Ameliyathane Kaynaklı Cerrahi Alan Enfeksiyonlarını Önlemeye İlişkin Ameliyathane Hemşirelerinin Bilgi Düzeyleri
Öz
DOI:10.17681/hsp.458122
Amaç: Bu araştırma, ameliyathane hemşirelerinin cerrahi
alan enfeksiyonlarını önlemeye ilişkin kanıta dayalı uygulamalar hakkında bilgi
düzeylerinin belirlenmesi amacıyla tanımlayıcı olarak planlanmıştır.
Gereç ve Yöntem: Çalışma 01.04.2018-
15.05.2018 tarihleri arasında Zonguldak’ta bir devlet hastanesi ve bir sağlık
uygulama ve araştırma merkezinin ameliyathane ünitesinde çalışan hemşireler ile
yapılmıştır. Araştırmacılar tarafından oluşturulan anket formu, sosyodemografik
verileri içeren 11 soru ve kanıta dayalı uygulama rehberleri doğrultusunda
cerrahi alan enfeksiyonlarını önlemeye yönelik kanıta dayalı uygulamaları
sorgulayan 33 soru, alınabilecek en yüksek puan 33, en düşük puan 0 olmak üzere
toplam 44 sorudan oluşturulmuştur. Madde güvenilirlik analizi Cronbach Alpha
skalasına göre 0,70 olarak hesaplanmıştır. Verilerin değerlendirilmesinde,
sayı, yüzde, ortalama, standart sapma, minimum ve maksimum değerler ve Man
Whitney U testi ve Kruskal-Wallis varyans analizi kullanılmıştır.
Bulgular: Araştırmadan elde edilen verilere göre
hemşirelerin cerrahi alan enfeksiyonlarını önlemeye ilişkin yönelik kanıta
dayalı uygulamalar hakkında bilgi puan ortalaması 22,05±3,53 (min: 10, max: 32)
olarak bulunmuştur. Çalışmaya katılan hemşirelerin ortalama yaşlarının 38,29 ± 9,00
olduğu ve çoğunluğunun %63,2 ile lisans mezunu oldukları belirlenmiştir.
Hemşirelerin %75,4’ünün 6 yıldan daha
uzun süredir ameliyathanede çalıştığı ve %77,2 sinin scrub ve sirküle hemşire
olarak çalıştığı görülmüştür. Hemşirelerin tümünün cerrahi alan enfeksiyonları
ile ilgili eğitim aldıkları ve bunun %66,72’sini hizmet içi eğitimin
oluşturduğu bildirilmiştir. Hemşirelerin %64,9’u kurumlarında kanıta dayalı
uygulamaların uygulandığını düşünmektedir. Hemşirelerin demografik özellikleri
ile puan ortalamaları arasında istatistiksel olarak anlamlı farklılık
bulunmamıştır.
Sonuç: Araştırmadan sonuçlarına göre hemşirelerin cerrahi
alan enfeksiyonlarını önlemeye ilişkin yönelik kanıta dayalı uygulamalar
hakkında bilgi puan ortalaması 22,05±3,53 puan ile orta seviyenin üstünde
bulunmuştur.
Anahtar Kelimeler
Kaynakça
- Centers For Disease Control and Prevention. National and state health care associated infections progress report, Mart 2016. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://www.cdc.gov/HAI/ pdfs/progress-report/hai-progress-report.pdf.
- Centers For Disease Control and Prevention. Procedure - associated Module. Surgical site infection (SSI) event, January 2016. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf.
- Diaz V, Newman J. Surgical site infection and Prevention Guidelines: A primer for certified registered nurse anesthetists. AANA Journal Course. 2015; 83 (1): 63-68.
- European Centre for Disease Prevention and Control, Surveillance of surgical site infections in European hospitals – HAISSI protocol, 2012. Erişim Tarihi: 29.05.2018. Erişim Adresi: https://www.google.com.tr/?gfe_rd=cr&ei=zxwAV9q5CIbY8Afa2IHAAg&gws_rd=ssl#q=Surveillance+of+surgical+site+infections+in+European+hospitals+–+HAISSI+protocol.+.
