Türkiye Hastanelerinde Yoğun Bakım Hemşileri Arasında Sağlık Bakım ile İlgili Enfeksiyon Kontrol Önlemleri Hakkında Bilgi ve Farkındalık

Yıl 2022, Cilt: 4 Sayı: 3, 422 - 427, 22.09.2022

Ferda Kartufan , Ömer Doğanay , Güldem Palavan Ata , Çağrı Büke

https://doi.org/10.37990/medr.1109972

Öz

Amaç: Bu çalışmada, Türkiye’deki hastanelerdeki yoğun bakım ünitesi (YBÜ) hemşirelerinin sağlık hizmetleri ile ilişkili enfeksiyon kontrol önlemleri konusundaki bilgi ve farkındalıklarını vaka vinyetleri kullanarak belirlemeyi amaçladık.
Materyal ve Metot: Bu çalışmada kullanılan anket formu araştırmacılar tarafından ilgili literatür taranarak tasarlanmış ve hazırlanmıştır. Formun bilgilendirici kısmı demografik verilerden oluşmuştur. Soru kısmı ise olgu vinyetlerinin anlatımsal sorularını ve çoktan seçmeli maddeleri içeren beş ana bölümden oluşmuştur. Toplam 285 hemşireye e-posta adresleri üzerinden ulaşılmış ve ankete katılmayı kabul eden ICU hemşilerine anket bağlantısı gönderilmiştir.
Bulgular: Toplam 285 hemşireden 149’u anketi tamamlayarak formu çevrimiçi olarak göndermiştir. ICU’lara başka başka bir sağlık kuruluşundan gönderilen hastaların MRSA, VNE ve karbapenemaz üreten enterobakteriler açısından taranması gerektiğini düşünen hemşirelerin sayısı sırasıyla 111 (%74.4), 118 (%79.1) ve 93 (%62.4)’tür. Ellerin alkol bazlı el dezenfektanı ile ve 20-30 saniye boyunca ovulması gerektiğini düşünen hemşirelerin sayısı sırasıyla 90 (%60.4) ve 95’tir (%63.8). Clostridium difficile diarrhea bulunan hasta olması durumunda ellerin antimikrobiyel sabun ve su ile yıkanmasıyla el hijyeni sağlanması gerektiği şeklinde cevap veren hemşirelerin sayısı 26’dır (%17.4).
Sonuç: Bu çalışmanın sonuçları ICU hemşireleri arasında HCAI bilgi ve farkındalığının istenen düzeyde olmadığını göstermiştir. Bulgularımız ICU’larda HCAI kontrolünün farkındalığını artırmak amacıyla özellikle el hijyeni konusundaki eğitim ihtiyacını vurgulamaktadır.

Anahtar Kelimeler

Yoğun bakım ünitesi, sağlık bakım edinilmiş enfeksiyon, el hijyeni, izolasyon, hemşire, anket

Knowledge and Awareness of Health Care Associated Infection Control Measures Among Intensive Care Unit Nurses in Hospitals, Turkey

Öz

Aim: In this study, we aimed to determine knowledge and awareness of health care associated infection control measures among intensive care unit (ICU) nurses in Turkish hospitals using case-vignettes.
Material and Methods: The questionnaire form used in this study was designed and prepared by the researchers by screening the relevant literature. Informative part of the form consisted of demographic data. The question part included 5 main sections with narrative questions of case vignettes and multiple-choice items related to the vignettes. A total of 285 nurses were accessed through e-mail addresses; the survey link was then sent to the ICU nurses who accepted participation in the questionnaire.
Results: A total of 149 out of 285 nurses completed the questionnaire and sent filled the form online. The number of the nurses who consider screening of patients admitted to the ICUs from another health care institutions in terms of MRSA, VRE and carbapenemase-producing Enterobacteriaceae was 111 (74.4%), 118 (79.1%) and 93 (62.4%), respectively. The number of the nurses who thought that the hands should be rubbed with alcohol-based hand sanitizer and for 20-30 seconds was 90 (60.4%) and 95 (63.8%), respectively. In case of patients with Clostridium difficile diarrhea, the number of nurses gave the answer as the hand hygiene must be provided by washing hands with antimicrobial soap and water was twenty-six (17.4%)
Conclusion: The result of this study indicated that knowledge and awareness of HCAIs among ICUs nurses were not at a desired level. Our results highlight the need for education and training especially on hand hygiene to raise awareness of control of HCAIs in ICUs.

