ABSTRACT
Background: patients on hemodialysis are at risk of nosocomial infections especially Hepatitis C Virus [HCV] and Hepatitis B Virus [HBV]. Nurses' adherence to infection control procedures is instrumental to control the transmission of the virus among patients. The identification of gaps in knowledge, attitudes and practices [KAP] of nurses aims at tailoring related training programs
Aim: the study was conducted to determine the knowledge, attitudes and practices of nurses working in dialysis units regarding standard recommendations of infection control
Methods: a cross-sectional study was conducted between December 2014 and January 2015 targeting all nurses in three dialyses units affiliated to the Ministry of Health in Abha city. Data was collected using a self-administered questionnaire to assess nurses' KAP and an observation checklist to report on the environmental aspects
Results: one hundred and nine nurses were included with a response rate of 94.78%. Most of them were Saudi nationals [62.39%] and holding a diploma [78.90%]. The percentage score was 60.18+17.51 for knowledge, 85.59+8.09 for attitudes and 92.11+7.98 for practice. Nurses' practice was high despite the deficiency in knowledge. Gaps in practice were identified including not always adherent to hand washing [15% to 18%], use of eyewear when blood splash is likely [31.19%], simultaneous care for positive and negative patients [24.77%], passing needles from hand to hand [29.36%] and recapping needles after use [25.69%]. Multivariate linear regression analysis revealed that attitudes towards infection control, attempt to access infection control guidelines, on job training and being non-Saudi independently predicted higher practice scores
Conclusion: nurses' knowledge is deficient but their performance is significantly related to their attitudes. Nurses tend to be adherent to certain infection control practices than the others. Training in infection control should address the gaps in performance with emphasize on creating favorable attitude
ABSTRACT
To determine the rate of device-associated healthcare-associated infections [DA-HAIs] at a respiratory intensive care unit [RICU] and in the pediatric intensive care units [PICUs] of member hospitals of the International Nosocomial Infection Control Consortium [INICC] in Egypt. A prospective cohort DA-HAI surveillance study was conducted from December 2008 to July 2010 by applying the methodology of the INICC and the definitions of the NHSN-CDC. In the RICU, 473 patients were hospitalized for 2930 d and acquired 155 DA-HAIs, with an overall rate of 32.8%. There were 52.9 DA-HAIs per 1000 ICU-days. In the PICUs, 143 patients were hospitalized for 1535 d and acquired 35 DA-HAIs, with an overall rate of 24.5%. There were 22.8 DA-HAIs per 1000 ICU-days. The central line-associated blood stream infection [CLABSI] rate was 22.5 per 1000 line-days in the RICU and 18.8 in the PICUs; the ventilator-associated pneumonia [VAP] rate was 73.4 per 1000 ventilator-days in the RICU and 31.8 in the PICUs; and the catheter-associated urinary tract infection [CAUTI] rate was 34.2 per 1000 catheter-days in the RICU. DA-HAIs in the ICUs in Egypt pose greater threats to patient safety than in industrialized countries, and infection control programs, including surveillance and guidelines, must become a priority
ABSTRACT
Hospital-acquired infections affect 5% to 10% of all hospitalized patients, and are the most common cause of preventable morbidity and mortality facing health care. It is estimated that 30% of hospitalacquired infections are avoidable with healthcare provider adherence to hand hygiene [HH] guidelines .Thus preventing patient-to-patient and healthcare worker-to-patient transmission of microorganisms can prevent most nosocomial infections. This work was conducted to study the effect of HH practices on hospital-acquired infections in the Respiratory Intensive Care Unit [RICU] at Ain Shams University Hospital. The study was done in three phases; the first was an observational study for HH practices among physicians and nurses and evaluation of HH resources during the period from December, 2008 to March, 2009, so termed pre-intervention phase. The second was the intervention phase, started by education and on job training for HH practices among physicians and nurses together with replenishing of HH resources in a two months period from April to May 2009. The third was the post-intervention phase, which extended from June to December 2009. The infection rates were calculated through the three phases and re-evaluation of the intervention was carried out by calculating the compliance rates before and after intervention. HH compliance increased significantly from 8.2% in the pre-intervention phase to 53.9% in postintervention phase. The HH practices increased in nurses more than doctors, nurses' compliance in preintervention phase was 42.4% and increased to 70.7% in the post-intervention phase. Doctors' compliance increased from 36.8% in pre-intervention to 55.3% in post-intervention. Overall patient infection rates declined from 63.7% to 50.2% during the study. Such simple, non costly methodologies can increase the compliance of HH practices which can decrease infection rates in RICU
Subject(s)
Respiratory Care Units , Hand , Hygiene , Cross Infection , Infection ControlABSTRACT
Macrophages numbers are elevated in the lungs of smokers and those patients with COPD, where they accumulate in the alveoli, bronchioles and small airways. The slow progression and chronicity of COPD parallels the chronic increase of macrophages that is seen in sites of tissue injury / damage and supports the concept that macrophages are at least in part responsible for the pathological consequences. The aim of this work was to study the phagocytic activity of peripheral blood macrophages in COPD patients, either in the stable and during acute exacerbation compared to the normal subjects, which might be reflected on the therapeutic intervention strategies. Prospective case - control study. Seventy subjects were enrolled in this study, divided into two groups: Group I: 50 patients with COPD and Group II: 20 healthy volunteers serving as a control group. All subjects were submitted to ABG analysis, spirometric studies and assessment of phagocytic function, namely phagocytic and lytic indices using opsonised suspension of candida of their peripheral blood macrophages. Results showed a highly significant statistical difference as regards both phagocytic and lytic indices among COPD patients [group 1] and control group [group 2] where both indices were significantly lower among the COPD group as compared to the control group indicating obvious phagocytic dysfunction among peripheral blood macrophages in COPD patients, and both indices were significantly lower in patients in exacerbation than patients in stable state. This study is directed to the evaluation of the phagocytic function of peripheral blood macrophages among COPD patients, results revealed that there is actually a phagocytic dysfunction and that it is not always positively correlating to the severity of the disease. This also draws the attention to the peripheral blood cell population in COPD disease which had not taken its share of proper assessment. Hence, it would be recommended to include the peripheral blood cell population and macrophages in particular while searching in the pathophysiology and management of COPD disease