Infection control and prevention in burn victims:The role of nurses

Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.

Impact of designed infection control educational program on nurses’knowledge and compliance with standard precautions at maternity hospitals

Objectives:This study aimed to assess the nurses’knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses’knowledge and compliance with standard precautions at the maternity hospital.Materials and Methods:A quasi‑experimental one‑group pretest‑posttest design was used on convenient sample of 60 nurses working at Obstetrics and Gynecological hospital in Cairo University Hospital,Kasr El Ainy,who received“designed infection control educational program”for 6 months.The data were collected through the questionnaire comprising demographics,knowledge,and compliance with standard precautions questionnaire.The nurses’knowledge and compliance score were compared before and after intervention.Results:The studied nurses had higher level of knowledge(85.3%)and compliance(92.8%)regarding infection control standard precautions after the educational program compared to before the program.The results revealed statistically significant difference between before and after the program regarding nurses’knowledge score(15.5±2.9 vs.17.1±1.6,P<0.001)and compliance score(58.5±13.2 vs.74.3±5.1,P<0.001).In addition,there was insignificant relation between nurses’knowledge and compliance with standard precautions both before(r=0.952,P=0.474)and after educational program(r=0.164,P=0.223).Conclusion:The nurses’level of knowledge and compliance regarding infection control standard precautions was significantly improved after the program.Therefore,it is recommended that periodical educational programs regarding the standard precautions of infection control are essential for nurses at maternity hospital.

Knowledge and awareness of infection control practices among nursing professionals:A cross-sectional survey from South Asia and the Middle East

BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC practices.METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.RESULTS A total of 1333 nurses from 13 countries completed the survey.The average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ICUs.Statistically,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of ICUs.Working in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among respondents.CONCLUSION There is considerable variation in knowledge among nurses working in ICU.Factors like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.

Application of PDCA in improving hand hygiene compliance and nosocomial infection quality in orthopedics

Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization.Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time,and compare the compliance of hand hygiene before and after implementation,and evaluate the quality of nosocomial infection.Results:The hand hygiene compliance of doctors and nurses in stage P was 82%.The compliance of medical staff in stage D was 93%.The compliance of stage C was 94%and that of stage A was 95%.The quality score of hospital self-examination nosocomial infection was also significantly increased.Conclusions:The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality,which is wor thy of circulatory application in or thopedic nosocomial infection quality control,especially improving the quality of hand hygiene.

Developing a tool for nurses to assess risk of infection in pediatric oncology patients in China:a modified Delphi study

Infections are identified as the most common preventable cause of death in pediatric oncology patients. Assessing and stratifying risk of infections are essential to prevent infection in these patients. To date, no tool can fulfill this demand in China. This study aimed to develop a nursing work-based and Chinese-specific tool for pediatric nurses to assess risk of infection in oncology patients. This research was a modified Delphi study. Based on a literature review, a 37-item questionnaire rating on a 0-5 scale was developed. Twenty-four experts from 8 hospitals in 6 provinces of China were consulted for three rounds. Consensus for each item in the first round was defined as： the rating mean was 〉 3 and the coefficient of variation （CV） was 〈 0.5. Consensus for each item in the second round was defined as CV 〈 0.3. Consensus among experts was defined as： P value of Kendall＇s coefficient of concordance （W） 〈 0.05. After three rounds of consultation, a two-part tool was developed： the Immune Status Scale （ISS） and the Checklist of Risk Factors of Infection （CRFI）. There were 5 items in the ISS and 14 in the CRFI. Based on the ISS score, nurses could stratify children into the low-risk and high-risk groups. For high-risk children, nurses should screen risk factors of infection every day by the CRFI, and twice weekly for low-risk children. Further study is needed to verify this tool＇s efficacy.

Jordanian Nurses’ Knowledge of Preventing Surgical Site Infections in Acute Care Settings

