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Hand disinfection from the point of view of nurses
VRZÁKOVÁ, Karolína
Hygienic hand disinfection is one of the basic measures to prevent healthcare associated infections. The principles of hygienic hand disinfection are laid down by the World Health Organization and the Ministry of Health of the Czech Republic. By following the procedures of hygienic hand disinfection, the health of not only the patients but also the healthcare personnel is protected. The issue of hygienic hand disinfection is often mentioned, but compliance can be a problematic aspect. The theoretical part of the thesis deals with the issue of hygienic hand disinfection and related areas. This is the area of indications for hygienic hand disinfection and the procedure, which in practice may hide deficiencies. The thesis also mentions disinfectants and the topic of jewellery and nail treatment, which is also crucial in terms of the quality of the hygienic hand disinfection performed. The use of alcoholic disinfectants can cause skin manifestations and it is necessary to take care of the skin of the hands. Hygienic hand disinfection is a global topic and has been the subject of many studies. This thesis is enriched by a number of them. Health care-associated infections are closely related to hygienic hand disinfection. The theoretical part of the thesis also focuses on this. In the research part of the thesis, the data obtained by observation and subsequent interview technique are processed. The objectives of the thesis are to find out the problem areas of implementation of hygienic hand disinfection among general nurses, to find out the reasons for non-adherence to hygienic hand disinfection among general nurses and to find out the recommendations of general nurses for adherence to hygienic hand disinfection. The study population consisted of general nurses of a standard ward of a selected regional hospital.
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Nové trendy prevence infekcí spojených se zdravotní péčí v ošetřovatelské praxi
KRAUSE, Martin
The aim of the dissertation thesis was to find out risky objects and surfaces used in the provision of nursing care in terms of transmission of healthcare associated infections. Another aim was to find out the current state of knowledge of nurses about the disinfection of objects and surfaces in the provision of nursing care. The last aim was to find out the microbial efficiency of nanomaterial applied to selected objects and surfaces in nursing practice. The research was carried out at a selected provider of health services, i.e. a regional hospital. The aims were achieved using a qualitative and a quantitative research methods. Part of the research was carried out with financial support within the student grant competition. In the first part of the research, risky objects and surfaces that are used in the provision of nursing care at standard departments of the selected hospital were identified by qualitative research using the technique of unstructured observation. In the second part of the research, the knowledge of nurses working in the departments of internal medicine and surgery in the principles of disinfection was found out by quantitative research using the questionnaire technique. Based on the results of the research, it was found out that the level of achieved knowledge depends on education, period of practice, age and department. However, knowledge is limited in some areas. In the third part of the research, the microbial efficiency of the nanomaterial applied to selected objects and surfaces (kidney dish, tray and box used to store medical material) was found out by quantitative research using an experiment. Based on the research results, it was found out that selected objects and surfaces with nanomaterial (antibacterial and hydrophobic nanolayer) showed bacterial contamination, i.e. it was not possible to demonstrate a statistically significant difference between bacterial contamination of objects and surfaces with and without nanomaterial. Further analysis revealed that, for example, kidney dishes would be contaminated with bacteria in 31.3% or trays in 38.1%. It was also found out that some objects and surfaces were also contaminated with pathogenic bacteria, such as Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacter cloacae or Serratia rubidaea. The results show that adherence to decontamination of objects and surfaces, especially high touch objects and surfaces, it is important to pay attention at all times, to improve knowledge and skills of nurses involved in providing care to patients and seek new ways to implement preventive measures to minimize transmission of healthcare associated infections. The dissertation thesis thus provides an insight into the prevention of healthcare associated infections problematics in the context of the use of reusable high touch objects and surfaces requiring chemical disinfection in the provision of nursing care. It also provides evidence for compliance with binding hygienic-epidemiological measures and verification of new possibilities for reducing the risk of transmission of healthcare associated infections. The dissertation thesis is beneficial in the field of education, practice, but also for further research in this problematics.
