ABSTRACT

Background: Nosocomial infections, or hospital-acquired infections, pose a significant risk to patients and healthcare systems, particularly in developing regions like Cameroon.

Objective: The objective of this study was to assess student nurses’ knowledge and practices regarding the prevention of nosocomial infections at Redemption Higher Institute of Biomedicals and Management Science. Specific objectives included evaluating their understanding of nosocomial infections, determining adherence to infection prevention practices, and identifying challenges faced by student nurses in implementing these practices.

Method: A cross-sectional study design was employed, targeting student nurses at the Redemption Higher Institute of Biomedicals and Management Science. A convenience sampling technique was used to select participants, and data were collected through well-structured questionnaires. Data were analysed using Microsoft Excel 2016, with results presented in frequency tables, bar charts, and pie charts. Quantitative variables were expressed as proportions and percentages.

Results: The findings revealed that 74% of participants understood that nosocomial infections are acquired during hospital admissions; however, 69% could identify key pathogens associated with these infections. Notably, 31% reported inconsistent use of personal protective equipment (PPE) during procedures, indicating gaps in practice. Additionally, 63.8% of respondents faced challenges related to overcrowding and insufficient training.

Conclusion: The study highlighted a significant lack of comprehensive knowledge and adherence to infection prevention protocols among student nurses, with 68% exhibiting inadequate understanding of essential infection control practices. While awareness of nosocomial infections was relatively high, there remains a critical need for enhanced training and resource allocation to improve practices.

Recommendation: Community outreach and educational programs focusing on infection prevention and control should be implemented to strengthen the knowledge and practices of RHIBMS student nurses.

CHAPTER ONE

INTRODUCTION

1.0: Introduction:

This chapter will consist of Background, conceptual, contextual, Theoretical and empirical review.

1.1 Background.

The history of nosocomial infection can be trace to the origin of the hospital themselves and have been define by the WHO as infection that develop in a patient during his or her stay in the hospital or a type of clinical facilities which were not present at the time of admission (Samuel SO,). According to Samuel et al., these infections usually become clinically apparent either during hospitalization or after discharge and as such organisms that causes these infections are termed nosocomial pathogens.

Infection acquired in the health care are mostly commonly occurs in health care delivery worldwide. Hundreds of millions of patients are affected by health care associated infection, worldwide each year, resulting in significant mortality and financial losses for health system (Varshney et al 2014). Infection is the invasion and multiplication of microogranisms such as bacteria, virus, and parasites that are not normally within the bod. Faris and Hassan,2016.

A nosocomial infection (Hospital acquired infection) is an infection occuring in a patient during the process of care within a health care facility, which was not present, or incubating at the time of admission (WHO,2014).these infection are those occuring more than 48 to 72 hours after admission and within ten days after hospital discharge (Collins,2008).Due to the admission of patients with different organisms, the hospital environment has become saturated with highly virulent organisms, namely: Staphylococcus aureus, streptococcus pyogenic, Escherichia coli, Hepatitis viruses that survive in a hospital. These organisms cause diseases ranging from minor skin infection to life-threatening condition such as sepsis (Sydnor and perl,2011).

Infection prevention and control aims to prevent the spread of infection in health care facilities and the community. infection control is a universal discipline with relevance to all aspects of health care. It is a part of every health care workers duty to ensure that no harm is done to patient, visitor or staff.

According to WHO (2014), the components of infection prevention and control areas follows organization, technical guidelines, human resources surveillance, microbiology laboratory support, environment evaluation and links with public health services. Infection acquired in the health care are mostly commonly occur in health care delivery worldwide. Hundreds of millions of patients are affected by health care associated infection, worldwide each year, resulting in mortality and financial losses for health system (Varshney et al.,2014).

In sub -Saharan Africa, data available show that the incidence of nosocomial infections ranges from 2-49% with patients in intensive care units have the highest rate range from 35.6% Infectious diseases are still the main causes of death in Cameroon, according to the 2018 health profile acquired by the World Health Organization (WHO ,2018) statistics. The burden of in Cameroon include HIV,TB, Malaria, and other infectious diseases and respiratory infection.

Expansion of the infection prevention and control movement occur due to the increase in infection occurrences in the country. This increase in infection related disease’s impact the increase health financing in Cameroon with a government contribution on health care of 57.5% above the figure budgeted for (WHO,2014).

