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A STUDY TO EVALUATE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON PREVENTION OF NOSOCOMIAL INFECTION AMONG THE STUDENT NURSES IN A SELECTED SCHOOL OF NURSING GULBARGA.

PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

Mr. Abdul SamadM.Sc. Nursing I year.

AL KAREEM COLLEGE OF NURSING, GULBARGA, KARNATAKARAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA. ANNEXURE II PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

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1.

NAME OF THE CANDIDATE AND ADDRESS (IN BLOCK LETTERS)

MR.ABDUL SAMAD H.NO.-5-23/2,JALAWADI,BEHIND KHAJA HIGH SCHOOL, ROZA(B) GULBARGA 585105 KARNATAKA

2.

NAME OF THE INSTITUTION

AL-KAREEM COLLEGE OF NURSING,

3.

COURSE OF ADMISSION OF THE COURSE

1st YEAR M.Sc. NURSING, MEDICAL AND SURGICAL NURSING 24-05-10

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DATE OF ADMISSION TO THE COURSE

5.

TITLE OF THE STUDY

A STUDY TO EVALUATE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON PREVENTION OF NOSOCOMIAL INFELTION AMONG THE STUDENT NURSES IN A SELECTED SCHOOL OF NURSING GULBARGA.

6. INTRODUCTION 2

While there is life there is hope - R. Macaulay The term infection refers to a state in which parasitic organisms attach themselves to the body, or to the inside of the body, of another organism, causing contamination and disease in the host organism. Infections fall into two general categories: endogenous, which occur when the body's resistance is lowered and exogenous, or those that originate outside the body. Nosocomial infection is an exogenous type of infection1. Nosocomial Infection is an infection originating in a patient in hospital. It is a serious hospital health hazard world wide. In spite of advances in the prevention and control propgramme of nosocomial Infection; they continue to be a major side effect of hospital and contribute significantly to the rate of morbidity, mortality and cost of care2. Florence nightingale more than 100 years ago, said No stronger condemnation of any hospital or ward could b e pronounced than the single fact that zymotic (infectious) disease has originated in it, or that such a disease has attacked other patients than those brought in with them. The history of Hospital Acquired Infection goes back to the period since the sick were housed together for the treatment. The enormity of the problem of Hospital acquired infection during pre Lister era can be best stated by quoting, John Bell who in 1801 wrote : There is no hospital, however small or well regulated, where this epidemic ulcer is not to be found at times; and then no operation dare be performed, every care, stands still, every wound becomes a sore, every sore is apt to run into gangrene. The Nosocomial Infection is a problem, world over in all the hospitals, However, due to emergence of H.I.V. Infection the need to prevent and control nosocomial infection is being emphasized. The aim is to reduce nosocomial infection and ensure that no one acquires HIV infection from the hospital by strictly observing the precautions recommended for handling blood and body fluids, precautions in relation to injections, skin piercing and invasive procedures, effective use of sterilization, disinfection and disposal of infective waste3. No Hospital can continue to perpetuate such condemnation, however hospital acquired infection remains a problem world over. In a recent survey conducted by WHO on 28,861 patients in 47 hospitals of 14 countries located in 4 continents, the prevalence rate of nosocomial infection of different hospitals, varied from 3% - 21% with mean of 8.4%. The results of the survey reported in 1988 indicated that the nosocomial infection is a considerable problem, 3

even in hospital with means and interest in control of nosocomial infection. Further it is possible to reduce in incidence of infection. The authors concluded that there is a need and opportunity for international co-operation in finding and applying effective means of prevention and control4. Infections occurs within 48 hours after admission are considered as nosocomial infection. Nosocomial infection cannot be cradicated entirely but many of them can be prevented by proper aseptic measures5.