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Usage of personal protective equipment in nursing practice
KULAJEC, Lilija
Current situation: Nurses' health can be endangered by various influences. One of the possibilities of prevention is personal protective equipment (PPE) which provides effective protection against infectious agents and other risk factors, both for the nurse and the patient. The aim of the thesis was to find out the nurses' awareness of PPE and its use. Find out which PPE nurses use and evaluate whether they use it properly. Methods: The research was carried out using a qualitative method, a technique of non-standardized in-depth interviews and observation. 16 nurses attended the interviews and were observed during 112 nursing activities. Qualitative research was supplemented by an interview with the institutional epidemiologist and a nurse from the department of epidemiology. Results: Nurses use PPE to protect their health and are well-aware of the risks. They realize that it also protects the patient. Nurses commonly use gloves, face masks and protective aprons. When choosing proper PPE, they base their choice primarily on the standard of nursing care, legislation, the nature of the activity performed, the specifics of the department, the risks involved or the type and method of transmission of the respective disease. At workplaces there are a sufficient number of several types of PPE and nurses have the opportunity to educate themselves on the issue. However, there are some obstacles to the correct use of PPE. These obstacles include: lack of information, lack of staffing, pressure on performance and time stress. During the observation the most frequent errors were found in the use of gloves and taking off PPE. Recommendations for practice: The introduction of comprehensive training on individual PPE, increased checks by managers, regular updating of standard nursing procedures, sufficient staffing and sufficient spare protective equipment at the department may contribute to increasing the level of use of PPE.
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Problems of healthcare-associated infection in selected nursing activities
KRAUSE, Martin
The diploma thesis deals with problems of healthcare-associated infection in selected nursing activities. The thesis is a theoretical one; it has been processed by means of review and synthesis. In this thesis, four objectives were set, namely to create a comprehensive overview of the problems of healthcare-associated infection in selected nursing activities. Other objectives were to map and analyze clinically relevant sites of transmission and possibilities of prevention of healthcare-associated infection in selected nursing activities and to propose recommendations for the prevention of these infections. The thesis is divided into several chapters that deal with the characteristics of healthcare-associated infection, focusing on the causative agents, formation, spreading and prevention. It also deals with particular nursing activities. The first chosen activity was the care of medical devices intended for repeated use, with a particular focus on the implementation of their disinfection. Secondly, hand sanitation as a basic factor affecting the transmission of healthcare-associated infection activity was selected. This chapter deals primarily with the hygienic hand disinfection, its indications, methods and implementation of disinfection products. It also deals with strategies for improving hand hygiene and glove use in providing nursing care. As the third nursing activity, aseptic techniques, which are an essential part in providing nursing care, were chosen. The thesis describes three specific clinical nursing procedures: aseptic collection of venous blood from a peripheral vein, preparation and administration of a drug into an existing peripheral venous catheter, and uncomplicated (aseptic) wounds dressing. Processing of the thesis was based on a range of relevant sources from the Czech Republic but also from abroad. It also contains various recommendations of national and international institutions. The thesis can serve as a basis for more effective prevention of healthcare-associated infection in certain areas.
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Health protection depending on prevention of nosocomial infections in Hospital Prachatice a.s.
BIBOROVÁ, Emília
This diploma thesis is focused on the prevention and monitoring of healthcare-associated infections at the Hospital Prachatice, a.s. The main objective was to describe current situation in the field of prevention of nosocomial infections in this hospital. I focused on verification of medical personnel knowledge of nosocomial infections, the work of cleaners and the quality of hand hygiene of medical personnel. Diploma thesis is focused on the 4 selected departments of the hospital department of internal medicine, gynecology-obstetric department, surgical department and ARO and ICU. Thesis is divided into theoretical and practical part. The present knowledge about the healthcare-associated infections are processed in the theoretical part. To obtain all needed information was used domestic and foreign professional literature. The practical part was about the observation and the short research in the Hospital Prachatice, a.s. The research part was combined. The qualitative method including short interviews with the cleaners was combined with a quantitative method. Within this quantitative method have been used short questionnaires, which were intended for nurses. With these questionnaires I tried to find out their basic knowledge about nosocomial diseases and how they prevent them. The microbiological department of the Hospital Prachatice, a.s. was helpful in monitoring the quality of hand hygiene through method of microbiological fingerprinting. The questionnaires were handed out to nurses which worked on shift in that time on four mentioned departments of hospital. I return total 32 questionnaires back. Questionnaire had 11 questions and my plan was find out the basic knowledge of nurses about the issue. Interviews were conducted with cleaners working on focused departments where the research took place. The microbial fingerprints of hands were collected from medical staff on current work shift including doctors and cleaners. The fingerprints were made on blood agar where after 24-hours of incubation the colonies of bacteria were evaluated. None of the fingerprints was completely negative. I determined totaly 4 research questions: 1. Are all workers of selected hospital departments well informed about nosocomial diseases? 2. What is the hygiene quality of hands among medical staff? 3. On what hygienic level is job of cleaners how often they are cleaning, which way and how often they are changing the working equipment and are the all hygiene criterions followed? 4. How is manipulated with laundry? The results of the questionnaires was surprised for me because most of the medical personnel correctly answered all the asked questions. It was found a total 16 kinds of gram+ and gram microorganisms during a hand hygiene by microbial fingerprints. Most occurred findings was Staphylococcus epidermidis and Microccocus species. In two cases occurred a epidemiologically significant Staphylococcus aureus, which in both cases was found among cleaners. From my observation, investigation and interviews with cleaners I can infer that the work they are doing, they do really conscientiously and normally the health regulations are not violated. Further was found that the manipulation with laundry in Hospital Prachatice, a.s. is in accordance with the hygiene requirements for medical devices. What is important is the effective education of personnel in the prevention of infections and supervision of compliance of mandated procedures.
