Volume||6||Issue||05||May-2018||Pages-7938-7944||ISSN(e):2321-7545
Website: http://jsae.in
Index Copernicus Value- 76.10 DOI: http://dx.doi.org/10.18535/ijsre/v6i5.04
A Study To Assess Knowledge Regarding Nosocomial Infections And Its Prevention
Among B.Sc. Nursing Students in A Selected Nursing College Under West Bengal
University of Health Sciences
Author Anita Bag
M.Sc. Nursing ( Obstetrical and gynaecological nursing ), Clinical Instructor , Govt. College of Nursing, Burdwan Medical College and Hospital, The West Bengal University of Health Sciences.
ABSTRACT
Introduction:Nosocomial infections increase patient’s treatment cost, length of hospital stay, morbidity and mortality. 6 Therefore, knowledge about nosocomial infections is important to improve infection control measures as well as to develop effective preventive and curative strategies which, in turn, will help us in decreasing incidence, morbidity and mortality 7 Effort towards education in terms of training and retraining about standard infection control, as well as strict adherence by health care staff and students to aseptic practice, can reduce the extent of these risks.12 Considering the lack of information regarding student’s knowledge on nosocomial infections and its prevention, this study provides insight into knowledge about nosocomial infection.
Materials and methods: A cross sectional descriptive design was used in the study. 112 B.Sc.nursing students were selected as sample by nonpropability convenience sampling. A self reporting questionnaire including 20 multiple choice questions was prepared and administered.
Result: No percentages among B.Sc.nursing students have excellent knowledge regarding nosocomial infection. Only 0.89%.have very good knowledge and 6.25% have good knowledge. 63.39% B.Sc. nursing students have below average knowledge regarding nosocomial infection. There is statistical significant difference in knowledge score about nosocomial infection among three different groups of nursing students (ANOVA 4.88, p < 0.05 ). There is a statistical significant association between different groups of nursing students and their knowledge regarding nosocomial infections ( Chi square value 9.8, p<0.05)
Conclusion: There is lack of knowledge regarding nosocomial infections among B.Sc. nursing students, so improvement in the knowledge towards nosocomial infections need to be done. For this purpose the Faculty of College of nursing should introduce the module of IPCs at the earliest opportunity to the students, hospitals should take initiative to mandate infection control guidelines to students before entering the wards, continuing education programs, seminars, symposiums or workshops should be arranged on regular basis.
Key wards : nosocomial infections, Knowledge, B. Sc. Nusing students, INTRODUCTION
A Nosocomial infection can be defined as an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge and also occupational infection among staff of the facility.2
An infection is considered nosocomial if it becomes evident 48 hours or more after hospital admission or within 30 days of discharge following inpatient care.3 The best clinical care in the world will be worthless if patients pick up other infections from the hospital.4
A wide variety of microorganisms are responsible for nosocomial infections including bacteria, virus, fungi and mycoplasmas. They most commonly affect the urinary tract, lower respiratory tract, surgical wounds, skins and the blood stream. These infections affect patients in a variety of ways, from increased discomfort and pain to severe chronic illness, permanent disability and in some cases may cause death. Infection can also lead to extended lengths of stay of affected patients and increased diagnostic and treatment costs.5,6 Therefore, knowledge about nosocomial infections is important to improve infection control measures and to develop effective preventive and curative strategies which, in turn, will help us in decreasing incidence, morbidity and mortality.7
Nursing students are exposed early to the hospitals and to activities which increase their risk of acquiring and transmitting infections. These diseases can be spread from health worker to patient or vice versa through contact with an infected surface, airborne transmission through droplets and/or aerosols and, finally, by common vehicles as food or water. Exposure to infectious diseases is one of the most frequently identified occupational hazards facing health care workers. Therefore the early provision of training programs that provides information about protecting medical students from exposure to blood borne pathogens is appropriate and is of paramount importance.8
Although infection is most prevalent in patients upon admission, health care workers also act as potential vectors for pathogenic agents. Hospitals provide a favorable transmission pathway for the spread of nosocomial infections, due to poor infection control practices among health workers and overcrowding of patients in most clinical settings.9 Nosocomial infections goes beyond its impact on morbidity and mortality figures in any country, and it has profound economic implications. According to Robert, nosocomial infection can prolong duration of hospitalization, increase the costs of health care, and place a serious economic burden on patients and their families.10
This scenario should alert faculties of College of Nursing to the need to pay adequate attention to imparting knowledge to students throughout their training period about measures to prevent nosocomial infections.11 Effort towards education in terms of training and retraining about standard infection control, as well as strict adherence by health care staff and students to aseptic practice, can reduce the extent of these risks.12 Considering the lack of student’s knowledge on nosocomial infections and its prevention, this study provides insight into knowledge about nosocomial infection.
