Factors associated with the level of compliance of nurses in universal precaution application

Background: The highest prevalence of surgical wound infections in NurHidayah Hospital occurred in 2014 which is at 2.80%. This was because nurses’ compliance in using PPE and hand washing was still low and the culture for reporting needle puncture events had not been implemented so that the number of nurses who were punctured was still unknown. Meanwhile, the lowest prevalence of surgical wound infections occurred in 2016 amounting to 0.76%, this happened because the compliance of nurses in using PPE was quite high and the incidence of needle puncture reached 0 (zero) but compliance in hand washing was still low.Methods: This study was a quantitative study with an observational analytic method with a cross sectional design. The variables in this study were knowledge, attitudes, working period, training and nurse compliance in the application of universal precaution with the number of respondents 46 nurses. The research instruments used were questionnaires and observation sheets. The data analysis was conducted using chi square test and fisher test.Results: Factor associated with the level of nurse compliance in universal university application was attitudes (0.000), while factors not related to the level of nurse compliance in the application of universal precaution include knowledge (0.124), years of service (0.657) and training (0.098).Conclusions: There is a relationship between attitudes and levels of nurse compliance in implementing universal precaution in NurHidayah Hospital. There is no relationship between knowledge, work and training with the level of nurse compliance in the application of universal precaution at NurHidayah Hospital.

Reliability and Validity of Malay Language Version of International Physical Activity Questionnaire (IPAQ-M) among the Malaysian Cohort Participants

Validation of instruments is essential when assessing physical activity (PA). The aim of this study was to validate a Malay language version of the International Physical Activity Questionnaire (IPAQ-M) against Actical accelerometer and to determine its reliability and validity. A total of 90 Malay adults aged 35-65 years old participating in The Malaysian Cohort project were recruited for this study. The IPAQ-M is comprised of 12 items, covering vigorous, moderate, walking, sitting and sleeping activities, and was administered on two occasions (Day 1 and Day 9) by interviewing the participants. Participants wore the Actical accelerometer for seven consecutive days between the two interview sessions. Validity tests showed that time spent in moderate-vigorous physical activity (MVPA) (min wk-1) from IPAQ-M was significantly correlated with MVPA from accelerometer (ρ=0.32, p<0.01). Time spent in vigorous activity (ρ=0.44) and total activity (ρ=0.36) from IPAQ-M were significantly correlated (p<0.01) with that measured by accelerometer, but no correlation was observed for sedentary behaviour. Reliability tests revealed significant correlations between the two interview sessions for all intensities of PA (=ρ0.55 to 0.71, p<0.01). Bland-Altman plots showed that time spent in MVPA for IPAQ-M was significantly different from that measured by accelerometer (mean difference: 98.02 min wk-1; 95% limits of agreement: -785.33 to 1317.83 min wk-1; p<0.01). When classifying people into meeting PA recommendation, the agreement between the two instruments was fair (κ=0.22). The IPAQ-M has acceptable validity for MVPA, vigorous and total physical activity, and was reliable for assessing the physical activity of Malay adults.​

Assessment of Infection Control among Health Care Workers in Healthcare Centers Sana'a, Yemen : A cross-sectional study

An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen. A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05. The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice. We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.

Influência de fatores individuais, organizacionais e relativos ao trabalho na adesão às precauções padrão / Influence of individual, organizational and work-related factors in the adherence to standard precautions

A equipe de saúde bucal, devido às peculiaridades que envolvem a prática odontológica, está predisposta a um alto coeficiente de acidentes envolvendo material biológico potencialmente contaminado. A fim de evitar tais injúrias, as precauções padrão foram estipuladas e recomendam, entre suas medidas, o não reencape de agulhas. Entretanto, ainda é comum entre os profissionais da área odontológica esta prática inadequada, que caracteriza a não adoção a comportamentos preventivos. Objetivou-se, neste trabalho, analisar a prevalência dos acidentes ocupacionais envolvendo as equipes de saúde bucal e verificar a influência de crenças, fatores psicossociais e organizacionais na adesão às precauções padrão entre as equipes de saúde bucal alocadas em um município de médio porte do interior do Estado de São Paulo. Para averiguar o número de acidentes, foi realizado um levantamento das notificações envolvendo material biológico, com base na ficha do Sistema de Informação de Agravos de Notificação, entre profissionais da saúde bucal no período de 2007 a 2011. Para explicar a adesão à recomendação de não reencapar agulhas, utilizou-se o Modelo de Crenças em Saúde, por meio de um questionário validado contendo variáveis relativas à frequência do reencape e crenças em saúde, através de escalas tipo Likert, sendo aplicada a Análise de Regressão Logística. A influência dos fatores psicossociais e organizacionais na adesão às precauções padrão foi obtida por meio de outro questionário validado, composto também por variáveis na forma de escalas tipo Likert, em que a associação destes fatores com a adesão às precauções padrão foi obtida por meio de análise de regressão logística múltipla. Do total de notificações registradas no período entre as equipes de saúde bucal (n=21), observou-se que a maioria dos acidentes era do tipo percutâneo (n=20/95,2%), sendo o sangue o material biológico mais frequentemente relatado (n=20/95,2%) e o agente causal mais referido foram as agulhas...

