Reduction of the incidence of pressure sores by an education program on nursing care.

OBJECTIVES: To determine whether an education and campaign program would reduce the incidence of pressure sores. MATERIAL AND METHOD: The study was performed in a 1,400-bed teaching hospital in Thailand with a total number of 697patients from 47 wards for a point prevalence study; 1,201 and 1,268 patients from 12 wards to determine whether reduction of pressure sore occurrence would be obtained by an education program. RESULTS: The point prevalence of pressure sores was 10.8%. The significant risk factors were age older than 60 years, fecal incontinence, and history of diarrhea. The occurrence of pressure sores was significantly reduced after the educational program from 9.91% to 5. 76%. The education on patient care aiming at reduction of the occurrence of pressure sores could be adopted nation-wide in order to reduce the morbidity, mortality and expenses. CONCLUSION: The education program was effective in reducing the incidence of pressure sores.

Roles of infection control nurses in provincial hospitals.

OBJECTIVE: To study the roles of infection control nurses (ICNs) in provincial hospitals. MATERIAL AND METHOD: Interview using a semi-structured interview form. RESULTS: Nine hospitals were enrolled by stratified sampling and 11 ICNs were included. Interview was done by the researcher during April and May 2002. All ICNs were female and in middle-aged group. Their mean experience in IC was 6.4 +/- 4.5 years. All ICNs could perform their duties according the roles set by the Department of Nursing in surveillance, personnel health, education, consultation, administration and quality improvement. Only about one half had experience in outbreak investigation and research. The commonest problems were excessive workload, lack of co-operation of medical personnel and lack of budget for immunization. CONCLUSION: All sampled ICNs in provincial hospitals performed their roles except only one half were involved in outbreak investigation and research.

Evaluation of a training course in infection control for nurses.

OBJECTIVE: To evaluate the effectiveness of a training course in infection control for nurses. MATERIAL AND METHODS: A quasi-experimental study was performed from November 1, 2001 to December 31, 2002. The study was divided into three phases; 1) pre-intervention (November 1-30, 2001) to survey baseline data among participants, 2) intervention (January 1-31, 2002) to establish, develop and conduct the training course, 3) post-intervention (February 1, 2002 to December 31, 2002) to evaluate the effectiveness of the training program, and conduct a workshop for infection control project presentations. The research instruments consisted of questionaires and a focus group discussion guide. RESULTS: Forty-six nurses who had experience of working as infection control nurses (ICN) for more than one year and 46 hospital administrators were enrolled in the pre-interventional phase. Major problems identified among ICNs were inadequate knowledge, multiple simultaneous job descriptions, overwork and lack of collaboration from colleagues. After intervention, significant improvement was observed on their knowledge and confidence among ICNs (rating scale, 4.09 vs. 3.43; p< 0.001). All administrators agreed that the training course was beneficial to ICNs and believed that the problems in practices of IC would be solved. More satisfaction of ICNs among hospital administrators was also observed (97.7% vs. 28.3%; p< 0.001). CONCLUSION: The present study suggested that the training course to provide practical knowledge for ICNs be effective and should be conducted periodically to keep up with the advance in medical technology. An ICN network with other academic institutions should be established.

Effectiveness of education and problem solving work group on nursing practices to prevent needlestick and sharp injury.

OBJECTIVES: To examine the effect of an education program and problem solving work group on nursing practices for prevention of needlestick and sharp injury. MATERIAL AND METHOD: A quasi-experimental study design with a control group was conducted at the emergency and labor rooms in Sermngam Hospital, Lampang. All healthcare workers (HCWs) in the emergency and labor room were randomly assigned to the experimental and control group from April 17, 2002 to September 3, 2002. Data collection included demographics, a participatory problem solving plan, and safety nursing practice observation recording form. The present study was divided into a two months observation period, followed by a one month intervention period and a two month post-intervention observation period. Interventions included education and posters to promote safe nursing practices, peer reminders to avoid unsafe nursing practices, providing devices for recapping needles and small-sized trays to facilitate one-handed recapping, and making a hole in the lid of a sharp container Nursing practices on prevention of needlestick and sharp injury were prospectively monitored. RESULTS: Twelve HCWs (12/24; 50%) were randomly assigned to the experimental group and 12 (12/24; 50%) were assigned to the control group. There was no difference with respects to demographic and safety nursing practices on prevention of needlestick and sharp injury during the pre-interventional period among these groups. Compared to the pre-interventional period, significant improvement on safety nursing practices for all nursing practice categories were observed in the experimental group after the intervention (P=0.001). Compared to the control group, all safety nursing practice categories were performed more often in the experimental group (p=0.001). CONCLUSION: The educational and problem solving work group on nursing practices to prevent needlestick and sharp injury were effective and should be considered as an intervention to reduce needlestick and sharp injury in emergency and labor rooms at Sermngarm Hospital.