Knowledge, Attitude, and Compliance of Healthcare-associated Infection Control among Nurses in the Western Development Region, Nepal / 병원감염관리

BACKGROUND: Healthcare-associated infection (HAI) affects the morbidity and mortality of inpatients worldwide. Nepal is a developing country in which HAIs pose a major problem in terms of patient safety. Therefore, this study was designed to assess the level of knowledge and attitude toward HAIs and compliance for infection control among nurses. METHODS: A cross-sectional survey was conducted using a self-administered questionnaire including general characteristics, and knowledge of, attitude toward, and compliance with HAI control practices, on a sample of 259 nurses from 11 hospitals in 3 cities in Nepal, from July 17 to August 5, 2014. RESULTS: The average score on knowledge of HAI was 6.56, on a 13-point scale. In total, 59 nurses had undergone HAI control training and 211 nurses reported that they were governed by some guidelines, but there were no significant differences. The overall level of compliance with HAI control guidelines was 79.2 points based on a 100-point scale, which did not differ in terms of age, exposure to infection control training, and the presence of any guidelines. CONCLUSION: The level of knowledge of HAI control among nurses was very low and a majority had never undergone any HAI control training. Evidently, there is an urgent need to provide HAI control training to nurses, and to develop infrastructure to provide training for them.

Understanding of Technical Terms and Contents of Informed Consent Forms for Sedative Gastrointestinal Endoscopy Procedures

PURPOSE: This was a cross-sectional study designed to evaluate the subjective understanding of technical terms and contents of the informed consent forms given to patients about to undergo conscious sedative upper gastrointestinal endoscopy. METHODS: A group of conveniently selected 180 patients, who were undergoing sedative endoscopy were recruited in the endoscopy procedure room in a tertiary hospital from June to July 2011. Data were collected with a structured questionnaire. RESULTS: The average number of terms exposed was 8.12 out of 10 items, the average number of terms understood well by the patients was 5.53 out of 10 items, and the average number of right answers was 3.30 out of 5 items, and the percent of correct answers ranged from 26.1% to 90.0%. The exposure to terms differed by gender, education, and previous exposure to sedative endoscopy procedures. The number of "understanding of the terms well" responses differed according to age and previous exposure to sedative endoscopy procedures, and the correct answer rate was differed by education. CONCLUSION: The understanding of the terms and knowledge about the procedures were disappointing. Therefore, sufficient explanations should be provided to the patients. While the informed consent was taken by doctors, the level of understanding should be monitored by nurses. In particular, subjects who did not have any previous experience with endoscopy procedures showed relatively lower level of understanding. We recommend that medical terms should be replaced with more common and nontechnical words in consent forms.

Knowledge and Attitude towards Pathogen Transmission Precautions among Healthcare Workers in a General Hospital

BACKGROUND: Pathogen-transmission precautions (PTP), including standard precautions, have been introduced to control the transmission of pathogens among patients and healthcare workers. The aim of this study was to assess the level of knowledge regarding PTP and the attitude towards these precautions among healthcare workers in a hospital setting. METHODS: A cross-sectional survey was performed from March to April 2007 using a self-administered questionnaire completed by 235 physicians, 491 nurses, and 117 laboratory technicians working at a large teaching hospital in urban area in Korea. RESULTS: The overall percentage of correct answers to 13 knowledge-type questions was 66.3%, and the percentage of correct answers differed significantly depending on the profession of the respondents (P<0.001) and exposure to PTP training (P=0.003). The guidelines were the preferred source of information on PTP (57.3%) followed by infection control practitioners (32.0%). The most important obstacles to compliance with PTP guidelines were lack of time (67.5%), forgetfulness (46.8%), lack of knowledge (33.8%), and lack of means (11.0%). CONCLUSIONS: Level of knowledge on the PTP guidelines was low and required improvement. Lack of time was the most important factor reported leading to poor compliance with the PTP guidelines.

