الفهرس 
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Abstract
Bedridden patients is a serious life-threatening complication that results in a high morbidity and mortality has multiple effects on the major systems of the body lead to overall complication rates ranging from 6 to 80% and have been associated with poor functional outcomes. It is generally easier to prevent the complications than to treat or cure them. Hygienic care measures are very important during initial period to achieve best possible outcome and have good prognosis for the bedridden patient (Riley & Ellis, 2016).
Bedridden patients are not limited to the internal medical and orthopedic care setting but present on a wide variety of nursing units such as acute care, geriatrics, oncology, rehabilitation units, medicine, and surgery units. So that, to provide safe and compètent care, nursing staff must understand the immédiate long-term management of bedridden patients. Therefore it is important to evaluate the nursing care knowledge, practice and attitude regarding hygienic measures for bedridden patients (Tobin, 2018).
Aim of the Study:
The aim of this study was to:
Assess nurses’ performance regarding hygienic measures for bedridden patients through:
5. Assess nurses’ knowledge regarding hygienic measures for bedridden patients
6. Assess nurses’ practice regarding hygienic measures for bedridden patients.
7. Assess nurses’ attitude regarding hygienic measures for bedridden patients.
8. Develop a guideline regarding hygienic measures for bedridden patients.
Research questions:
What is the nurses’ performance regarding hygienic measures for bedridden patients?
Research design:
A descriptive exploratory research design was utilized to conduct this study.
Setting:
This study was conducted in the Internal Medical and Orthopedic Units at Sohag Educational Hospital affiliated to the general organization of the Ministry of Health and Population (MOH).
Subjects:
A convenience sample of all the available staff nurses of 50 nurses working in the Internal Medical and Orthopedic Units at Sohag Educational Hospital. They were recruited to assess the nurses’ performance regarding hygienic measures for bedridden patients, their years of experience fromifive iyears ito iless ithan iten iyears for working in Internal Medical and Orthopedic Units and they were agree to participate in the study.
Tool of data collection
Data was collected using the following tools:
Tool (1): Nurses’ self-administrated questionnaire:
Part (I): it was concerned with demographic characteristics of the nurses under study such as age, gender, qualification, marital status, years of experience and previous attendance of training courses regarding to care of bedridden patients and composed of 10 closed- ended questions.
Part (II): it was concerned with assessing nurses’ level of knowledge regarding hygienic measures for bedridden patients. The questionnaire consisted of 42 multiple choices questions (MCQ) in the form of (41) MCQ and (1) true/false question.
Tool (2): Nurses’ practice observational checklists:
It was used to assess nurses’ level of practice regarding hygienic measures for bedridden patients. It was written in English language and included 15 procedures hygienic measures which divided into four parts.
Tool (3): Nurses’ attitude questionnaire:
It was used to assess nurses’ level of attitude regarding hygienic measures for bedridden patients. It was consisted of 39 Arabic sentences and response is grading according to likert scale (agree, natural and disagree).
The results of this study showed that:
- Regarding nurses’ demographic characteristics 44% of the studied nurses’ age was ranged between 20 to 30 years old and 100% of them were females and 82% of them were married. Also, regarding the residence, 52% of the studied nurses reveal rural area and related to their qualification of the studied nurses, 64% of them studied in technical health institute with, 36% of the studied nurses their years of experience were 5 -<10 years. In addition, shift duration per day of the studied nurses, 80% of them worked 12 hours shift. Moreover, 100% of the studied nurses didn’t have any training course about care of bedridden patients.
- Concerning the nurses’ knowledge it was found that, 76% of the studied nurses had unsatisfactory level of knowledge regarding hygienic measures for bedridden patients. While, 24% of them had satisfactory level of knowledge regarding hygienic measures for bedridden patients.
- Regarding nurses’ total practice, 82% of the studied nurses had unsatisfactory level of practice regarding hygienic measures for bedridden patients. While, 18% of them had satisfactory level of practice regarding hygienic measures for bedridden patients.
- Regarding nurses’ total attitude, 54% of the studied nurses had negative attitude regarding hygienic measures for bedridden patients. While, 46% of them had positive attitude regarding hygienic measures for bed ridden patients.
- Furthermore, there was statistically significance different relation between nurses’ knowledge, practice, attitude and demographic characteristics of the studied nurses.
- Also, there was significant strong positive correlation between total knowledge and practice of the studied nurses and there was positive correlation between total knowledge and total attitude and also between total practice and total attitude.
The results of this study concluded that:
The study revealed that, more than three quarters of the studied nurses had unsatisfactory level of total knowledge and the majority of them had unsatisfactory level of total practice regarding hygienic measures for bedridden patients. Meanwhile, more than half of the studied nurses had a negative attitude regarding hygienic measures for bedridden patients. Also there was statistically significance difference between nurses’ knowledge, practice, attitude and their demographic characteristics. In addition to, there was a statistically significant strong positive correlation between total knowledge and practice of the study nurses and there was positive statistically significant correlation between total knowledge and total attitude and also between total practice and total attitude. So, based on the previous factors the suggested guideline was developed.
The study recommended that:
Recommendation related to nurses
- On-going and regular in-service educational programs regarding evidence-based guidelines should include the care of bedridden patients with the hygienic measures.
- Nursing educators and clinical facilitators must incorporate strategies regarding hygienic measures for bedridden patients into the internal medical and orthopedic units and use learning opportunities to raise awareness of nursing staff.
- Developing a simplified and comprehensive booklet and procedure book should be designed including guidelines about basic information and skills regarding hygienic measures for bedridden patients.
- Learning resources such as articles, journals and electronic resources such as computers and internet should be made accessible in the units for nursing staff members. Continuing professional development programs should include skills updates.
- Increase the number of nurses in internal medical and orthopedic units based on international nurse patient ratio to improve quality of care.
Recommendation related to patients
- Establish a simplified and illustrated educational booklet for the bedridden patients about basic information regarding immobility and hygienic measures.
Recommendation related to environment
- Internal medical and orthopedic units should be containing all supplies related hygienic measures for managing bedridden patients.
- Provide internal medical and orthopedic units with isolation rooms for patients with infectious diseases.
- Provide sterilization system includes cleaning, disinfection, sterilization and storing for instruments and equipment.
Recommendation related to research:
- Replication of the current study on large sample and different hospitals setting to be able to generalize the results.
- Further study is recommended to evaluate the effect of educational training program regarding nurses’ perception, managing of bedridden patients and consequently their effect on the patients’ outcome