7. BRIEF RESUME OF THE INTENDED WORK. 7.1 Need for the study Nosocomial infection is an infection originating in a patient, while in hospital. Nosocomial infection is a serious health hazard worldwide. Despite advances in the control and prevention of nosocomial infection, they constitute to remain as the major side effect of hospital treatment and contribute significantly to the rate of morbidity and mortality and cost of care6. The Nosocomial infection is responsible for about 29,000 deaths in U.S. per year. 10% American hospital patient acquired clinically signified nosocomial infection. The infections transmit from patient to patient due to high prevalence of pathogens. Nosocomial infection is potential hazard for all person having contact with the hospital because of the high concentration of pathogenic micro organisms exists in hospital. It is estimated that out of 16 million patients undergoing surgical procedure each year, 24% suffer with nosocomial infection4. The incidence rate of Nosocomial infection in U.S.A was 2,159,230 amnong the estimated population 29,36,55,405 and in India it was 78,31,401among the population 106,50,70,607 7. A study on effectiveness of self instructional module on knowledge of health worker care providers regarding protection against hospital acquired infection at Ramaiah College. 50 samples were selected by using purposive sampling technique. The tool used was structured questionnaire. The mean pre test was 46.2 +- 25.0 whereas the post test score was 74.4 +- 24.2.8

A quasi experimental study was conducted to evaluate the effect of an educational training programme for 100 randomly selected hospital nurses on universal precautions in Chang Hospital in China. Questionnaire were administered to the 100 nurses prior to and four months after the training. The result showed that educational 4

training significantly improved Chinese nurses knowledge, practice and behaviors related to universal precautions. There was remain room for improvement in glove use and needle stick injury reporting. 9

According to above studies and incidence, as a researcher myself according my experience, felt there is a need for in depth knowledge regarding prevention of Nosocomial infection among nursing students to reduce mortality and morbidity related to Nosocomial infection 7.2 REVEIW OF LITERATURE The review of literature is traditionally considered a systematic critical review of the most important published, scholarly literature on particular topic. A thorough literature review on prior research provides a foundation on which to base knowledge. 1. 2. 3. Review literature related to general studies of Nosocomial Infection. Review literature related preventive measures of Nosocomial Infection. Review literature related to Structured Teaching on prevention of Nosocomial Infection. On

G.N.M.Students.

4.

1.

Review literature related to general studies of Nosocomial Infection.

A study on an outbreak of severe acute respiratory syndrome was detected in Singapore at the beginning of March 2003. The outbreak initiated by a traveler to Hongkong in February 2003 lead to spread of SARS to three major acute care hospitals in Singapore. The critical factor, of this outbreak was early, detection and

complete assessment of movement and follow up of patients, healthcare workers and visitors who had contacts. In the 3 hospital outbreaks, 3 different containment strategies were used to contain spread of infection, closing an entire hospital, removing all potentially infected persons to a dedicated SARS hospital and managing exposed persons in place on the basis of his experience. If a nosocomial outbreak is detected late, a hospital may need to be closed in order to contain spread of disease, outbreaks detected early can be managed by either removing all exposed persons to a designated location or isolating and managing them in place10.

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A study on neurosurgical patients operated upon over a period of one year from January to December. Samples of surgical patients about 2441 were taken. A total of 2558 operations were performed, 1824 on elective and 734 as emergency. They observed nosocomial infection was (7.03 %) 186 patients. Prolonged catheterization (more than 7days) caused bacterial infection accounting about 79 %( 132)11. A survey on identifying knowledge and performance of the nursing personals and medical students in Korea was conducted. The questionnaire was administered to a total of 714 nursing and Medical students for the period between Nov 2, 1998 and April 30, 2000. The results showed that the knowledge level of the nursing students (270.4+-19.4) was higher than that of the medical students (261.0+-24.4). The average performance level was 52.7 +- 60.2 (scores ranged from 14 to 75).The student of the nursing college showed a higher performance level in universal precautions (53.2 +- 5.9,p=0.002). The correlations showed :a weak and positive correlation(r=0.317).12 2. Review literature related preventive measures of Nosocomial Infection An evaluation study with one group pretest post test design in the medical, surgical and orthopedic wards of Guru Tej Bahudur hospital, Delhi. The surgical knowledge and practice of staff nurses on biomedical waste management were accessed through structured knowledge questionnaire and observations check list and book let was administrated to 32 nursing personnel. It was observed that less than half of staff nurses were aware of various risks and methods of treatment and disposal of biomedical waste. The post test knowledge score were significantly higher than pre test kn