Anahtar Kelimeler

Intensive care unit, health care acquired infection, hand hygiene, isolation, nurse, questionnaire

Kaynakça

• 1. Collins A.S. Preventing Health Care-Associated Infections. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 41.
• 2. Parameswaran Nair N, Chalmers L, Peterson GM, Bereznicki BJ, Castelino RL, Bereznicki LR. Hospitalization in older patients due to adverse drug reactions –the need for a prediction tool. Clin Interv Aging. 2016;11:497–505.
• 3. Desikan R, Krauss MJ, Dunagan WC, et al. Reporting of Adverse Drug Events: Examination of a Hospital Incident Reporting System. In: Henriksen K, Battles JB, Marks ES, et al, editors. Advances in Patient Safety: From Research to Implementation (Volume 1: Research Findings). Rockville (MD): Agency for Healthcare Research and Quality (US); 2005.
• 4. Sydnor ERM, Perl TM. Hospital Epidemiology and Infection Control in Acute-Care Settings. Clin Microbiol Rev. 2011;24(1):141–173.
• 5. Head MG, Fitchett JR, Holmes AH, Atun R. Funding healthcareassociated infection research: a systematic analysis of UK research investments, 1997-2010. J Hosp Infect. 2014;87(2):84–91.
• 6. https://apps.who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf (Access Date: 25/12/2021)
• 7. Khan HA, Baig FK, Mehboob R. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine. 2017;7(5):478-482.
• 8. https://www.ecdc.europa.eu/sites/default/files/documents/HAI-Net-ICU-protocol-v2.2_0.pdf (Access Date: 23/12/2021)
• 9. https://www.ecdc.europa.eu/sites/default/files/documents/AER-HCAI_ICU_3_0.pdf (Access Date: 20/12/2021)
• 10. Soh KL, Davidson PM, Leslie G, DiGiacomo M, Soh KG. Nurses' perceptions of standardised assessment and prevention of complications in an ICU. J Clin Nurs. 2013;22(5-6):856-865.
• 11. Hensel KO, van den Bruck R, Klare I, Heldmann M, Ghebremedhin B, Jenke AC. Nursing staff fluctuation and pathogenic burden in the NICU - effective outbreak management and the underestimated relevance of non-resistant strains. Sci Rep. 2017;7:45014.
• 12. Halain AA, Soh KL, Ibrahim A et al. Nursing workload in relation to nosocomial infection in public hospital intensive care unit, Malaysia. International Journal of Pharmaceutical Research. 2018;10(4):15-20.
• 13. Kritsotakis EI, Kontopidou F, Astrinaki E, Roumbelaki M, Ioannidou E, Gikas A. Prevalence, incidence burden, and clinical impact of healthcare-associated infections and antimicrobial resistance: a national prevalent cohort study in acute care hospitals in Greece. Infect Drug Resist. 2017;10:317-328.
• 14. Askarian M, Yadollahi M, Assadian O. Point prevalence and risk factors of hospital acquired infections in a cluster of university-affiliated hospitals in Shiraz, Iran. J Infect Public Health. 2012;5(2):169–176.
• 15. Hammoud S, Khatatbeh H, Zand A, Kocsis B. A survey of nurses' awareness of infection control measures in Baranya County, Hungary. Nurs Open. 2021;8(6):3477-3483.
• 16. Park HY, Kim SK, Lim YJ, Kwak SH, Hong MJ, Mun HM, et al. Assessment of the appropriateness of hand surface coverage for health care workers according to World Health Organization hand hygiene guidelines. Am J Infect Control 2014; 42(5):559-61.
• 17. Sharma VS, Dutta S, Taneja N, Narang A. Comparing hand-hygiene measures in a neonatal ICU: a randomized cross-over trial. Indian Pediatric 2013; 50(10): 917- 21.
• 18. Malekmakan L, Haghpanah S, Askarian M, Jowkari M, Moalaee M. Hand hygiene in Iranian health care workers. Am J Infect Control 2008; 36 (8): 602-3.
• 19. Bulut A, Bulut A, Yigitbas Ç, Tuncay S. Hand hygiene attitudes of healthcare staff working in intensive care unit of a state hospital. Turk Hij Den Biyol Derg, 2017; 74(2): 139-146.
• 20. Fox C, Wavra T, Drake DA, et al. Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses' hand washing. Am J Crit Care. 2015;24(3):216-224.
• 21. Arli SK, Bakan AB. Nurses' compliance with isolation precautions and the affecting factors. Appl Nurs Res. 2017;38:175-178.
• 22. Oughton MT, Loo VG, Dendukuri N, Fenn S, Libman MD.Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile. Infect Control Hosp Epidemiol. 2009;30(10):939-44.