ABSTRACT
Background: With advances in health care system, threat to Hospital Acquired Infections (HAIs) still remains. HAIs continue to affect hospitalized patients and results in morbidity, mortality and additional costs. Health care workers, especially nurses can play critical role in prevention and control of HAIs. The purpose was to study their awareness regarding HAIs and practice towards prevention and control measures. Methods: It was a cross sectional study conducted in Civil Hospital, Rajkot from October 2014 to December 2014. Out of total 184 staff nurses, 92 (50% of the total following convenient sampling) were selected. A list of all staff nurse was made alphabetically and every alternate nurse was selected for interview. Of the 92 staff nurses approached, 83 consented and gave complete response. Interview was conducted using a pretested semi structured questionnaire and analysis was done using Excel 2007. Results: 80 (93.02%) participants had heard about HAIs. More than half (60.4%) of the participants acknowledged that urinary and respiratory tract infections were the two most common HAIs. 52 (60.4%) of the participants acknowledged that direct skin to skin contact and improper handling of bio medical waste were the two most common modes of transmission of HAIs. 47 (56.6%) practiced hand washing before and after surgical procedures. 30 (36.1%) participants had ‘good’ knowledge regarding HAIs. Conclusions: The present study showed that level of awareness and practice regarding HAIs among nursing staff was average. Considering the important role of nurses in HAIs, there is a need to develop a system of continuous education to increase nurses’ awareness and hence adopt appropriate health behaviours and increase adherence to precautions.
ABSTRACT
Background: Despite significant progress in improvement of Government health care delivery system over past decade, community is reluctant to accept it because of substandard level of quality. “5S” is one of the strategies used to improve the physical quality and work efficiency of organization. 5S stands for five Japanese words which can be translated in English as Sort, Set in order, Shine, Standardize, and Sustain. Rajkot Municipal Corporation has adopted 5S strategy within its health centers with the aim to improve image of public health care facility among community and thereby to increase coverage of health services. This study was conducted to assess 5S implementation status at all Urban Heath Centers under health department of Rajkot Municipal Corporation, Gujarat, India. Methods: “5S” was implemented by the corporation in campaign mode in 18 Urban Health Centers in July 2014. Campaign included training, baseline assessment, and observing 5S week. A cross sectional study was carried out by personal observation and interview to assess the implementation of 5S campaign. Standard audit check list recommended by the State Quality Assurance Cell, Gujarat was used to evaluate. Results: Overall; all five components of 5S showed significant improvement (p<0.001) with highest improvement in Sorting and Setting in order. Significant improvement in utilization of Out Patient, laboratory services, immunization, family planning services etc were observed in comparison to previous year’s corresponding period. Conclusions: Significant improvement in utilization in major health care services was noted in the study after implementation of 5S. ‘5S’ practice can be sustained with sincere and continuous efforts.
ABSTRACT
Background: Children with severe acute malnutrition (SAM) have nine times higher risk of dying than well- nourished children. Child malnutrition can be managed by community based approach (80-85% SAM children) and institution based approach (10-15% SAM children). The objective of the study is to know the effectiveness of the mixed interventions to improve the nutritional status of the children (0-6 yrs), to decrease the prevalence of malnutrition in the children attending ICDS in Rajkot city for combating child malnutrition. Methods: A baseline survey of total registered 26578 children was carried out at 330 anganwadis and 701 SAM children were identified till the end of June 2014. A model of mixed interventions i.e. i) Community based management consisting of special food program, monthly health checkup and treatment and health education to parents, ii) Institution based management of SAM children with complication was planned and implemented since July 2014. Results: 701 children were identified as SAM at the beginning of the intervention while 160 children were SAM at the end of March 2015. The difference in the proportion of SAM children before and after intervention was statistically significant. An improvement of 80.9% in the status of SAM children was seen among boys while 74.1% was seen among girls. Conclusion: Convergence of Health and ICDS activities, high risk approach, community based and institutional management and community awareness in combating the malnutrition showed significant effect. This model can be replicated elsewhere and sustainability may be ensured for long term results.