Nagwa Younis Abou El-Enein1, Hala M El Mahdy. 1. aDepartment of Health Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University bRenal dialysis Unit, Students University Hospital, Alexandria, Egypt.
Abstract
BACKGROUND: Compliance with standard precautions measures is essential to prevent and control health-care-associated infections. OBJECTIVES: This study was conducted to determine the degree to which standard precautions were applied by nurses in a dialysis unit in terms of hand hygiene and use of personal protective equipments. It also aimed to assess nurses' knowledge and attitudes toward standard precautions. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted in the dialysis unit of the Student University Hospital in Alexandria governorate. The study population included all nurses (17 nurses). An observational checklist was used to record practical activities performed by the nurses and a self-administered questionnaire was used to assess their knowledge and attitude toward standard precautions. A minimum required sample size was estimated to be 323 observations per shift. Each nurse was observed 19 times on different work shifts. RESULTS: During the study period, 1082 opportunities for applying standard precautions were recorded. None of the nurses (0%) washed hands before and after the different activities that required hand washing or used plastic aprons or face protection. In contrast, all of them (100%) wore nonsterile gloves before or after the different activities that required wearing of gloves. Less than half of nurses (47.1%) correctly knew that they had to wash their hands before and after caring for a patient. None of the nurses received training in infection control. Among the reported barriers for not applying standard precautions, inaccessibility of sinks, high workload or lack of appropriate staffing, and interference with the practice of care, were cited as the most important barriers. CONCLUSION AND RECOMMENDATIONS: The dialysis unit should revise staff compliance with dialysis unit precautions, and wherever necessary improve the precautions to be applied in the care of all patients and provide performance feedback to nurses. Training of health-care workers (preservice and inservice) about blood-borne infections and universal blood precautions should be regularly carried out.
BACKGROUND: Compliance with standard precautions measures is essential to prevent and control health-care-associated infections. OBJECTIVES: This study was conducted to determine the degree to which standard precautions were applied by nurses in a dialysis unit in terms of hand hygiene and use of personal protective equipments. It also aimed to assess nurses' knowledge and attitudes toward standard precautions. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted in the dialysis unit of the Student University Hospital in Alexandria governorate. The study population included all nurses (17 nurses). An observational checklist was used to record practical activities performed by the nurses and a self-administered questionnaire was used to assess their knowledge and attitude toward standard precautions. A minimum required sample size was estimated to be 323 observations per shift. Each nurse was observed 19 times on different work shifts. RESULTS: During the study period, 1082 opportunities for applying standard precautions were recorded. None of the nurses (0%) washed hands before and after the different activities that required hand washing or used plastic aprons or face protection. In contrast, all of them (100%) wore nonsterile gloves before or after the different activities that required wearing of gloves. Less than half of nurses (47.1%) correctly knew that they had to wash their hands before and after caring for a patient. None of the nurses received training in infection control. Among the reported barriers for not applying standard precautions, inaccessibility of sinks, high workload or lack of appropriate staffing, and interference with the practice of care, were cited as the most important barriers. CONCLUSION AND RECOMMENDATIONS: The dialysis unit should revise staff compliance with dialysis unit precautions, and wherever necessary improve the precautions to be applied in the care of all patients and provide performance feedback to nurses. Training of health-care workers (preservice and inservice) about blood-borne infections and universal blood precautions should be regularly carried out.