospital and that wearing personal protective equipment like gloves decreases the risk of hospital contamination. With regards to practice of waste disposal, majority of respondents agreed that they do not  dispose waste by open burning, that they use hospital waste bins provided very well, that  they wash their hands after handling waste before continuing to do their work, that they use personal protective equipment like gloves when handling wastes and that they   separate wastes before throwing them into the rubbish bin. Based on the findings, it was   recommended among other things that training, seminars and workshops should be organized regularly for nurses and other healthcare workers as this will help them  develop more positive attitudes and desirable practices towards hospital waste disposal  and consequently take necessarily precaution in order to avert the dangers associated with   improper solid waste disposal.