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Point prevalence survey of healthcare-associated infections in the specialized surgical facility
CHMELAŘOVÁ, Šárka
My thesis is focused on the healthcare associated infections. This area is under considerable control in the developed countries and their health systems, whether in terms of medical, organizational, social, economic, or political. Epidemiology is the world's fastest growing field which knowledge can be applied very soon into everyday practice. The results of that have effect on the patients, whose visit in the hospital is becoming safer. It has also have effect on the healthcare that becomes a better and more professional. In our country, you can still meet the lack of awareness of professional and especially the current context, which accompanies this issue during the contact with the staff of health facilities. Nowadays, we are trying to implement the issue in our laws according to the requirements of the European Union. I try to outline this new European perspective on infections related to the healthcare in the theoretical part. We need to realize the main idea that these infections from healthcare facilities never disappear completely. In the interests of healthcare providers and their staff, it should be to get these infections under the control and to try to minimize the impact of these infections on the patients' health. The meaning of the term healthcare-associated infections or outdated nosocomial infections, and possible types of them, their most common cause and the process of their spread is explained at the outset of work. Afterwards I focused on explanation of the meaning of the prevalence survey as one of the methods of active surveillance. Thanks to the results of the Point Prevalence Survey, which was conducted in the European Union, Norway, Iceland, and Croatia in 2012, it was found that the European prevalence of healthcare associated infections is equal to 5.7%. These results are also commented in the thesis. This prevalence corresponds to every inflectional 18th patient hospitalized in the European acute care hospitals. The European Union Council Recommendation worked out the Infection Prevention and Control Programme in the healthcare facilities to reduce this prevalence. This programme with its details and requirements is described at the end of the theoretical part. In the next part I am aimed to the research, whose implementation is one of my goals. I conducted the Point Prevalence Survey according to the methodology, which was developed by European Centre for Disease Prevention and Control (ECDC). I chose specialized surgical facility for my research. My control sample is consisted of departments that have the same focus as my facility. They are focused only on plastic and reconstructive surgery. The departments were selected from the all Czech hospitals, where the Point Prevalence Survey was conducted in 2012. I received the data from the previous survey thanks to the National Institute of Public Health. I intend to provide the thesis to the specialized surgical facility as a feedback to the research which was carried out in there. Not only for me, but also for the local staff, the benefits are to familiarize with the prevalence survey and to realize that the healthcare-associated infections may still be an actual issue.
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Nosocomial infections and their causes.
KROUPOVÁ, Lucie
The present thesis focuses on nosocomial infections and their causes. The theoretical part summarizes information on especially the sources of these infections, the way of their transfer and the most frequent infection agents. Clostridium difficile is studied in more detail. The illness caused by this pathogen leads to the complications especially with in-patients with a previous antibiotic therapy and immuno-compromised individuals. And this is the problem the present thesis is also concerned with. The thesis also divides nosocomial infections by their clinical manifestations and contains basic anti-epidemic measures and surveillance methods. Its empirical part focuses on the description of an occurrence of select nosocomial infections in Strakonice Hospital, a.s., especially an occurrence of the Clostridium difficile pathogen and methicillin-resistant Staphylococcus aureus (MRSA).
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