- Erdem HA, Sipahi OR, Kepeli N, Dikiş D, Küçükler ND, Aksoy B, Korkmaz N, Akşit Bank Ş, Arda B, Özinel MA, Çilli F, Ulusoy S. Ege Üniversitesi Hastanesi’nde hastane infeksiyonları nokta prevalansı. Mediterranean Journal of Infection Microbes Antimicrobials.2015; 4: 12-24.
- Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control. Best practices for surveillance of health care - associated ınfections in patient and resident populations, July 2014. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://www.publichealthontario.ca/en/eRepository/Surveillance_33_ENGLISH_2011-10-28%20FINAL.pdf.
- Vincent HSU. Prevention of health care–associated infections. American Academy Family Physicians. 2014; 90(6): 377-382.
- Pittet D, Allegranzi B, Boyce J. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol. 2009; 30: 611–622.
- Beldi G, Bisch-Knaden S, Banz V, Mühlemann K, Candinas D. Impact of intraoperative behavior on surgical site infections. The American Journal of Surgery. 2009; 198: 157–162.
- Magill SS, Hellinger W, Cohen J, Kay R, Bailey C, Boland B. Et al. Prevalence of Healthcare-Associated Infections in Acute Care Hospitals in Jacksonville, Florida. Infect Control Hosp Epidemiol. 2012; 33(3): 283-291.
- Uğurlu MÜ, Mokhtare S, Yıldız F, Pekru Y, Kuzucanli M, Aktan AÖ. Surgeon behavior and knowledge on hand scrub and skin antisepsis in the operating room. Journal of Surgical Education. 2014; 71(2): 241-245.
- Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. Journal of Hospital Infection. 2008; 70(52): 3-10.
- Meeks DW, Lally KP, Carrick MM, Lew DF, Thomas EJ, Doyle PD, Kao LS. Compliance with guidelines to prevent surgical site infections: as simple as 1-2-3?. The American Journal of Surgery. 2011; 201:76-83.
- Üstün C, Geyik MF, Aldemir M, Tekin R, Çelen MK, Girgin S, Hosoğlu S, Ayaz C. Genel cerrahi kliniğinde gelişen hastane enfeksiyonlarının sürveyansı: on yıllık verilerin değerlendirilmesi. Düzce Tıp Dergisi. 2010; 12 (3): 1-6.
- Àngeles-Garay U, Morales-Màrquez L, Sandoval-Balanzarios MA, Velàzquez-Garcia JA, Maldonado-Torres L, Méndez-Cano AF. Risk factors related to surgical site infection in elective surgery. Cirugía y Cirujanos. 2014; 82 (1): 44-56.
- Reyes GE, Chang PS. Prevention of surgical site infections: Being a winner. Operative Techniques in Sport Medicine. 2011; 19: 238-244.
- Berríos-Torres SI, Umscheid CA, Bratzler DW, Brian Leas MA, Erin C. Stone, Rachel R. Kelz et al. CDC Guidelines for the Prevention of Surgical Site Infection. JAMA Surg. 2017; 152(8):784-791.
- Centers Disease for Prevention and Control. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Erişim Tarihi: 29.05.2018. Erişim Adresi: https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines.pdf.
- World Health Organizatıon. Global Guidelines For The Prevention Of Surgical Site Infection, 2016. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://apps.who.int/iris/bitstream/handle/10665/250680/9789241549882-eng.pdf;jsessionid=5D9857762063566B044710AFBC18245B?sequence=1.
- National Health Institute for Health and Care Exellence (NICE). Surgical site infections: prevention and treatment. Güncelleme Tarihi: 2017; Erişim Tarihi: 29.05.2018. Erişim Adresi: https://www.nice.org.uk/guidance/cg74/resources/surveillance-report-2017-surgical-site-infections-prevention-and-treatment-2008-nice-guideline-cg74 4358983213/chapter/Surveillance-decision.
- Guideline Summary:Hand Hygiene. AORN J 105 :213-217, 2017.
- Labeau SO, Witdouck SS, Vandijck DM, Claes B, Rello J, Vandewoude KH, Lizy CM, Vogelaers DP, Blot SI. Nurses' Knowledge of Evidence‐BasedGuidelines for the Prevention of Surgical Site Infection. Worldviews Evid Based Nurs. 2010; 7(1):16-24.
