thesis presentation sept 14

8/4/2019 Thesis Presentation Sept 14

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A ThesisPresented to

Thesis Congress

Union Christian

CollegeSan Fernando City,La Union


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Presented by:

Alfredo G. Lim, RN, MAN


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COMPLIANCE OF STAFF

NURSES WITH STANDARDPRECAUTION IN SELECTED

HOSPITALS IN LA UNION:A BASIS FOR AN ENHANCED

RLE PROGRAM AMONGCOLLEGES OF NURSING


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The Background

Over 59 Million health care workers are exposed to acomplex variety of health and safety hazards everydayincluding biological hazards, such as TB, Hepatitis,HIV/AIDS, SARS; and chemical hazards

Outbreak of SARS, Swine flu, and otherinfectious diseases

Observation backed- up with researches outside thePhilippines pinpointing to the compliance of healthcare workers with Standard Precautions specificallyHand Hygiene and the use of Personal ProtectiveEquipment


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Transmission of SARS in health carefacilities was frequently associatedwith noncompliance with standardprecautions. (Minnesota DOH, 2007)

According to DeLaune (2006),nurses should emphasize healthpromotion.


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What is Standard Precaution?

It is a guideline created by various agencies including the

World Health Organization and is the basic infectioncontrol precautions in health care.

It requires that HCWs assume that the blood and bodysubstances of all patients are potential sources ofinfection, regardless of the diagnosis, or presumedinfectious status. (WHO Regional Office for WesternPacific,2004)


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hand hygiene

use of personalprotective

equipment,

proper handling

of soiled linens,

COMPONENTS


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prevention ofneedle stick

injuries,

environmentalcleaning and spills-management, and

appropriatehandling of waste.


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Merle Mishels Uncertainty in IllnessTheory, the experiences of uncertaintyare directly related to chronic and lifethreatening illness.

uncertainty = inability to determine themeaning of illness-related events thatoccur when the decision maker is unable

to assign definite value to objects orevents and is unable to predict outcomeaccurately


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RESEARCH DESIGN

Quantitative Descriptive

Correlational Design

- formal, objective,systematic process in whichnumerical data are utilised to

describe the relationshipamong variables


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PARADIGM

INPUT PROCESS OUTPUT


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POPULATION AND LOCALE

STAFF NURSES ASSIGNED IN THE

HOSPITALS FOR 6 MONTHS

2 PRIVATE TERTIARY HOSPITALS1 PUBLIC TERTIARY HOSPITALS2 PUBLIC SECONDARY

HOSPITALS


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RESEARCH INSTRUMENT

Patterned toWHO policies

Other researchesincluded in theRRL

Surveyquestionnaire


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Part I - demographic profile

such as age, gender, andlength of experience.

Part II - Level of awareness ofthe respondents regardingStandard precaution.

Part III - level of compliance.


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Part IV - extent of

INFLUENCE of thedifferent factors to the

SNs level ofcompliance


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T bl 12


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Hand Hygiene FULLY AWAREUse of Personal ProtectiveEquipment FULLY AWAREAppropriate handling ofpatient care equipment and

soiled linenFULLY AWARE

Prevention ofneedlestick/sharp injuries FULLY AWAREEnvironmental cleaning and

spills-management MUCH AWAREappropriate handling ofwaste. FULLY AWAREGENERAL AVERAGE

WEIGHTED MEAN FULLY AWARE

Table 12Summary of Level of Awareness regarding Standard Precautions


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Hand Hygiene HCUse of Personal ProtectiveEquipment HCAppropriate handling of patientcare equipment and soiled linen HCPrevention of needlestick/sharpinjuries HCEnvironmental cleaning and spills-

management HCappropriate handling of waste. VHCGENERAL AVERAGE WEIGHTED MEAN HC

Table 21Summary: Level of Compliance with Standard Precautions


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A.Institutional/ Environmental Factors DescriptiveEquivalent

the lack of time or being too busy.HI

lack of means or supplies. HIdistant equipment or facility forhandwashing, wearing of PPEs,etc MIthe lack of safety culture (or safetyclimate) in my department. MIAVERAGE WEIGHTED MEAN

MI

Table 22

Extent of Influence of Institutional/ Environmental Factors


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A.Behavioural/ Personal Factors DescriptiveEquivalent

my forgetfulness to utilize such precautions. MIthe perceived risk of me being exposed topathogens/ infection.

HIits negative effects on my appearance. (eg.make- up, hair, etc.) MIits negative effects on my nursing skills. (eg. finddifficulty in rendering care due to the use of PPE) MIgiving me discomfort. PIthe need to provide care IMMEDIATELY. MIthe type of patient. MIAVERAGE WEIGHTED MEAN MI

Table 23Extent of Influence of Behavioural/ Personal Factors


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A.Educational Factors DescriptiveEquivalentmy academic training. (eg. school,imparted by my instructors) HImy clinical training in terms of using

Standard precautions, especially theuse of PPE, etc. (eg. OJT/RLE duties) HImy superiors/ doctors/etc. acting asnegative role model HIAVERAGE WEIGHTED MEAN

HI

Table 24Extent of Influence of Educational Factors


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Components AGE SEX YEARS OFEXPERIENCEHand Hygiene .002*Use of Personal Protective

Equipment .013*/+ .003*

Appropriate handling ofpatient care equipmentand soiled linen

.029*/+ .004*Prevention ofneedlestick/sharp injuries .011*Environmental cleaningand spills-managementAppropriate handling ofwaste. .018*/ + .026*

Table 25Significant Difference in the Level of Awareness

in terms of the profile of the respondents


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AGE SEX YEARS OFEXPERIENCE

Hand Hygiene .009*/vw -Use of Personal ProtectiveEquipment .015*/ + .000*/ vw -Appropriate handling ofpatient care equipmentand soiled linen

.000*/ vw -

Prevention of

needlestick/sharp injuries.007*/ + .000*/ nsr

Environmental cleaningand spills-management .000*/ vw -Appropriate handling ofwaste.