Predictors of Hearing Protection Behavior Among Power Plant Workers

PURPOSE: This study aimed to identify factors affecting the use of the hearing protection devices (HPDs) among workers exposed to noise using the Pender Health Promotion Model. METHODS: The 222 subjects came from thermal power plants with similar noise levels, which are between 80 dB and 90 dB in South Korea. Data were collected with self-administered questionnaires designed to measure concepts from the Health Promotion Model. RESULTS: Mean percent times of using the HPDs at their most recent job site were 50.9%, and 20.3% had never the HPDs. The predictors of HPD use were social modeling (OR = 1.380), perceived benefits (OR = 1.150), and working at noisy worksites (OR = 4.925) when the outcome was based on the "non-use" versus "used at least once". However, the predictors of HPD use were social modeling (OR = 1.795) and perceived benefits (OR = 1.139) based on the "less than half-of-the-time-use" versus "more than half-of-the-time-use". CONCLUSION: Social modeling and perceived benefits of using the HPDs are important for workers to keep minimal or certain level of using the HPDs.

Comparison of Catheter-associated Urinary Tract Infection Rates by Perineal Care Agents in Intensive Care Units

PURPOSE: This study compared the catheter-associated urinary tract infection (CAUTI) rates resulting from the use of four perineal care agents (soap-and-water, skin cleansing foam, 10% povidone-iodine, and normal saline) among patients in intensive care units (ICUs). METHODS: This four-group experimental study was done with 97 adult patients who had urinary catheters over 2 days in three ICUs between April and July 2008. The patients received one of the four types of perineal care. Data collected included the incidence of CAUTI at baseline (prior to perineal care) and 1 week, 2 weeks, and 4 weeks after beginning perineal care. Patients were divided into UTI and non-UTI groups based on the Centers for Disease Control and Prevention/National Healthcare Safety Network UTI definition to calculate incidence rates. The hazard ratio (HR) and 95% confidence intervals were calculated by Cox's proportional hazard analysis. RESULTS: The cumulative incidence of CAUTIs per 100 urinary catheter days were 3.18 episodes during 1 week with urinary catheter, 3.31 during 2 weeks, and 3.04 during 4 weeks. No statistically significant difference in hazard ratios of CAUTIs for each perineal care agent was evident with reference to soap-and-water at 1 week, 2 weeks, and 4 weeks after beginning perineal care after controlling for age, use of antibiotics, fecal incontinence, consciousness level, fever, and diabetes. CONCLUSIONS: The type of perineal care does not influence the incidence of CAUTIs. Further confirmatory studies with a larger patient population should be conducted, as well as determining perineal agent preference.

Effects of a Newborn Care Education Program on Newborn Care Confidence and Behavioral Accuracy of Primiparas in a Postpartum Care Center / 간호학회지

PURPOSE: The study aimed to identify the effects of a newborn care education program on newborn care confidence and behavioral accuracy of primiparas in a postpartum care center. METHOD: This was a quasi-experimental study with a non-equivalent control group non-synchronized design. Subjects were 29 primiparas selected from a postpartum care center in D and P hospitals in Ulsan. The intervention was a newborn care education program which was composed of education with a booklet, demonstration, watching a video, and verbal encouragement. The outcome variables were newborn care confidence and behavioral accuracy. Data was collected from Feb. 1 to Mar 22 in 2005 with self-administered questionnaires and observation by researchers. Data was analyzed using the chi-square-test, Fisher's exact test, t-test and ANCOVA. RESULT: The experimental group showed significantly higher score changes between the pre-test and post-test in confidence and behavioral accuracy than the control group. CONCLUSION: The newborn care education program showed positive effects on newborn care confidence and behavioral accuracy of primiparas in a postpartum care center. Therefore, we recommend that this program should be applied in postpartum care centers.