- Teshager F A, Engeda EH, Worku W Z. Knowledge, Practice, and Associated Factors towards Prevention of Surgical Site Infection among Nurses Working in Amhara Regional State Referral Hospitals, Northwest Ethiopia. Surgery Research And Practice. 2015.
- Labrague LJ, Arteche DL, Yboa BC, Pacolor NF. Operating Room Nurses’ Knowledge and Practice of Sterile Technique. Journal of Nursing & Care. 2012; 1:113.
- Taneja J, BibhaBati M, Aradhana B, Poonam L, Vinita D, et al. Evaluation of knowledge and practice amongst nursing staff toward infection control measures in a tertiary care hospital in India. Can J Infect Control. 2009; 24: 104-107.
- Dhakal B, Angadi S, Lopchan M. Nurses' Knowledge And Practice Of Aseptic Technique İn The Operation Theatre At Selected Hospitals of Bharatpur. International Archives of BioMedical and Clinical Research. 2016; 2(2): 32-34.
- Luo Y, He GP, Zhou JW, Luo Y . Factors impacting compliance with standard precaution in nursing, China. Int J Infect Dis. 2010; 14: e1106-e1114.
- Melo Dde S, Silva e Souza AC, Tipple AF, das Neves ZC, Pereira MS. Nurses’ understanding of standard precautions at a public hospital in Goiania -GO, Brazil. Rev Lat Am Enfermagem. 2006; 14: 720-727.
- Nakhaei M, Mofrad SA. Investigating Nurses’ Knowledge and Self-efficacy Regarding the Principles of Infection Control in the Operating Room. Mod Care J. 2015; 12(2):79-83.
- Qasem MN, Hweidi IM. Jordanian Nurses’ Knowledge of Preventing Surgical Site Infections in Acute Care Settings. Open Journal of Nursing. 2017; 7: 561-582.
- Sadia H, Kousar R, Azhar M, Waqas A, Gilani SA. Assessment of Nurses’ Knowledge and Practices Regarding Prevention of Surgical Site Infection. Saudi Journal of Medical and Pharmaceutical Sciences. 2017; 3(6):585-595.
- Sickder HK, Lertwathanawilat W, Sethabouppha H, Viseskul N. Nurses’ Surgical Site Infection Prevention Practices in Bangladesh . Pacific Rim Int J Nurs Res. 2017; 21(3): 244-257.
- Turan H. Cerrahi Antimikrobiyal Profilakside Güncel Öneriler. Klimik Dergisi. 2015; 28(1): 2-10.
- Madhu BS, Shashi Kumar HB, Naveen Kumar Reddy M. Abilash V. Reddy, Sangeetha Kalabhairav. Effect of single dose pre-operative antibiotic prophylaxis versus conventional antibiotic therapy in patients undergoing lichtenstein tension free mesh repair. International Surgery Journal. 2017; 4(2):738-742.
Öz
DOI:10.17681/hsp.458122
Purpose: This study was conducted to determine the knowledge levels of operating
room nurses on evidence based practices to prevent surgical site infections.
Materials and Methods: This descriptive study was carried out
between 01.04.2018 and 15.05.2018 with nurses working in the operating theater
unit of state and university hospitals in Zonguldak province. The questionnaire
created by the researcher in the light of the literature was consisted of 44
questions, 11 questions including sociodemographic data and 33 questions, which
can get minimum 0 point and maximum 33 points, questioning about evidence-based
practices to prevent surgical site infections. The item reliability analysis of
the questionnaire was calculated to be 0,70 with Cronbach alpha. Data were
analyzed by descriptive statistics as well as Mann Whitney U test and Kruskal-Wallis
test.
Results: According to the data obtained from the study, the information score
means of the nurses’ knowledge about the evidence –based practices to prevent
surgical site infections was found to be 22,05±3,53 (min:10, max:32). It was
determined that the average age of the nurses participating in the study was 38,29±9,00
and the majority of the nurses had a bachelor's degree with 63,2%. It was
reported that 75,4% of the nurses worked in the operating room unit for 6 or
more years and 77,2% of nurses worked as scrub and circulating nurses. It was
reported that all nurses were trained on surgical site infections and that
in-service training constituted 66,7% of the education. 64,9% of the nurses
think that they are working with evidence-based practices in the hospital. No
statistically significant difference was found between the demographical
characteristics and the nurses' information score means.
