CHAPTER ONE
INTRODUCTION
Background to the Study
Surgical aseptic technique is the application of those strict principles, practices, and procedures aimed at preventing the invasion of surgical sites by microorganisms during intra and post-operative period (Briggs, 2013). This according to Albany, (2010) is achieved by ensuring that only uncontaminated equipment, fluid, and items come in contact with the sterile field during clinical procedures. Albany, (2010) refers to this procedure as Aseptic Non Touch Technique (ANTT). However, ineffective application of these clinical procedures and protocols according to Briggs, (2013) usually result to surgical site infection which in turn gives rise to long periods of hospitalization and high cost of hospital bill to both patient and hospital
The prevention of surgical site infection has become a priority worldwide. Approximately 50,000 deaths are estimated to occur annually across Europe as a consequence of surgical site infection (Jones, 2012). In New York, the national infection average per 1000 is 2.7% (National Infection Control, 2010). Albany (2010) in a study in a New York hospital recorded 3.7% infection rate per 1000 in the surgical intensive care unit. If the infection rate is that high in developed economies, the situation may be expected to be worse in developing countries like Nigeria, where challenges to compliance to surgical aseptic standards are definitely more.(Infection Control Policy (2010) A descriptive study carried out in the University Hospital Lagos by Afolabi, (2012) showed about 15% to 20% infection rate in male surgical ward. This was linked to non- compliance due to poor attitude of theatre workers to surgical aseptic standard in the area of surgical hand scrub, use of personal protective device and maintenance of sterile field during surgery observed by Berkeley (20012).
Compliance in this regard implies the readiness of theatre workers to practice various aspects of surgical aseptic standard in the area of surgical hand scrub, use of personal protective device and maintenance of surgical field during surgery. In other word, it involves willingness of theatre workers to stick firmly in practice to the rules and principles of standard aseptic technique. Previous studies according to Ginasekara (2010) have shown that compliance to the surgical aseptic standard among theatre workers has been generally unstable and increase in compliance has been difficult to sustain. Nevertheless, He noted that poor attitude is responsible for substandard practice as far as compliance to the surgical aseptic practice is concerned. Several reasons for noncompliance have been identified, including staff attitude and lack of interest to work. Relationship among theatre users has also been identified as an important factor in improving compliance (WHO, 2013). Sidon (2011) also stated that the designing and establishment of a practicable evidence-based surgical aseptic standard coupled with a positive attitude to work has been known to improve compliance to surgical aseptic standard practice.
Macleod, (2010) defines attitude as a predisposition, a tendency or a propensity to respond positively or negatively to a certain idea, object, person or situation. Attitude is therefore a serious variable in compliance (Leon, 2011).This is precisely because attitude influences individual’s choice of action either positively or negatively. A positive attitude is sure to affect compliance positively with a low rate of surgical site infection as collateral, while poor attitude is associated with noncompliance to the protocol and corresponding increase of rate of surgical site infection.
Despite application of the standard aseptic technique in recent times as required by WHO (2013) coupled with National and International recommendations for good practice in infection prevention and control in many health institutions, compliance has been low leading to surgical site infection. Surgical site infection has remained the third most common hospital acquired infection responsible for longer hospitalization with increased cost for both the patient and hospital (Briggs, 2013).
This study therefore wishes to assess theatre workers’ attitude and compliance towards various aspects of surgical aseptic standard as practice in the three Tertiary Health Institutions in Enugu State.
| Project details | Contents |
|---|---|
| Number of Pages | 166 pages |
| Chapter one | Introduction |
| Chapter two | Literature review |
| Chapter three | methodology |
| Chapter four | Data analysis |
| Chapter five | Summary,discussion & recommendations |
| Reference | Reference |
| Questionnaire | Questionnaire |
| Appendix | Appendix |
| Chapter summary | 1 to 5 chapters |
| Available document | PDF and MS-word format |
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