A Proposal on Measures Utilized for Prevention of Nosocomial Infection in the Labour Ward of University of Calabar Teaching Hospital (UCTH), Calabar
CHAPTER ONE
Specific Objectives
- To ascertain the level of knowledge of nosocomial infection among nurses in UCTH, Calabar.
- To identify the nursing measures utilized for the prevention of nosocomial infection in the labour ward of UCTH, Calabar.
CHAPTER TWO
LITERATURE REVIEW
Etiology of Nosocomial Infections
Numerous epidemiological studies have documented that nosocomial infections are commonly caused by pathogens such as bacteria, fungi, parasites and viruses transmitted from one patient to another through indirect or direct contact (Edwards, Peterson, Mu, Banerjee, Allen-Bridson, Morrell, Dudeck, Pollock & Horan, 2009). The most common pathogens are the bacteria. In 1938, it was established that bacteria recovered from the human body could be divided into two categories: the resident flora (microbiota), or transient flora. The resident microbiota, also commonly referred to as normal flora consists of bacteria mostly found in the superficial cells of the skin and has protective functions. However, these bacteria may cause infections in non-intact skin. The most dominant species of resident microbiota is Staphylococcus epidermis. Transient rnicrobiota colonizes the superficial layers of the skin and is more amenable to removal by routine hand hygiene and such bacteria are often acquired by healthcare workers during direct contact with patients, or contaminated environmental surfaces, within the patient’s surroundings (Hayden et al., 2006). The transmission of transient bacteria depends on the number of microorganisms on the surface, toxins produced during colonization, skin moisture, and the transmission ofpathogens by healthcare workers (Abbo, Navon.venezia, Hammer-Muntoz, Krichali, Siegman-Igra, & Carmeli, 2005). The most common types of transient bacteria implicatedin nosocomialinfections are the Staphylococcus aureus, Escherichia coli, {3eta-hemolytic Streptococci, Serratia mercescens, Klebsiellapneumonia, Pseudomonas aeruginosa, Enterobacter species and Clostridium difficile. The affected bodysystems depend on the virulence ofthe pathogens and the body system affected. Some ofthe bacteria become highly resistant to multiple classes of antimicrobial agentsincluding antibiotics such as Methicillin and Vancomycin(Hayden et al., 2006). The resistance of bacteria to antimicrobial agents requires prescription of more potent and expensive classes of antibiotics and they contribute to extended hospital stay days, and ultimate increased cost of healthcare (Scott II, 2009).
The causative agents of nosocomial infections are commonly present in hospitals and other healthcare facilities and may be transmitted from one source to susceptible hosts by more than one route. For example, some of the pathogens are transmitted by “direct contact between the healthcare workers and patients or by “indirect contact with environmental surfaces and inanimate objects, or by air.
CHAPTER THREE
RESEARCH METHOD
Research Setting
The study will be conducted in University of Calabar Teaching Hospital (UCTH), situated in Calabar Municipality and will be founded in the year 1979. It is a tertiary health care facility located in the South-eastern area of Calabar.
The UCTH serves as clinical area for teaching medical, nursing, medical laboratory science, radiography and other health related students. It also provides specialist clinical services as well as promotion of scientific knowledge through research. At the apex of administration is the Chief Medical Director. There are several departments in the hospital which include Medical, Nursing, Pharmacy, Medical Laboratory and Medical Records Departments. The hospital runs 24 hours service and offer preventive and curative health care services.
The hospital is also made up of twenty-five (25) wards and units, with 392 bed complements and 118 cots, amongst which are Casualty Ward; Diarrhoea Treatment and Training Unit (DTTU); Eye Ward; Ear, Nose and Throat (ENT) Ward; Male Medical Ward; Male Surgical Ward; Female Medical Ward; Female Surgical Ward; Paediatric Medical Ward; Paediatric Surgical Ward; Male Orthopaedic Ward; Female Orthopaedic Ward; Cardiothoracic Ward; Intensive Care Unit (ICU); Gynaecological Ward; Ante-natal Ward; Post-natal Ward; Labour Ward; Special Care Baby Unit (SCBU); and Sick Baby Unit (SBU). The Nursing services department has at its apex the Assistant Director of Nursing Services (ADNS) with 580 nurses.
The labour ward of University of Calabar Teaching Hospital (UCTH), Calabar has eight (8) Chief Nursing Officers (C.N.O.), four (4) Assistant Chief Nursing Officer (A.C.N.O.), two (2) Principal Nursing Officers (P.N.O.), two (2) Senior Nursing Officers (S.N.O.), three (3) Nursing Officer I (N.O.I), six (6) Nursing Officer II (N.O.II) and eight (8) Health Assistant (H.A.).
Research Design
A descriptive study will be used to investigate nursing measures utilized for the prevention of nosocomial infection in the labour ward of University of Calabar Teaching Hospital (UCTH), Calabar.
CHAPTER FOUR
Instrument for Data Collection
A well-structured questionnaire will be used to elicit information from the respondents on nursing measures utilized for the prevention of nosocomial infection in the labour ward of University of Calabar Teaching Hospital (UCTH), Calabar. The instrument will be divided into three (3) sections;
Section A: Deals with the socio demographic features of respondents.
Section B: Level of knowledge of nosocomial infections among nurses in UCTH, Calabar.
Section C: Nursing measures utilized for the prevention of nosocomial infections in the labour ward.
Method of Data Collection
With the help of an assistant, the researcher will visit the labour wards during morning and evening duties for a period of a week to administer the questionnaire. These questionnaires will be distributed to all nurses who were available and willing to respond using the face-to-face method. On-the-spot collection of questionnaire will be done where possible.
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