A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals

Incidence and risk factors of surgical site infections after coronary artery bypass grafting surgery in Oman

Background

There is limited information about the incidence and risk factors of surgical site infections (SSIs) after coronary artery bypass (CABG) surgeries in the Omani population.

Aim

To estimate the prevalence and describe possible risk factors of SSIs after CABG surgeries in Oman.

Method

A retrospective nested case-control design was used to screen 596 patients who underwent CABG surgeries over 2 years (2016-2017) in two tertiary hospitals in Oman. The CDC definition for SSIs was used to identify the infected cases.

Results

Prevalence rate of SSIs was 17.4% and 17.5% in 2016 and 2017, respectively. The most isolated microorganism was Gram-positive bacteria (45.2%). Risk factors of SSIs include female gender (OR = 3.2, p < 0.001), diabetes (OR = 5.83, p < 0.001), overweight or obese (OR = 2.14, p < 0.05) and shaving technique [using razor shaving] (OR = 8.4, p < 0.001). Readmission rate for the case group was 44.2%.

Conclusion

The infection rate of SSIs after CABG surgeries in developing countries, such as Oman, is considerably high. There is an urgent need to establish SSIs preventive program at the national level. Frequent and systematic assessment of infection control practices before and after CABG surgeries is fundamental and priority strategy to prevent SSIs.

Review of literature: Knowledge and practice of standard precautions by nursing student and teaching techniques used in training

INTRODUCTION

Standard precautions (SP) help to combat healthcare-associated infections. It is of paramount importance that they be taught during nursing studies. The objective of this review of the literature was to determine the level of knowledge and practice of SP and hand hygiene (HH) of nursing students (NSs) and to identify the different pedagogical hygiene techniques applied in nursing training.

METHODS

A review of the relevant literature was carried out according to the PRISMA method between January 2010 and April 2021.

RESULTS

Eighty-one articles were selected: 36 studies were dedicated to NSs' knowledge, 43 to the SP practice of NSs, and 21 to hygiene teaching techniques in nursing training. While NSs knowledge of HH was found to be moderate, their knowledge of SP was moderate or good. Alcohol-based hand rub were little known. SP practice and compliance with SP and HH was moderate. The hygiene training programs set up in view of improving knowledge and practices have applied diversified pedagogical techniques. Multimodal approaches have proposed different associations of pedagogical techniques. As of now, no single teaching methods has been found clearly superior to the others.

CONCLUSION

Enhanced training for nurses by means of new technologies and a combination of different approaches is indispensable in view of improving their levels of knowledge and practice.

Water, Sanitation, and Hygiene and Infection Prevention and Control in Jordanian Hospitals in the Context of COVID-19: A National Assessment

Purpose

To identify areas that need improvement in Jordanian health centers regarding infection prevention and control (IPC) programs; water, sanitation, and hygiene (WASH) services; and other protective measures, especially in the context of coronavirus disease (COVID-19).

Methods

This is a national assessment study that comprised hospitals of different sectors in Jordan, including, Ministry of Health (MoH), private, and military hospitals. The study included 23 Jordanian hospitals. Assessment tools were developed and adapted mainly from the WASH Facility Improvement Tool (WASH FIT) and other tools. Hospitals were assessed to meet targets based on whether indicators were fully met, partially met, or not met.

Results

The mean percentage of the 150 indicators that met the standards was 83.2% (72.6% for MoH, 84.5% for private, and 90.4% for military hospitals). The percentage of indicators, both WASH/IPC and training and education indicators, that met the targets were higher in military hospitals than in MoH and private hospitals. However, in context of COVID-19, only 64.7% of indicators related to precautionary measures were met by all hospitals.

Conclusion

The data available on WASH/IPC in Jordan are scarce, and the study findings will help in preventing severe consequences of the COVID-19 pandemic. There is scope for improvement in many WASH/IPC aspects, and urgent actions should be taken, especially to fill the gaps in COVID-19 precautionary measures.