Nosocomial infection, also know as hospital-acquired infection which is the leading cause of death and has economic cost due to increase hospitalized and prognosis (WHO,2015). The Cameroon Ministry of Public Health has indicated that COVID-19 pandemic is a major public health threat and therefore to prepare in infection prevention and control measure should be strengthened.

In clinical practice, the researcher has observed cases where nurses handle contaminated linen with bare hands, put needles in patient’s mattress after giving injection, do not clean the stethoscope between patients and do not wash hands regularly in the clinical environment .

Poor infection prevention and practice among nurses increases the rate of hospital- acquired infection. Hand hygiene is the most important intervention to prevent transmission of infection and should be a quality standard in all health facilities. An attitude of not washing hands among individuals involved in the provision of health care can increase the rate of hospital -acquired infections.

In India, study was conducted where Nair et al. (2015) assessed knowledge, attitude and practices of hand hygiene among medical and nurses students at a tertiary health care centre, majority of students had poor knowledge regards to hand hygiene. Lack of knowledge among  and other health care provider can increase the rate of hospital acquired infections. This is supported by the study that was conducted in Zimbabwe by Trivanhu et al .2014 who determine the barriers of infection prevention and control practices among nurses at Bindura provincial hospital.

The study revealed that the majority of nurses’ lack knowledge on infection control principles. Infection control workshop were poorly organized as 68% of the nurses did not attend any workshop on infection prevention and control practices( Trivanhu et al.,2014).Hayeh and Esena (2013) assess the infection prevention and control (IPC) practices among health workers at Ridge Regional Hospital in Accra( Ghana).

The study showed that knowledge in IPC practice among health care workers was moderate 51% availability and access to material for IPC practice at the facility was 58% and overall compliance with IPC guidelines was 54%.Effecient knowledge, good attitude and good practices by nurses in infection prevention and control may contribute to reduce infection rate in the hospital. minimizing the challenges faced by nurses in infection prevention and control could be a huge step in reducing infection rate in the hospital. Limited studies have assessed the knowledge, practice and challenges faced by student- nurses in infection control and prevention in Cameroon. The current study aims at identifying the challenges faced by student-nurses in the prevention of Nosocomial infection in the Regional Hospital Buea.

Abd El-Azeem (2013) who assess nursing knowledge and performance regarding infection control measures with central venous catheter found that majority of nurses experience deficits in the knowledge regarding infection control.

1.2 Problem statement

Nosocomial infection is a problem affecting the quality of health care and a principal source adverse health care outcome. These infections have impact in the lives of patients and the nurses, increased hospital stay days, increase cost of health care, economic hardship to patients, their families and even deaths.

These infections usually occur during the performance of medical procedure and non -compliance with recommended guild lines by the health workers and exposed patients to pathogens. The researcher has observed that nurses do not effectively apply infection prevention and control measures in the hospital setting, which required patients’ safety.

Lack of knowledge and practices in infection prevention and control contribute to high rates of hospital- acquired infection (20.74% in Cameroon; SOREPS,2010). Uncontrollable Nosocomial infection contributes to prolonged stay, morbidity and mortality, which put stress on health care economy of the country (Mishta et al.,2014).

In sub–Saharan Africa,Nejade et al., described that overall burden of nosocomial infection of range from 2.5% -14%. The burden of nosocomial infections has long been recognized globally and about 1.4 million people suffer from infection acquired in the hospital.

1.3 Justification

Despite the high prevalence of nosocomial infections in most health facilities in Cameroon, there is no national policy on surveillance, prevention and management of nosocomial infections (SOREPS,2010). In addition, very limited data on the incidence of cases is asked from health facilities during the routine national surveillance.

The situation in each facility depends on the knowledge of health authorities on the issue, their motivation and the availability of resources to integrate this activity into their action plan. In addition, very few studies have investigated the knowledge, practices and challenges faced by student _nurses in the prevention of nosocomial infections in the Buea Regional Hospital.

 1.4 Research Questions

1. What level of knowledge do student nurses have on nosocomial infections in Redemption Higher Institution Buea?
2. What are the level of practices of student nurses regarding the prevention of nosocomial infections at the RHIBMS?

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