The oral health team, due the peculiarities involving dental practice, is predisposed to a high coefficient of accidents involving potentially contaminated biological material. Therefore, to prevent such injuries, standard precautions were stipulated and they recommend among its measures, not recapping needles. However, it is still common among dental professionals the inappropriate practice of recapping needles, what does not characterize the adoption of preventive behaviors. The aim of this work was to analyse the prevalence of occupational acidentes involving oral health teams and also verify the influence of beliefs, psychosocial and organizational factors on the adherence to standard precautions among oral health teams allocated in a average size city of the outback of Sao Paulo State. It was performed a survey based on the application of the information system of notifiable among professionals related to oral health in the previously mentioned city between the period 2007 to 2011 to determine the number of accidents. It was used the Health Belief Model, using a validated questionnaire containing variables related to the frequency of recapping needles and health beliefs through Likert scales, applying the logistic regression analysis, to explain the accession to the recommendation of not recapping needles. The influence of psychosocial and organizational factors was obtained through a validated questionnaire composed of variables in the form of Likert scales, where the association of these factors and the adherence to standard precautions was obtained using multivariate logistic regression. Among all the reported cases in the period between oral health teams (n = 21), it was observed that most of the accidents was the percutaneous type (n = 20/95, 2%) and the blood was the biological material more often reported (n = 20/95, 2%). The most frequently reported causative agent were needles (n = 13/61 9%).Among the professionals related to dentistry that...

Study on Pediatric Nurses' Attitudes and Compliance with Hospital Infection Standard Precautions

PURPOSE: The purpose of this study was to identify pediatric nurses' attitudes to, and compliance with, standard precautions in the prevention of hospital infections by enhancing their practice of standard precautions. METHODS: The participants were 206 nurses who worked in pediatric nursing departments of a general medical institution in Seoul. The questionnaire was a modification of Kim (2008) and consisted of 18 questions about hand washing, personal protective equipment, sharps, linen and patient care equipment. Collected data were processed using SPSS 15.0 WIN. RESULTS: Mean scores for attitudes to standard precautions and for compliance with standard precautions were 4.43 (+/-0.83) and 4.22 (+/-0.44) respectively. This difference was statistically significant (t=3.368, p=.001). The nurses' compliance with standard precautions differed significantly according to the general characteristics of age (F=8.705, p<.001), total clinical experience (F=9.426, p<.001), current department experience (F=6.555, p<.001), and education experience (t=0.616, p<.043). There was a positive correlation between attitudes to, and compliance with, standard precautions (r=.156, p=.025). CONCLUSION: The results of this study indicate that educational programs and policy on infection control and standard precautions for pediatric nurses are needed. Also these results should contribute to baseline data for establishing appropriate clinical policy on infection control.

Cause and management of delayed hemorrhage after minimally invasive percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To discuss the cause and management of delayed hemorrhage after minimally invasive percutaneous nephrolithotomy (PCNL). Methods From 2004 to 2009,there were 13 cases (10 men and 3 women, mean age 47 years) developed severe bleeding following PCNL. The cause of hemorrhage and treatments were retrospectively analyzed and summarized. Results The time of hemorrhage was 5-40 d. In 7 of 13 cases, the bleeding were was controlled by complete bed rest,hemostatic,balloon compression and clamped nephrostomy tube. Six of 13 underwent selective renal arteriography after ineffective with conservative treatment. The DSA showed 4 were false aneurysm and 2 were arteriovenous fistula. All the 6 cases were treated by the super-selective arteriolar embolization. The hematuria was disappeared 1- 3 d later. The intravenous pyelogram revealed the renal function kept well during follow-up visit. Conclusions Delayed hemorrhage is one of the severe complications, which may be caused when the renal puncture passage established as forming false aneurysm and arteriovenous fistula. The renal arteriography and super-selective arteriolar embolization could be a safe and effective treatment for the severe hemorrhage after PCNL.