.038*/ vw -

Significant Difference in the Level of Compliancein terms of the profile of the respondents


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COMPONENTS RELATIONSHIP DIFFERENCEHand Hygiene r= .288** p= 7.24x10^-12*Use of PersonalProtective Equipment r= .347** p=1.58375x 10^-21*Appropriate handling

of patient careequipment and soiledlinen

r=.447** p=7.62406x10^-08*

Prevention ofneedlestick/sharp

injuriesr=.584** p=0.036633311*

Environmental cleaningand spills-management r=.508** p=0.648272968

Appropriate handlingof waste. r=.403** p= 0.009583972*

Significant Relationship and Difference

Between the Level of Awareness and Level of Compliance


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RATIONALE: This program is being proposed inresponse to the findings that there is an inadequatecompliance of nurses with standard precautions.Many factors arose that led to this inadequacy, and

it was found out that the academic training of thesenurses highly influences their compliance. Hence, it isimperative that our nursing curriculum must evolve todevelop a competent professional in the future- anurse having a sense of responsibility and consciousawareness. Thus, this program proposes an strictintegration of the standard precautions in the relatedlearning experiences of the students.


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GOAL: The programs goal is to increase theadherence of the future nurses to standardprecautions.

OBJECTIVES: After the duration of the RLE program,the student will be able to:

Explain the chain of infection, its nature, and how to

break the chain.Discuss and explain the importance, components,

and indication of standard precautions.

Demonstrate proper use hand hygiene, use of PPE,

and the like.Demonstrate strict adherence to standard

precautions.


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PERSONS RESPONSIBLE:

Dean of the different schools and colleges of nursing forproper dissemination and compliance

Clinical Coordinator

Clinical instructor and class lecturers

Faculty Development Committee

ACTIVITIES:

Discussion in classrooms, pre-conference, post-conferences.

Reporting and journal sharing in updates regardinginfection control.

Demonstrations and Return Demonstrations.

Role playing

Critical Thinking- activities.


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CONCLUSIONS

Based on the findings of the study, the followingconclusions are derived:

1. Majority of the staff nurses are young adults, female,and with 1-2 years of experience. Hence, they can beeasily be trained and re- oriented to the guidelines setby their respective institutions.

2. Staff nurses generally are knowledgeable on theguidelines of standard precautions which indicate thatthey have a better grasp of concepts to deliver qualitypatient care.


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3. Staff nurses highly comply with standard

precaution and follow the guidelines set by the WorldHealth Organization. All of the components wereoften being followed by staff nurses, hence, issustained by them. This indicates that staff nurses

deliver an acceptable nursing care to their patients.

4. Staff nurses behaviour, education, training,environment and their workplace influence in thedevelopment of their compliance with standardprecautions. (education highly influencescompliance)


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5. Sex and the length of experience can affect the

level of awareness and compliance of staff nurseswith standard precautions. Female staff nurses andnurses with longer hospital experience tend to bemore aware and compliant; hence, can render

nursing care with regards to infection control.

6. Staff nurses who are aware of standard

precautions are compliant, as well. This indicatesthat nurses who are knowledgeable and consciousin minimizing infection tend to practice infectioncontrol more often in taking care of their patients.


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RECOMMENDATIONS

Based on the conclusions derived in the study, thefollowing recommendations are made:

1. Although the respondents have adequateawareness and knowledge regarding standardprecautions, it is imperative that symposiums, andtrainings must be held, emphasizing its importance,

the indications of hand hygiene, therecommended guidelines on prevention of needlestick injuries, the proper use of PPE, proper wastedisposal, and disinfecting patient care equipment.


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2. In order to increase the compliance of staff nurses, otherresearch- based strategies can be done. These may involve

posters that encourage and reminds personnel to handwash; seminars; provision of alcohol-based dispensers instrategic areas of each department; and availability ofsupplies.

3. Standard precautions must be fully integrated in thenursing curriculum. It must emphasize its importance,indications, and proper use. This must be integrated in

courses such as Health Care 1, Health Care 2, Microbiology,Nursing Care Management subjects. It must be alsoemphasized, used (together with the clinical instructor) andproperly complied with during Related Learning Experiences.


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4. Clinical instructors, Staff nurses, Head nurses,physicians and other health care providers must be a

good role model for the students to follow.

5. The researcher recommend that another researchstudy should be done to compare the level ofawareness and compliance of staff nurses to the typeof hospital they are working at (eg. Private vs. Public,Secondary vs. Tertiary). Also, it is recommended to

increase the population from province- wide to region-wide to have more accurate result. The researcher alsorecommends that other health care providers can beassessed to find out their level of compliance, andcompare the findings among them.


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END

Thank you for listening!

thesis presentation sept 14

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