Nurses' Knowledge and Practice of Aseptic Technique in the Operation Theatre at Selected Hospitals of Bharatpur

 

Babita Dhakal¹, Siddeshwar Angadi², Milan Lopchan³

¹B.Sc. Nursing, College of Nursing, Chitwan Medical College, Bharatpur – 13, Chitwan, Nepal

²M.Sc. (Nursing), Assistant Professor, College of Nursing, Chitwan Medical College, Bharatpur – 13, Chitwan, Nepal

³Professor and Principal, College of Nursing, Chitwan Medical College, Bharatpur – 13, Chitwan, Nepal

 

ABSTRACT:

The nurses are involved in major part of patient care; they are thus important target population to determine their level of knowledge and practice of aseptic technique in the operation theatre. A descriptive study approach was used to find out the nurses' knowledge regarding aseptic technique in the operation theatre of selected hospitals, Bharatpur. Fifty six nurses working in operation theatre of the selected hospitals i.e. Chitwan Medical College, Bharatpur Hospital and College of Medical Sciences were taken for the study.Data were collected by using semi-structured self-administered questionnaire. The findings revealed that, 62.5 % respondents had high knowledge, 37.5% had average knowledge and none of the respondents had low knowledge on aseptic technique. The level of knowledge on aseptic technique is statistically significant (p=0.031) with the age and educational qualification of the respondents.

 

 

 

INTRODUCTION:

Infections are a major source of morbidity and cause of mortality during the postoperative phase for patients. Wound infections are the second most commonly encountered type of nosocomial, hospital-acquired, infection in the United States (Nichols, 2007). Knowing the fact that wound infection may be induced, by not practicing enough infection control measures and sterile techniques in the operating theatre, it is essential to implement infection control principles and apply sterile technique principles.

According to Phillips, sterile technique is the basis of modern surgery and therefore strict adherence to the recommended practices of sterile technique is mandatory for the safety of the patient as well as for the personnel in the operating room complex. From this we can understand that aseptic technique is of prime importance in the operation theatre, which includes mainly hand hygiene, gowning and gloving.

 

NEED FOR THE STUDY:

It is estimated that 4.5 to 5.7 billion people are affected with SSI per year due to lack of aseptic technique practices in hospital. (Infection Control and Hospital Epidemiology). Approximately 9% of Indian hospital  patients acquire health care associated infections especially post-operative infections and as a result 5000-15,000 die every year. It also recommended the importance of improving the knowledge and practice of aseptic technique among theatre nurses (Wilson, 2000). National surveillance service 2002 conducted a survey for healthcare workers in UK reported 2,351 cases of wound infection. Out of these, 44% of infections occur due to lack of knowledge on aseptic procedures, 29% due to lack of time and 28% due to shortage of staffs.

 

MATERIAL AND METHODS:

Descriptive study approach was used in the research. Fifty six participants were selected from the operation   theatre by purposive sampling method from selected   hospitals of Chitwan i.e. CMCTH, CMSTH and   Bharatpur Hospital. Semi-structured self-administered   questionnaire was used to measure knowledge of nurses. The collected data was checked, reviewed and   organized daily for its completeness and consistency. The data was entered in statistical package for social science (SPSS) version 20 and then was analysed and interpreted in term of descriptive statistics (frequency, percentage, mean etc.) and inferential statistics (Fisher exact test).

 

RESULTS:

The analysis of the data revealed that, demographically, highest percentage (67.9%) of the respondents were in the age group of below 25 years and majority (80.4%) had completed PCL Nursing. Most of the respondents (75%) had working experience of five years and below, and nearly 35.7% of the participants had taken formal   training on aseptic technique. Among those who had taken formal training, 65% had received formal training on the time period of more than 12 months ago. Regarding the knowledge of aseptic technique among nurses’, more than half of the participants (62 %) had high level of knowledge on aseptic technique, few (37.5%) had average level of knowledge and none of the respondents had low knowledge on aseptic technique.

 

Table 1: Respondents’ Socio-Demographic Characteristics n=56

 

Table 2: Respondents’ Level of Knowledge on Aseptic Technique

Level of knowledge	Frequency	Percentage
High	35	62.5
Average	21	37.5
Low	0	0.0

n=56

 

Table 3: Association between Respondents’ Level of Knowledge and Demographic Variables

Variables	Level of Knowledge		p-value
	Low (%)	High (%)
Age f <25 25 and above	19 (50.0) 2 (11.1)	19 (50.0) 16 (88.9)	0.007
Educational Qualification f PCL Nursing BN and MN	20 (44.4) 1 (9.1)	25 (55.6) 10 (90.9)	0.039

Significance level at 0.05                 

 ^f=Fisher exact test              

 x² is computed for p-value

 

Table 3: Shows that the level of knowledge on aseptic technique is statistically significant with age and educational qualification of the respondents.