Conclusion: The study showed that operating room nurses
had moderate level knowledge about the evidence-based practices for prevention
of surgical site infections.
Anahtar Kelimeler
Evidence-based practices Operating room nurse surgical site infection
Kaynakça
- Centers For Disease Control and Prevention. National and state health care associated infections progress report, Mart 2016. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://www.cdc.gov/HAI/ pdfs/progress-report/hai-progress-report.pdf.
- Centers For Disease Control and Prevention. Procedure - associated Module. Surgical site infection (SSI) event, January 2016. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf.
- Diaz V, Newman J. Surgical site infection and Prevention Guidelines: A primer for certified registered nurse anesthetists. AANA Journal Course. 2015; 83 (1): 63-68.
- European Centre for Disease Prevention and Control, Surveillance of surgical site infections in European hospitals – HAISSI protocol, 2012. Erişim Tarihi: 29.05.2018. Erişim Adresi: https://www.google.com.tr/?gfe_rd=cr&ei=zxwAV9q5CIbY8Afa2IHAAg&gws_rd=ssl#q=Surveillance+of+surgical+site+infections+in+European+hospitals+–+HAISSI+protocol.+.
- Erdem HA, Sipahi OR, Kepeli N, Dikiş D, Küçükler ND, Aksoy B, Korkmaz N, Akşit Bank Ş, Arda B, Özinel MA, Çilli F, Ulusoy S. Ege Üniversitesi Hastanesi’nde hastane infeksiyonları nokta prevalansı. Mediterranean Journal of Infection Microbes Antimicrobials.2015; 4: 12-24.
- Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control. Best practices for surveillance of health care - associated ınfections in patient and resident populations, July 2014. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://www.publichealthontario.ca/en/eRepository/Surveillance_33_ENGLISH_2011-10-28%20FINAL.pdf.
- Vincent HSU. Prevention of health care–associated infections. American Academy Family Physicians. 2014; 90(6): 377-382.
- Pittet D, Allegranzi B, Boyce J. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol. 2009; 30: 611–622.
- Beldi G, Bisch-Knaden S, Banz V, Mühlemann K, Candinas D. Impact of intraoperative behavior on surgical site infections. The American Journal of Surgery. 2009; 198: 157–162.
- Magill SS, Hellinger W, Cohen J, Kay R, Bailey C, Boland B. Et al. Prevalence of Healthcare-Associated Infections in Acute Care Hospitals in Jacksonville, Florida. Infect Control Hosp Epidemiol. 2012; 33(3): 283-291.
- Uğurlu MÜ, Mokhtare S, Yıldız F, Pekru Y, Kuzucanli M, Aktan AÖ. Surgeon behavior and knowledge on hand scrub and skin antisepsis in the operating room. Journal of Surgical Education. 2014; 71(2): 241-245.
- Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. Journal of Hospital Infection. 2008; 70(52): 3-10.
- Meeks DW, Lally KP, Carrick MM, Lew DF, Thomas EJ, Doyle PD, Kao LS. Compliance with guidelines to prevent surgical site infections: as simple as 1-2-3?. The American Journal of Surgery. 2011; 201:76-83.
- Üstün C, Geyik MF, Aldemir M, Tekin R, Çelen MK, Girgin S, Hosoğlu S, Ayaz C. Genel cerrahi kliniğinde gelişen hastane enfeksiyonlarının sürveyansı: on yıllık verilerin değerlendirilmesi. Düzce Tıp Dergisi. 2010; 12 (3): 1-6.
- Àngeles-Garay U, Morales-Màrquez L, Sandoval-Balanzarios MA, Velàzquez-Garcia JA, Maldonado-Torres L, Méndez-Cano AF. Risk factors related to surgical site infection in elective surgery. Cirugía y Cirujanos. 2014; 82 (1): 44-56.
- Reyes GE, Chang PS. Prevention of surgical site infections: Being a winner. Operative Techniques in Sport Medicine. 2011; 19: 238-244.
- Berríos-Torres SI, Umscheid CA, Bratzler DW, Brian Leas MA, Erin C. Stone, Rachel R. Kelz et al. CDC Guidelines for the Prevention of Surgical Site Infection. JAMA Surg. 2017; 152(8):784-791.
