CHAPTER ONE

INTRODUCTION

1.1 Background

The skin is the body’s largest organ. It measures about 1.5 -2m2 in adults and weighs about 15% of total body weight. It is portal of entry for micro-organisms and recent studies have showed that wound infection is a common disease accounting for 5-34% of the total patients. Out of which 77% of the deaths of surgical patients were related to surgical wound infections [43].

Major advances in the theory of disease transmission and prevention occurred in the nineteenth century and these discoveries built on the gradual increase in knowledge and understanding of anatomy, physiology, and disease that occurred during previous centuries [1].

Surgical asepsis is a set of specific practices and procedures performed under carefully controlled conditions, with the goal of minimizing contamination by pathogens. It employed to maximize and maintain asepsis (the absence of pathogenic organisms in the clinical setting). Aseptic technique protects the patient from infection and prevents the spread of pathogens [44]. 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 [45].

Compliance with infection control and sterile technique principles in practice may prevent nosocomial infections in the operating room complex and will result in the patient’s hospital stay being shorter and a reduced cost for the medical aid and hospital whereas infections results in an instrumentation, and, of course, good aseptic technique throughout the surgical procedure [46]. Sterilization plays an important role in maintaining asepsis in the preventing and contamination of the open surgical wound.

Educational intervention on wound care management has been seen as effective to improve knowledge and practice among nurses and other healthcare professionals. Many theories postulated that specific trainings could develop critical thinking and improve performances in nurses and medical students and healthcare professionals [7].

Healthcare-associated infections (HCAIs), particularly those involving multi-resistant bacteria, are associated with increased morbidity, mortality, and cost of care and as well as longer length of stay in hospitals [47].

Based on Centers for Disease Control (CDC) and Prevention National Nosocomial Infections Surveillance system (NNIS) reports, surgical site infection (SSI) are the third most frequently reported nosocomial infection, accounting for 14–16% of all nosocomial infections among hospitalized patients [48] and prevention of infection is the goal for all surgical patients.

One of the expected outcomes for surgical intervention is that the patient is free from signs and symptoms of infection, such as pain, foul odor, purulent drainage, and/or fever through 30 days following the procedure. Hand washing has been a means of maintaining aseptic technique in the past to minimize the spread of infection to patients and health professionals [2].

In Europe, over 4 million patients develop at least one Healthcare –associated infection (HCAI) per annum with 37,000 deaths (European Centre for Disease Prevention &, inflating the cost of health care [11] and increasing the global threat of antimicrobial resistance [9]. So many research works have been conducted to assess nurses’ practice of aseptic technique in the care of patients in various units and wards and in Cameroon, it is quite obvious that little have been carried out among undergraduate nursing students in the universities. Therefore, assessment of nursing students knowledge and practice will provide a baseline for intervene so as to reduce the rate of nosocomial infections in the hospitals.

1.2 Problem Statement

Asepsis requires excellent skills and knowledge to prevent massive complications, such as infection, gangrene and amputation or, in severe cases, even death. To prevent such complications, it is necessary to study existing practices and knowledge of asepsis and base more on evidence-based practices for asepsis [13].

Throughout the mid-1990s pre-registration nursing courses moved from hospital-based schools of nursing to universities, with universities responsible for their own arrangements to assess competence.

Lack of asepsis standard is one of the numerous problems affecting both the university-based teaching of asepsis and students’ experiences during clinical placements. Additionally, more than one guideline was identified as underpinning teaching by 88% of the universities surveyed and these may interfere with studies exploring other key infection prevention issues [15].

Asepsis was predominantly taught by university lecturers, with teaching approaches including classroom-based sessions, simulation in clinical skills laboratories and self-directed learning. Variations in asepsis practice asepsis by nursing students have been identified by health practitioners during clinical placements therefore, it is important to formulate strategy that will improve the practice of asepsis among nurses and nursing students.

Nursing student who do not practice asepsis during his or her training will eventually become a nurse that will neglect the practice of asepsis when attending to patients and so the need to train nursing students toward good asepsis practice that cannot be compromised.

Also assessment of asepsis amongst nursing students will enable lecturers and clinical instructors to know the area where the nursing students are lacking in order to maintaining standard asepsis during wound dressing so as to improve on nursing care and minimize infections.

1.3 Goal Of Study

The goal of this study is to determine levels 300 and 400 Nursing students knowledge, practice and compliance of Asepsis during wound dressing.

This study will help the nursing students to evaluate themselves on the different steps of Aseptic Technique to prevent contamination during subsequent clinical practice hence, necessary to carry out the study.

1.4 Research Questions

1. What educational system is used to train the nursing students on Asepsis/Aseptic tic technique?
2. What knowledge do nursing students have on Asepsis/Aseptic technique?
3. To what extent can nursing students practice the standard of Asepsis/septic technique during wound dressing?

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