OBJECTIVE OF THE STUDY
To assess knowledge of B.Sc. nursing students regarding nosocomial infections and its prevention.
METHODOLOGY
Design – cross sectional descriptive design was used in the study.
Participants- The study was carried out at Govt. College of Nursing, Burdwan, West Bengal. For the purpose
Survey instrument- A questionnaire with 20 multiple choice questions including 4 questions regarding agent factor, 2 questions regarding sources, 2 questions regarding predisposing factors, 2 questions regarding transmission, 4 questions regarding sterilization including hand hygiene, 3 questions regarding decontamination and 3 questions regarding protection. Arbitrarily knowledge score more than 90% was considered as excellent knowledge, from 80% - 90% as very good knowledge, from 70% - 80% as good, from 60% - 70% as average and <60% as below average knowledge.
PROCEDURE
Prior to the study, participants were given a brief introduction to the purpose of the study, after which their consent was sought and obtained. All the participants completed and returned the questionnaire, giving a response rate of 100%.
Statistical analysis
Descriptive statistics were used to summarize the data obtained. Association between courses of study and knowledge about nosocomial infections was tested using the Chi-square test, ANOVA is calculated to compare differences in the knowledge between the different student groups. All statistical tests had a significant level of 5% (P < 0.05).
RESULTS
Distribution of sample according to their age
Age Frequency Mean age SD
20 years 15
21.69 1.187
21 years 37
22 years 26
23 years 27
24 years 5
25 years 2
All the students were within 20 to 25 years of age group. The mean age of the students was 21.69 and SD was 1.187.
Distribution of sample according to year of the course
Year of the course Frequency Percentage
3rd year 36 32.14
4th year 38 33.9
Intern 38 33.9
Similar number of students was from 4th year and intern. Only 2 students was less in 3rd year. Percent correct to each question category for all respondents and for each student group
Question categories Percentage of 3rd year
Percentage of 4th year
Percentage of intern
Percentage of total students
Agent factor 36.1 34.2 27.63 32.58
Sources 68 69.7 71 69.6
Predisposing factors 73.6 73.6 77.6 75
Transmission 63.88 50 78.94 64.28
Sterilization 56.94 55.92 58.55 57.14
Decontamination 58.33 61.40 83.33 67.85
Protection 37.96 25.43 32.45 31.84
Distribution of sample according to knowledge score
Knowledge score Frequency Percentage
>90% excellent 0 0
80% - 90% very good 1 0.89%
70% -80% good 7 6.25%
60% - 70% 33 29.46
>60% 71 63.39
No percentages among B.Sc.nursing students have excellent knowledge regarding nosocomial infection. Only 0.89%.have very good knowledge and 6.25% have good knowledge. 63.39% B.Sc. nursing students have below average knowledge regarding nosocomial infection.
Mean, SD and ANOVA for knowledge of different year
Year Mean SD F ratio
3rd year 10.64 2.54
4.88
4th year 9.97 1.75
Intern 11.47 1.94
On referring the variance ratio table the tabulated F value for horizontal df (df = 2) and vertical df (df = 109) at 0.05 level of significance ( p<0.05 ) is 3.07. The calculated F value ( 4.88 ) is greater than tabulated F value ( 3.07 ) at 0.05 level of significance. Therefore null hypothesis is rejected and inferred that there is statistical significant difference in knowledge score about nosocomial infection among three different groups of nursing students.