- Centers Disease for Prevention and Control. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Erişim Tarihi: 29.05.2018. Erişim Adresi: https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines.pdf.
- World Health Organizatıon. Global Guidelines For The Prevention Of Surgical Site Infection, 2016. Erişim Tarihi: 29.05.2018. Erişim Adresi: http://apps.who.int/iris/bitstream/handle/10665/250680/9789241549882-eng.pdf;jsessionid=5D9857762063566B044710AFBC18245B?sequence=1.
- National Health Institute for Health and Care Exellence (NICE). Surgical site infections: prevention and treatment. Güncelleme Tarihi: 2017; Erişim Tarihi: 29.05.2018. Erişim Adresi: https://www.nice.org.uk/guidance/cg74/resources/surveillance-report-2017-surgical-site-infections-prevention-and-treatment-2008-nice-guideline-cg74 4358983213/chapter/Surveillance-decision.
- Guideline Summary:Hand Hygiene. AORN J 105 :213-217, 2017.
- Labeau SO, Witdouck SS, Vandijck DM, Claes B, Rello J, Vandewoude KH, Lizy CM, Vogelaers DP, Blot SI. Nurses' Knowledge of Evidence‐BasedGuidelines for the Prevention of Surgical Site Infection. Worldviews Evid Based Nurs. 2010; 7(1):16-24.
- Teshager F A, Engeda EH, Worku W Z. Knowledge, Practice, and Associated Factors towards Prevention of Surgical Site Infection among Nurses Working in Amhara Regional State Referral Hospitals, Northwest Ethiopia. Surgery Research And Practice. 2015.
- Labrague LJ, Arteche DL, Yboa BC, Pacolor NF. Operating Room Nurses’ Knowledge and Practice of Sterile Technique. Journal of Nursing & Care. 2012; 1:113.
- Taneja J, BibhaBati M, Aradhana B, Poonam L, Vinita D, et al. Evaluation of knowledge and practice amongst nursing staff toward infection control measures in a tertiary care hospital in India. Can J Infect Control. 2009; 24: 104-107.
- Dhakal B, Angadi S, Lopchan M. Nurses' Knowledge And Practice Of Aseptic Technique İn The Operation Theatre At Selected Hospitals of Bharatpur. International Archives of BioMedical and Clinical Research. 2016; 2(2): 32-34.
- Luo Y, He GP, Zhou JW, Luo Y . Factors impacting compliance with standard precaution in nursing, China. Int J Infect Dis. 2010; 14: e1106-e1114.
- Melo Dde S, Silva e Souza AC, Tipple AF, das Neves ZC, Pereira MS. Nurses’ understanding of standard precautions at a public hospital in Goiania -GO, Brazil. Rev Lat Am Enfermagem. 2006; 14: 720-727.
- Nakhaei M, Mofrad SA. Investigating Nurses’ Knowledge and Self-efficacy Regarding the Principles of Infection Control in the Operating Room. Mod Care J. 2015; 12(2):79-83.
- Qasem MN, Hweidi IM. Jordanian Nurses’ Knowledge of Preventing Surgical Site Infections in Acute Care Settings. Open Journal of Nursing. 2017; 7: 561-582.
- Sadia H, Kousar R, Azhar M, Waqas A, Gilani SA. Assessment of Nurses’ Knowledge and Practices Regarding Prevention of Surgical Site Infection. Saudi Journal of Medical and Pharmaceutical Sciences. 2017; 3(6):585-595.
- Sickder HK, Lertwathanawilat W, Sethabouppha H, Viseskul N. Nurses’ Surgical Site Infection Prevention Practices in Bangladesh . Pacific Rim Int J Nurs Res. 2017; 21(3): 244-257.
- Turan H. Cerrahi Antimikrobiyal Profilakside Güncel Öneriler. Klimik Dergisi. 2015; 28(1): 2-10.
- Madhu BS, Shashi Kumar HB, Naveen Kumar Reddy M. Abilash V. Reddy, Sangeetha Kalabhairav. Effect of single dose pre-operative antibiotic prophylaxis versus conventional antibiotic therapy in patients undergoing lichtenstein tension free mesh repair. International Surgery Journal. 2017; 4(2):738-742.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | ARAŞTIRMA YAZILARI |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 6 Sayı: 2 |