The Present Situation of Infection Control Professionals, Organization, and Activities in Korean Acute Care General Hospitals / 병원감염관리

BACKGROUND: It has been more than 15 years since infection control was first introduced in Korea, but there is little information available on the status of infection control program in the country. METHODS: Included in the study were 139 acute care hospitals with more than 300 inpatient beds. A questionnaire, modified from US SENIC (Study on the Efficacy of Nosocomial Infection Control) and Canadian RICH (Resources for Infection Control in Canadian Acute Care Hospitals) survey, was mailed to the hospitals in the winter of 2003. RESULTS: Ninety-eight (70.5%) of 139 hospitals responded. There was an average of 1.2 (SD, 0.7) Infection Control Practitioners (lCPs) in each hospital and 95.7% were nurses and only 56.5% of the ICPs worked as full-time. The 71.4% of the hospitals had a position for Infection Control Doctor. All hospitals had an Infection Control Committee, which met an average of 3.7 (SD, 1.7) times a year. The 85.7% of the hospitals performed surveillance, but only 31.6% were monitoring surgical site infections. Review of microbiology data was the most common method for case-finding. More than 90% of the hospitals had infection control policies and guidelines, but an adherence to the policies and guidelines was not monitored regularly. CONCLUSION: This study reports the first comparable profile of infection control program of general acute care hospitals in Korea. Although the foundation for infection control program appears to have been established, there is the need for a further increase in the number of ICPs, the standardization of the surveillance method, and the promotion of adherence to the infection control guidelines.

Predictors of Stage of Change for Smoking Cessation among Adolescents based on the Transtheoretical Model / 예방의학회지

OBJECTIVES: The purpose of this study was to investigate the predictor associated transitions with each stage of smoking cessation based on the Transtheoretical Model, and to provide basic data for smoking cessation programs for adolescents. METHODS: The participants were 297 current and former smokers, obtained from stratified random sampling of 2nd graders from 127 high schools in B cities. The data were collected between April 6th and 16th 2002, using a structured self-report questionnaire, and analyzed using a multiple logistic regression, with the SPSS program for Windows (Version 10.0). RESULTS: The predictors of transition from precontemplation to contemplation were consciousness raising (OR=1.22, 95% CI: 1.07-1.40), coping pros (OR=.84, 95% CI: .70-1.00) and attitude of parents to smoking (OR=2.97, 95% CI: 94-9.24). The predictors of transition from contemplation to preparation were helping relationships (OR=.83, 95% CI: 72-.96), self-liberation (OR=1.15, 95% CI: 99-1.33) and nicotine dependence (OR=.76, 95% CI: 56-1.03). The only predictor of transition from preparation to action was the social pros (OR=.66, 95% CI: .57-.82). The predictors of transition from action to maintenance were self-reevaluation (OR=.81, 95% CI: .71-.92) and negative affective situation (OR=.85, 95% CI: .72-1.00). CONCLUSIONS: Adequate examination on the factors for predicting the transitional stages of change for smoking cessation in Koreans are presented in this study. The results of this study will become the pillar of smoking cessation planning and application programs.

Knowledge on the Disinfection among Nurses in the Hospital / 병원감염관리

BACKGROUND: This study was aimed to assess the level of knowledge on the disinfection among nurses in the hospital. METHODS: Data was collected from the nurses who participated in an educational meeting of Korean Association of Infection Control Nurses for two days from July 7 to 8 in 2000. Seventy nurses (58.3%), among 120 participants. were answered to the 32 item questionnaire which was developed to test the level of knowledge in different types of disinfection. The correct answers for each item were computed and the rate of the total correct answer was dichotomized and compared at the level of 60% correct answer to identify the respondent's characteristics which affect the knowledge on the disinfection. RESULTS: The percent of the correct answer was 60.0% in total. 63.4% for the disinfectants general; 59.4% for the disinfection of skin: 57.6% for the disinfection of devices: 63.9% for the disinfection of endoscopies, and 55.1% for the disinfection of environments. The percent of correct answer was significantly higher among the nurses who participated in the educational programs on the disinfection previously (p=0.006), as well as the nurses who are at the infection control office or at the quality improvement department compared to other areas in the hospital (p=0.001). CONCLUSIONS: This study indicates that the level of knowledge about the disinfection was low with only 63% of the correct rate in total. We perceive that more educational programs and manuals on the use of disinfectants in a hospital setting is urgently required.