Factors influencing knowledge, awareness, and compliance with standard precautions among psychiatric nurses

This study aimed to assess the level of knowledge, awareness, and compliance with standard precautions and to examine individual factors related to compliance with standard precautions among psychiatric nurses. Data were collected from September 2020 to March 2021. A total of 160 questionnaires were distributed, and a total sample of 134 valid questionnaires was analyzed. Compliance with standard precautions was significantly correlated with knowledge and awareness. Awareness (β = 0.547, p < .001) was a significant factor of compliance with a total explanatory power of 35.0% (F = 7.27, p < .001). Thus, the current coronavirus disease pandemic has significantly influenced the mental health infection system. These findings highlighted that psychiatric nurse must continue their efforts to improve compliance with infection prevention to prepare for an uncertain future with potential pandemics.

A survey of nurses' awareness of infection control measures in Baranya County, Hungary

AIM

This study aimed to assess nurses' awareness of infection control (IC) measures in Baranya County, Hungary.

DESIGN

A cross-sectional survey.

METHODS

The study used the infection control standardized questionnaire to assess nurses' awareness in standard precautions (SP), healthcare-associated infections (HAIs) and hand hygiene (HH). Data collection was done from two hospitals in February and March 2020. SPSS was used for statistical analysis.

RESULTS

The study included 121 nurses. The mean scores were 16.55 ± 2.69 for IC overall awareness, 10.10 ± 1.58 for SP, 2.07 ± 0.71 for HAIs and 4.38 ± 1.47 for HH. Acceptable scores were reached in overall awareness and SP. The overall and HAIs' scores significantly differed across educational degrees. The difference in SP mean ranks was statistically significant across hospital types. The low HAIs and HH scores highlight the need to enhance IC trainings in Hungarian hospitals and improve nurses' knowledge on IC.

The Efficacy, Safety, and Convenience of a New Device for Flushing Intravenous Catheters (Baro Flush™): A Prospective Study

Background and Objectives: An effective flushing technique is essential to reduce intravenous (IV)-related complications and improve patient care. New technology should contribute to such improvements, while reducing costs and increasing care efficiency. This study evaluated the efficacy, safety, and convenience of a new flushing technique using a Baro Flush™ controller. Materials and Methods: We evaluated the efficacy and safety of Baro Flush™ by measuring the infusion flushing volume and pressure in vitro. Afterwards, we prospectively enrolled 3000 patients with flushing and assigned 1500 patients with a new technique for flushing and 1500 with a conventional flushing method, which was performed by 48 registered nurses (RNs) at the Gil Medical Center in June 2018. The efficacy, safety, and convenience of the new flushing method were evaluated though a questionnaire survey. Results: The average flushing pressure was 12.5 ± 0.6 psi (86.18 ± 4.14 kPa) with 1.2 ± 0.2 mL per flush, as recommended by the Centers for Disease Control and Prevention based on 85 experiments. No IV-catheter-related complications were reported by the RNs during the study. More than 80% of the RNs reported that the new flushing method was easier to learn, improved care efficacy, and was more convenient than conventional flushing. Conclusions: The new flushing method using a Baro Flush™ controller showed improved efficacy, safety, and convenience compared with the conventional flushing method, and no IV-catheter-related complications occurred, including occlusion and inflammation. The new flushing method promises to reduce IV-catheter-related complications and shows improved efficacy, safety, and convenience.

Evaluation of infection prevention and control policies, procedures, and practices: An ethnographic study

BACKGROUND

The intensive care unit (ICU) is considered the epicenter of infections, and patients in the ICU are at higher risk of infection because of their vulnerability, age, and lengthy hospitalization.

METHODS

The ethnographic design has been used to describe, examine, and evaluate the policies and procedures that are implemented to prevent and control hospital-acquired infections (HAIs) in the medical ICU in King Abdullah University Hospital. In-depth semi-structured interviews with 23 participants supported by nonparticipant observation and document analysis were carried out to collect triangulated data. The themes and subthemes were developed through a software package and hand-coding procedure.

RESULTS

Health care workers were aware but not fully engaged to prevent and control HAIs; nevertheless, they presented themselves as knowledgeable. Staff recognized the importance of involving family members and visitors. However, they had serious concern toward open visitation. The nurse to patient ratio was another challenge of infection prevention and control practices. The findings demonstrated that performing continuous prospective surveillance by highly qualified and trained staff can reduce the risk of endemic HAIs.

CONCLUSIONS

The study highlighted the importance of changing behaviors and practices of health care providers and visitors to improve adherence to infection prevention and control policies and practices.