 

DISCUSSION AND CONCLUSION:

Concerning the demographic characteristics, this study revealed that among 56 the respondents, their mean age was 24 years with standard deviation of 5.47 and 7.1% respondents had total working experience of 21-25 years. The findings of this study is supported by Leodoro et al. (2012) titled: "Operating Room Nurses' Knowledge and Practice of Sterile Technique" which revealed the respondents‟ mean  age was 32.86  with standard deviation of 7.58 and 4.76% respondents had total working experience 21-25 years. Regarding the safe distance for an unsterile person from sterile field, 87.5% respondents answered 30 cm and 1.8% answered 60 cm. The findings of this study is in contrary with Malan (2009) titled: "Registered nurses‟ knowledge of infection control and sterile technique principles in the operating room complex of private hospitals." which revealed that 20% answered 30 cm and 80% answered 60 cm. In the present study, regarding sterile part of the gown, 71.4% respondents answered from the chest level to the level of the sterile field and 5 cm above elbows to the cuffs of the sleeves which is inconsistent with the same study which revealed that 49% of the participants knew that the gown was considered sterile only from the chest to the level of the sterile field and 5cm above the elbows to the cuffs of the sleeves and 51% did not know. Regarding hand washing, 71.4% answered it is the cornerstone technique to minimize the spread of wound infection. The finding of this study is supported by John (2006) titled: "Effectiveness of self-instructional module on aseptic wound dressing practices among staff nurses in selected hospitals at Mangalore". The study revealed that 64% of the respondents knew that the cornerstone  technique to minimize the spread of wound infection is   hand washing. In the present study, concerning the opening of sterile glove, 51.8% respondents answered   glove is opened placing on a clean dry surface.  Regarding keeping thumb against palm during gloving, 70.2% answered thumb is kept against palm during gloving to make hand easy to enter the glove and 66.1% answered that hand is held above elbow during surgical hand washing. These all findings of the study are inconsistent with the same study of which revealed that 29% respondents answered glove is opened placing on   a clean dry surface, 50% answered thumb is kept against palm during gloving to make hand easy to enter the glove and 45% answered that during surgical hand washing, the hand should be held above elbow. Regarding steps of hand washing, 96.4% answered wet hand, apply antiseptic agent, rinse, dry and 3.6%   answered wet hand, apply soap and rinse as the step of   hand washing. The finding of this study is inconsistent with Sickder (2009) titled: "Nurses‟ Knowledge and Practice Regarding Prevention of Surgical Site   Infection in Bangladesh” which revealed that 73.3%   answered correctly that the correct step of surgical hand washing is, Wet hands, apply antiseptic agent, rinse, dry. Regarding practice on aseptic technique, 100 %   respondents gloved surgical glove properly.The     finding of this study is supported Hassan et al (2011)     titled: "Assessment of existing practices in the   operating theatre in the Khartoum North Teaching Hospital, Sudan, South Africa" which revealed that 100 % of respondents gloved surgical glove properly. About   sixty three percent respondents had high knowledge on   aseptic technique, 37.5% had average knowledge and   none of the respondents had low knowledge on aseptic technique.

 

 Thus, it can be concluded that more than half of the respondents had high knowledge on aseptic technique     and the level of overall knowledge is statistically significant with age and educational level of   respondents.

 

REFERENCES:  

1      Phillips N, Berry EC (2007) Berry & Kohn’s Operating Room Technique. (11th edn) Mosby, Missour

2      Infection Control and Hospital Epidemiology. (2013). Journal of Chicago, 34 (4).  Retrieved from http://www.jstor.org/discover/10.1086/669857?uid=2&uid=4& sid=21103002720747

3      Leodoro, J., Labrague, D. L., Arteche, B. C., Yboa., & Nenita, F. P. (2012). Operating Room Nurses ‟Knowledge and Practice of Sterile Technique. Journal of  Nursing  Care, 1(4), Retrieved from http://dx.doi.org/10.4172/2167-  1168.100013

4      Hassan, A. N., Hassan, M. A., Abdrahman, A. A., Elshallaly, G. H., & Saleh, M. A. (2011). Assessment of existing practices in the operating theatre in the Khartoum North Teaching Hospital, Sudan, South Africa. Journal of Epidemiological Infection . 26 (2), 79-82. Retrieved from http://www.sajei.co.za/index.php/SAJEI/article/view/232

5      Malan, K. (2009). Registered nurses‟ knowledge of infection control and sterile technique principles in the operating room complex of private hospitals. Retrieved from http://dspace.nmmu.ac.za:8080/jspui/bitstream/10948/1079/1/Kim%20Malan pdf

6      John, J. (2006). Effectiveness of self-instructional module on aseptic wound dressing practices among staff nurses in selected hospitals at Mangalore. Retrieved from http://14.139.159.4:8080/jspui/bitstream/123456789/1352/1/CDNNMSN

 00012.pdf

7      Sickder, H. K. (2009).Nurses ‟ Knowledge and Practice Regarding Prevention of Surgical Site Infection in Bangladesh. Retrieved from

8      Wilson, J. (2000). Infection control in clinical practice. (2nd ed., p.471).  Balliere  Tindall.

 

 

 

 

 

 

 

 

Received on 03.02.2016           Modified on 16.02.2016

Accepted on 21.02.2016           © A&V Publication all right reserved