Background: Surgical Site Infection (SSI) is one of the most common healthcare-associated infections, its account for up to 16% of all healthcare-associated infections worldwide. The SSIs can contribute to post-operative morbidity, prolonged recovery, delayed discharge and increasing cost. Nurses’ knowledge of the evidence-based recommendations is necessary to provide high-quality nursing care. Aims: To assess the level of Jordanian nurses’ knowledge regarding evidence based guidelines for the prevention of SSIs, to describe the relationship between nurses’ knowledge and selected sociodemographics, to examine the differences in nurses’ knowledge with respect to selected dichotomized variables, and to identify the most significant predictors of Jordanian nurses’ knowledge regarding evidence based guidelines for the prevention of SSIs. Design: Cross-sectional design. Sample: Two hundred registered nurses at four targeted hospitals were recruited conveniently. Results: The mean of the total knowledge scores of the sample was 3.28 out of nine (SD = 1.72, range = 0 - 7), the median was 3 out of nine. There were a statistically significant correlation between all tested continuous sociodemographics variables and the total knowledge score (p > 0.05). There is a significant difference in nurses’ knowledge between those who are attending to special surgical related training course and who are not. The most significant predictors of Jordanian nurses’ knowledge were: the number of credit hours attended by nurses for surgical-related training courses and the total years of work experience in nursing. These variables explained 16.7% of variance. Conclusion: The results of this study shed light on the obstacles that hampers the Jordanian nurses’ knowledge regarding evidence based guidelines for the prevention of SSIs in acute care settings. However, the successful implementation of infection control measures, particularly SSIs prevention measures, and well-structured continuing education programs are considered as a substantial element that would improve nurses’ knowledge.

Infection Control Measures among Healthcare Workers: Knowledge, Attitude and Practice

Background: Nosocomial infections are some of public health problems globally and continue to be increased regardless of the hospital’s efforts on infection control measures and are contributing significantly to morbidity, mortality and cost. The absence of infection control policies, guidelines and trained professionals also contributes to the magnitude of the problem. The aim of this study was to assess the Knowledge, attitude and practices towards infection control measures among healthcare workers at Old Mutare Hospital. Methods: A cross-sectional survey design was used to acquire information. A purposive sampling method was used to select 22 nurses, 15 nurse Aids and 2 laboratory technicians (Lab Tech). A self-administered questionnaire with four components addressing demographic data, knowledge, attitudes and practices was used to collect data that was completed by a checklist. Results: The study findings revealed a poor knowledge of infection control measures among the nurse’s aide. The attitude and practices among participants were impartially good in all variables. The participants had scored over 50% towards their attitude and their practices on infection control. A significant statistical difference was found between the professional status of the participants and the ability to explain how one can get Hospital Acquired Infections (HAIs) and awareness of infection control programs in their hospital (rs = 0.640, 0.645) with P < 0.05 (0.01, 0.01) respectively. Conclusion: Despite of having a fair attitude and practice towards infection control, the participants had presented poor knowledge;therefore, it had been recommended that in service training and workshop should be planned by the administration to update their knowledge and attain full compliance towards their practice.

充分发挥护理在感控中的作用,提升医疗质量安全水平

在健康中国建设的关键时期,国家卫生健康委员会发布了一系列文件,旨在全面提升医疗质量并改善患者体验。医院感染预防与控制是保证医疗质量的基础和重要措施,护理管理者应提升认识,发挥其领导力,推动护理人员落实感控措施,在降低导管相关感染、手术部位感染等方面取得成效,提升护理专业影响力和价值。

分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响

目的探讨和分析分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响和改善效果。方法选择安徽医科大学第二附属医院402名护士作为研究对象,于2023年3月1日—7月31日开展分层次教学培训,采用回顾性分析,对是否担任过医院感染管控护士的护士知识掌握程度、培训前后护士医院感染防控知识掌握水平和医院感染管理质量进行比较与分析。结果担任过医院感染管控护士的护士医院感染防控知识掌握评分高于未担任过的护士,差异有统计学意义(P<0.05)。培训后,护士在医院感染管理规范、诊疗器械处理程序、医院感染概念、空气消毒方面的知识掌握评分高于培训前,差异有统计学意义(P<0.05);护士在操作技能、应急能力、理论知识以及消毒管理方面的医院感染管理质量评分高于培训前,差异有统计学意义(P<0.05)。结论分层次教学培训的实施,显著提升了护士的医院感染防控知识掌握水平,同时也改善了医院感染管理质量。

护理人员导管相关感染防控护理实践知识现况调查

目的:调查护理人员对导管相关感染防控护理实践知识的掌握现况,以期为提高护理人员导管相关感染防控知识水平提供参考。方法 :于2023年7月12日至8月12日,采用自行设计的导管相关感染防控相关知识问卷,通过中华护理学会医院感染管理专业委员会平台向临床护士、护理管理者及专业为护理的感控专职人员发放问卷。结果 :知识问卷11题中回答正确人数比例达到50%的有5题,达到80%的仅有3题。正确率最高的是输液接头消毒方法(97.49%),正确率较低是吸痰前稀释痰液方式(19.80%)、留置尿管的清洁消毒(19.06%)、气管插管患者不要定时气囊放气(15.51%)、拔出尿管前膀胱无需功能锻炼(9.97%)等。不同级别医院、不同工作年限、职称及所在岗位的护理人员比较,回答正确率差异具有统计学意义(P<0.05)。结论 :护理人员导管相关感染防控护理实践知识掌握水平有待提升,需要加强循证能力及相关知识培训。

