| Abstract: |
SUMMARYNosocomial transmission has been demonstrated between patients hospitalized in the ward and from health workers to patients. Procedures such as digestive endosocpy may explain some unclear contamination by HCV. Universal precautions are a set of principleA randomized controlled intervention study was conducted in the endosopy units and gasteroenterology departments of Zagazig university hospitals. The aim was to assess the knowledge, attitude and performance of nurses caring for variceal bleeding patientsThe study sample consisted of two groups: patients and nurses. The total number of 24 nurses was divided into 2 equal groups, a study group for implementation of the program, and a control group. Two groups of patients, 52 each were assigned to each of thThe tools used to accomplish the aims of this study consisted of the following:Four tools were used in this study for data collection, namely a knowledge questionnaire, an attitude scale, and a performance checklist, in addition to the lab form for patients.? Knowledge questionnaire: to assess nurses’ knowledge regarding infection control in esophageal varices endoscopy, and HCV. The first part covered nurses’ demographic and work characteristic. The second part consisted of 56 questions covering various rel? Attitude scale: for assessment of nurses’ attitudes towards infection control and use of standard and universal precautions in esophageal varices endoscopy. It consisted of 17 positive and negative statements.? Observation checklist: for nurses’ performance in relation to infection control in esophageal varices endoscopy, and prevention of HCV. It consisted of 113 items covering various performance areas.? Laboratory methods: included routine investigations, serum liver biochemistry, and detection of serum HCV antibodies by third generation ELISA, and RT-PCR for detecting serum HCV-RNA.The training program was designed after reviewing related literature, and an instructional booklet was prepared for participants. The actual time required for program implementation is 13 hours, 10 practical, and 3 theoretical.A pilot study was carried out on ten nurses to test content of questionnaire sheet and checklist validity and reliability. The actual work was performed over a period of six months from March to September 2003.The following results were obtained:• Three fourths of nurses in the study group had nursing diploma and were aged over 30 years.• The majority of nurses (83.3%) had more than 1 year of nursing experience in endoscopy unit, and approximately (25%) had more than 3 years of nursing experience in hematemsis ICU.• Lower incidence of HCV infection (9.6%) had been reported among esophageal varices patients who have undergone sclerotherapy after application of universal precautions program, compared to the control group (21.1%).• The majority of nurses’ knowledge and practice scores before the program implementation were below satisfactory level, in both groups.• There was statistically significant improvements in total nurses’ knowledge scores after program implementation (64.0±11.5, 80.0±7.5, 81.7±4.5, in pre, first post, and second post tests, respectively).• The highest improvements were observed in nurses’ basic knowledge regarding esophageal varices, HCV, universal precautions, and caring of the endoscopy instruments.• The socio-demographic characteristics of nurses had no effect on their pre-posttest improvements in knowledge or performance.• The highest improvements in nurses’ practice scores were related to universal precautions measures, and cleaning and disinfection of the endoscope, with statistically significant differences between practice scores before and after application of the un• There was a statistically significant improvement in the adequacy of nurses’ attitude scores of the study group after implementation of the universal precautions program (16.7%, 91.7% pre-post program, respectively).It was concluded that nurses were lacking knowledge and practice related to universal precaution measures, and procedures related to cleaning, disinfection, and sterilization of endoscopic instruments, and the application of a universal precautions trainiIt was recommended to have written policy and universal precautions infection control manuals, to make equipment and protective cloths available, to organize in-service training programs for nurses, and to apply quality control measures using strict obser
|
|
|