Chi – square test to find out the association between different group of nursing students and knowledge score about nosocomial infection.
Group of students Knowledge score Chi square value
<Median ≥ Median
9.8
3rd year 19 17
4th year 23 15
Intern 10 28
On referring the chi-square table, at 2 degree of freedom, the value of chi-square under probability 0.05 is 5.99. So the calculated chi-square value ( 9.8 ) is greater than tabulated value at 0.05 level of significance. Hence, we reject the null hypothesis and infer that there is a statistical significant association between different group of nursing student and their knowledge regarding nosocomial infection at 0.05 level of significance.
DISCUSSION
Health care-associated infections have been recognized as crucial factors undermining the quality and outcomes of health care delivery. Developing countries were reported to have up to 20 times more nosocomial infection than developed countries.13 Day by day nosocomial infection becoming more and more burden to the world health care system through increased risk to patient and employees. These infections have tremendous health and financial costs with an estimate incidence of 2,000,000 infection per year, 20,000 death per year and added costs of billion dollars per year. Therefore effective infection control program are essential to controlling and preventing Nosocomial infection.14
clinical settings.9 Nosocomial infections goes beyond its impact on morbidity and mortality figures in any country, and it has profound economic implications. According to Robert, nosocomial infection can prolong duration of hospitalization, increase the costs of health care, and place a serious economic burden on patients and their families.10
There are several studies which reveal the importance of infection control practice in Nurses, medical students and physicians knowledge of standard and isolation precautions have been reported to be insufficient.15,16,17 Study conducted by Masavka S.P. et al concluded that improvement in the knowledge, attitude and practice towards nosocomial infection need to be done. For this purpose continuing education programs, seminars, symposiums or workshops should be arranged in the health care settings on regular basis.15 Study conducted by J Ojulong, KH Mitonga, and SN Iipinge concluded that Serious efforts are needed to improve or review curriculum so that health sciences student’s knowledge on infection prevention and control is imparted early before they are introduced to the wards.16 A study conducted by Ajediran I Bello et al concluded that The students sampled demonstrated moderate knowledge of nosocomial infections and this was acquired largely through formal classroom training. These findings underscore the need for more emphasis on education about this important source of infection in the clinical training curriculum.17 Another study conducted by Sodhi KI et al on intensive care nurses provide different result, the study concluded that the infection control knowledge among the nurses was fairly good; however, there is still a wide scope of improvement with regular educational programs and training.18
The present study is consistent with the study conducted by Masavka S.P. et al, J Ojulong, KH Mitonga, and SN Iipinge, and Ajediran I Bello et al. The present study has find that there is not adequate knowledge regarding nosocomial infections among B.sc. nursing students. It has revealed that no percentages among B.Sc.nursing students have excellent knowledge regarding nosocomial infection. Only 0.89%.have very good knowledge and 6.25% have good knowledge. 63.39% B.Sc. nursing students have below average knowledge regarding nosocomial infection. The present study is inconsistent with the study conducted by Sodhi KI et al where they conducted the study on intensive care nurses and concluded that the infection control knowledge among the nurses was fairly good.
Conclusion
Improvement in the knowledge, attitude and practice towards nosocomial infection need to be done. For this purpose continuing education programs, seminars, symposiums or workshops should be arranged on regular basis.
Recommendations
The Faculty of College of nursing should introduce the module of IPCs at the earliest opportunity to B.Sc. Nursing students.
The hospitals should take initiative to mandate infection control guidelines to students before entering the wards.
Ministry of Health and Social Services in conjunction with hospitals should intensify infection control measures in clinical settings.
Teaching methods should be improved or modified to increase knowledge of infection control
Inter-professional approach to learning about significance of infection control measures should be encouraged. Infection control measures should be introduced repeatedly by arranging of continuing education programs, seminars, symposiums or workshops.
More research can be conducted on nursing students to assess their knowledge, attitude and practice regarding prevention of nosocomial infections.
More studies can be conducted on nursing personnel and other health care providers to assess their knowledge, attitude and practice regarding prevention of nosocomial infections.
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