护理主导多部门协作管理提升血培养标本质量的效果研究

目的 :评价护理主导的多部门协作管理模式对血培养标本质量提升的效果,为护理临床实践和质量改进提供参考。方法 :成立护理主导多部门协作管理团队,开展质量改进,比较措施实施前后血培养标本送检率、合格率、污染率,以及护士血培养知识、态度、行为的变化。结果 :2023年5月—6月血培养标本送检率、送检方式为双瓶双侧的比例分别为19.1%、61.3%,高于2022年同期的4.7%、35.6%,差异有统计学意义(P<0.05);2023年5月—6月和2022年同期污染率分别为2.9%和3.8%,呈下降趋势;2023年护士血培养相关知识、态度、行为得分分别为(12.69±2.81)、(5.89±0.44)、(36.73±3.40)分,高于2018年的(7.89±2.79)、(5.82±0.52)、(30.81±4.35)分,差异有统计学意义(P<0.05)。结论 :护理主导多部门协作管理模式下的质量改进策略,提高了血培养标本送检率和合格率,降低了血培养标本污染率,提高了护士血培养的知识、态度、行为水平,体现了护士在院感防控工作中的价值。

神经母细胞瘤扩增序列基因突变致急性肝功能衰竭患儿的护理

总结3例神经母细胞瘤扩增序列基因突变致儿童急性肝功能衰竭的护理体会。针对本组患儿高氨血症引发肝性脑病、感染引起高热、分解代谢增加及出院后护理等问题,采取严密监测意识评估肝性脑病发展,及时采取合适的血液净化方式快速降血氨;预防与控制感染,尤其是体温管理;加强营养支持;定期跟踪随访,避免再次发生急性肝功能衰竭。经过快速救治及精心护理,3例患儿病情稳定出院,出院后3个月随访恢复良好。

浙江省37家公立医院感染控制联络护士岗位职能及需求调查

目的:调查浙江省公立医院感染控制联络护士(Infection Control Link Nurses,ICLN)岗位职能及需求,为后续ICLN的准入、培养、考核及认证提供依据。方法:2022年5月13日至6月7日,由浙江省护理学会防感染专业委员会牵头,采用自行设计的ICLN岗位职能问卷对浙江省内11个市37家公立医院的ICLN进行线上问卷调查。结果:共发放1938份问卷,回收率及有效率均为100%。ICLN参与抗生素管理率(24.4%)与主观认同率(39.4%)低;86.9%的ICLN希望医院制度上定期给予排班支持;91.6%的ICLN认为需要院感防控专业知识和技能的培训。结论:浙江省ICLN岗位职能不够明确,需要建立系统的培养和认证体系,优化岗位标准,推进岗位的专科化发展。

三级甲等医院ICU中心静脉导管相关血流感染防控护理实践现况

目的 :调查三级甲等医院ICU中心静脉导管相关血流感染(Central Line-AssociatedBloodStreamInfections,CLABSI)三级质量控制中的共性问题,为进一步制订干预措施、促进护理质量持续改进提供依据。方法 :基于Donabedian三维质量结构模型,借鉴《预防血管内导管相关血流感染过程质控工具包(推荐版)》中四大指引量表,自行编制ICU中心静脉导管相关血流感染防控护理实践调查问卷,采用便利抽样法于2023年9月—10月对中华护理学会医院感染管理专业委员会委员所在三级甲等医院ICU进行问卷调查分析。结果 :共129家医院的215个ICU完成调查,护理实践结构维度中,156个(72.56%)ICU定期进行CLABSI培训;过程维度中,护士执行率低于80%的项目有10项(31.25%),其中52个(24.19%)ICU在CVC穿刺时使用超声引导,59个(27.44%)ICU采用指南推荐的思乐扣固定导管,55个(25.58%)ICU使用葡萄糖氯己定抗菌敷料。结果维度中,193个(89.77%)ICU填写了CLABSI发生率。结论 :目前CLABSI防控聚焦导管置管和维护过程中的结构、过程及结果环节,但调研发现临床仍未形成同质化的防控措施。建议进一步加强过程质控管理,以期更好地改进护理质量。

