الفهرس 
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Abstract
Intervention follow up study targeted for evaluating and improving the already established infection control system was done in the hepatology, hepatobiliary surgery departments, intensive care (ICU) and liver transplantation units as a part of a comprehensive hospital infection control program at National Liver Institute (NLI) hospital.
Two populations were involved in this study:
A) Patients: Two hundred and sixty five patients were recruited for this study. They were chosen randomly from who admitted to the selected departments and were followed up during the study
B) Health care workers: 111 were recruited as follows:
Physicians: out of 116 ones, 23 were randomly chosen with ages ranged from 26- 35 years and duration of work of 1- 9 years, 16 of them had Bachelor degree and 4 had Master degree.
Nurses: out of 316 ones, 65 were randomly chosen with ages ranged from 16-45 years and duration of work of 0.5- >10 years. They were graduated from nursing schools, technical health institutes and faculty of nursing.
Housekeepers: out of 69 ones, 23 were randomly chosen with their ages from 16-45 and duration of work of 1- 20 years. They were graduated from primary and technical schools.
This study was divided into three phases:
Pre-intervention phase: included:
a. Measurement of the pre-intervention incidence of hospital acquired infections (HAIs) in the previously selected wards and ICUs.
b. Assessment of Hospital health care workers` knowledge and attitude towards infection control measures.
Intervention phase:
a- Provision of training program in infection control principles to the medical staff, paramedical staff and housekeepers
b- Evaluation of the already established infection control program by auditing of the basic standards of infection control measures.
Post-intervention phase: Measurement of outcomes of the intervention and auditing.
from this study, the following results were obtained:
- Overall HAIs incidence rate at the NLI was 14.8%, medical department`s infection rate was 16.7%, however in the surgical ones incidence rate was 12%.
- HAIs infection rates were different at each department as follows:
Liver transplantation unit (10%)
Hepatibilliary surgery (14.2%)
Surgical ICU (11.4%)
Hepatology (13.6%)
Endoscopy unit (15%)
- Regarding the physicians mean KAP scores, practice level didn’t improve after training (P>0.05).
- A significant increase in the nurses `s post-intervention mean KAP score was noticed , as well as the attitude and practice scores (P<0.01);but for their knowledge there was no significant improvement after intervention (P>0.05).
- Regarding the housekeeper a significant increase was detected in the post-intervention mean knowledge and practice scores (P<0.01). Though their attitude scores didn’t change after training (p>0.05)
- Significant improvement in adequacy of infection control standards after training (P<0.01).
- There a significant reduction in the incidence of nosocomial infection rates in the hepatology after training (P<0.05).
- There is still no significant reduction in the overall infection rate in endoscopy unit after training (P>0.05).
Conclusion:
Based on the findings of the present study, we can conclude that, incidence of HAIs was 14.8% among 250 patients.
Regarding physicians, this study found that their KAP scores didn’t improve after training.
Applying the health education intervention was successful in raising nurses’ attitude and practice scores after training.
-For the housekeepers, this study demonstrated that knowledge and practice scores were significantly improved after training.
-The prevalence of antibiotic use in the medical departments was 96.0%. The most extensive use of antimicrobials in non infected patients was in surgical (95%) in pre-intervention and (91.0%) in post – intervention phases. The antibiotic prescription rates in the non infected patients didn’t improve in both medical and surgical departments after and before intervention.
Obstacles of the study:
1- Regarding the surgical departments post intervention infection rates couldn’t be measured, as it was neither surgical operations nor transplantation were done during the post intervention surveillance period (6 months).
2- It was no notable cooperation between the physicians towards application of the measures of IC policy such as hand washing and wearing PPEs.
3- Some files of the patients were deficient in many items such as :
-Weight and height
-Infection sheet data.