软式消化内镜再处理及其影响因素的研究进展

应用于消化系统疾病诊疗的软式内镜在操作中会接触消化道黏膜、进入血管和无菌组织,因此需要进行严格的再处理后才能重新用于患者,但因其具有材质特殊、管腔狭窄和结构复杂等特点,显著增加了再处理的难度。文章从护理管理的角度出发,对软式消化内镜再处理的定义、方案、影响因素进行综述,详细分析了影响再处理的多种因素并提出相应对策,以期为内镜再处理的管理提供借鉴和参考。

兼职感控护士在病区感染防控中的作用

文章介绍了国内外兼职感控护士的设立和发展,以及组织管理的现况。从促进感控措施落地、促进各类人员参与感控实践及影响组织文化和他人行为等角度阐述了兼职感控护士在病区感染防控中的作用,并总结了未来兼职感控护士的发展方向。

ICU感控护士在医院感染防控中的专业价值及启示

通过对ICU感控护士的发展现状、5种专业价值角色(教育者、管理者、联络者、监测者、研究者)进行综述,提出发展我国ICU感控护士的思考与启示,包括重视其临床价值,明确其角色及职能,完善其培训和考核体系,从而为未来我国的感控护理人才队伍建设提供借鉴,更好地发挥ICU感控护士在医院感染防控中的作用,以期为有效降低ICU感染的发生率,改善ICU患者生存结局提供依据,进一步引领我国医院感染防控走向专业化的发展轨道。

医疗失效模式与效应分析管理模式在降低急性脑卒中患者肺部感染中的应用研究

目的探讨医疗失效模式与效应分析(HFMEA)管理模式降低急性脑卒中患者肺部感染率的应用效果。方法选择2023年1-7月我院神经内科收治的114例急性脑卒中患者为研究对象。将2023年1-3月HFMEA实施前的57例患者为对照组;2023年4-7月HFMEA实施后的57例患者作为观察组。应用HFMEA评估工具,对引发肺部感染的潜在风险因素及风险环节进行分析,计算风险优先指数(RPN),对RPN>125分项目制定改进措施并评价其应用效果。结果应用HFMEA管理模式后,观察组6项失效模式的RPN值均低于对照组(P<0.05),监管其过程3项标准预防的合格率及3项护理流程合格率均高于对照组(P<0.05)。观察组患者肺部感染率、平均住院时间、平均住院费用均低于对照组(P<0.05)。结论应用HFMEA管理模式后,临床护士针对医院感染风险因素及环节,落实专科感控技术标准预防措施,规范关键环节护理流程,联合督导核查及感控技术得以持续质量改进,可降低急性脑卒中患者肺部感染发生率,缩短住院时间,降低住院费用。

ICU护士多重耐药菌感染防控行为评估问卷的编制及信效度检验

目的为编制ICU护士多重耐药菌(multi-drugresistant organism,MDRO)感染防控行为评估问卷,并检验其信效度。方法依据COM-B(Capability,Opportunity,and Motivation-Behavior,COM-B)模型,通过文献回顾、小组讨论、德尔菲法、预调查形成初始问卷。于2023年10月一11月便利选取国内22所医院的285名ICU护士作为调查对象,进行信度和效度分析;于2024年2月便利选取国内28所医院的309名护士作为调查对象,进行验证性因子分析。结果ICU护士MDRO感染防控行为评估问卷包括能力、机会、动机和行为4个维度,共32个条目。问卷各条目的内容效度指数为0.833~1.000,平均内容效度指数为0.944。问卷Cronbach'sα系数为0.968,重测信度为0.812,折半信度为0.890;探索性因子分析4个因子方差贡献率依次为17.243%、14.464%、15.208%、22.663%,累计方差贡献率为69.578%:验证性因子分析各拟合指标在可接受范围内。结论ICU护士MDRO感染防控行为评估问卷具有较好的信效度,可作为ICU护士MDRO感染防控行为现状及其影响因素的评估工具。

手术室细节护理管理在医院感染控制中的应用效果

目的观察医院感染控制中手术室细节护理管理的应用效果。方法采用2021年3月—2023年3月在我院接受手术治疗的80例患者,随机分为对照组、观察组,各40例,分别实行常规手术室护理管理、手术室细节护理管理,对两组医院感染发生率、护理质量、感染危险因素、患者对护理的满意度、护理人员自我防护知识掌握度以及护理人员对手术室细节护理管理方法的满意度进行评估。结果与对照组相较,观察组医院感染总发生率更低,护理安全、体征监测、器械准备、体征监测、文书记录等各项护理质量评分均更高,患者对护理的满意度更高,护理人员自我防护知识掌握度、满意度均更高(均P<0.05)。结论医院感染控制中手术室细节护理管理应用效果较佳,有效降低感染风险,提高护理质量,提高临床满意度,更利于手术室相关工作的顺利实施。