الفهرس 
Classification of pathogenic microorganisms
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Abstract
Hospital-associated infections are those infections acquired during
the patient’s stay in hospital. They form a major worldwide public health
problem. Hospital-associated infections also include occupational
infections which occur in health care workers due to occupational hazard.
Health care-associated infections have long been recognized as crucial
factors undermining the quality and outcomes of health care delivery
(Zanetta, 2013).
Aim of the study:
This study aimed to assess the factors affecting application of
infection control measures in critical care units through assessing:
1- The level of knowledge and practice of study‟s subject.
2- The unit‟s resources, structure, policy and procedures.
Research question:
What are the factors affecting the application of infection control
measures in the critical care units?
Subjects & Methods:
Research design:
A descriptive exploratory design was followed to achieve the aim
of this study.
Research setting:
This study was conducted at the Technical Nursing Institute and at
El-Demerdash Hospital, which affiliated to Ain Shams University. The
institute program consists of two academic years that aims to prepare
technical nursing students with high level of scientific knowledge and
skills.Subjects:
A purposive sample represents all available first year nursing
students of the academic year 2013/2014 enrolled in the Technical Nursing
Institute, Ain-Shams University. The total number was (56) students. Only
(14) of the students had a general secondary school certification and (42)
of the students had a diploma of nursing certification.
(1) Self-administer questionnaire sheet: (Appendix I)
The tool was designed to assess students‟ level of knowledge
regarding infection control measures. The questions of the sheet were
constructed by the researcher and guided by the infection control
assessment tools of U.S. Agency for International Development,
(2006). It consisted of two parts:
Part I: Is concerned with demographic characteristics of students
(age, sex, qualifications, “general secondary school and/or nursing
secondary school”).
Part II: Is assessing the students‟ level of knowledge regarding
infection control measures that should be applied in the critical care units.
It consists of thirty multiple choice questions (MCQ) and ten true and
false questions.
(2) Observation checklist: (Appendix II)
Is used to assess the technical nursing student‟s practice as regard
to the application of infection control measures. It was developed by the
researcher based on Practical Guidelines for Infection Control in Health
Care Facilities from World Health Organization, (2010). It was divided
into (12) parts which were; hand hygiene, usage of personal protective
equipment, assistance in insertion of peripheral intravenous catheter,
maintenance of peripheral intravenous catheter, preparation of
intravenous fluids and medications, administration of injectable
medications, assistance in the insertion of central venous catheter,handling urinary catheter, handling nasogastric tube, linen management,
waste management and cleaning of medical instruments. But there were
some parts which weren‟t applicable; such as the assistance in the
insertion of central venous catheter and the cleaning of medical
instruments. So the total number of the actual applied items was (75)
items. These items were distributed as the following:
Hand hygiene (7 items)
Usage of personal protective equipment (6 items)
Assistance in insertion of peripheral intravenous
catheter
(11 items)
Maintenance of peripheral intravenous catheter (7 items)
Preparation of intravenous fluids and medications (4 items)
Administration of injectable medications (7 items)
Handling of urinary catheter (12 items)
Linen management (4 items)
Handling nasogastric tube (6 items)
Waste management (11 items)
(3) Standardized observation checklist: (Appendix III)
The tool was designed to assess the standard of infection control
measures application in the critical care units. This tool was modified by
the researcher based on the national guidelines for infection control of the
ministry of health and population in Egypt, (2008). This tool was applied
on two critical care units at El-Demerdash Hospital, which affiliated to
Ain Shams University; where students spent their clinical practical
period. The tool was divided into two sections:
Section I: Is concerned with assessing the infection control
standard in the hospital that the critical care units are affiliated to it; and
included (40) items.Section II: Is concerned with assessing the infection control
standard in the critical care units; it included the following items:
Human resources (22 items)
Layout and design of the environment (44 items)
Health care procedures (19 items)
Equipment and supplies (39 items)
Results:
The important findings from the study can be summarized as
following:
More than the half of students under the study (59%) was (19 years).
In relation to sex, it was revealed that all students under study were
females. More than two thirds of students under study had nursing
diploma and one third had general secondary qualification.
More than three quarters of students under study (78.6%) had
unsatisfactory level of knowledge and only (21.4%) had satisfactory
level of knowledge regarding the infection control measures.
The majority of students (85.7%) had unsatisfactory level of
practice and only (14.3%) had satisfactory level regarding the
application of infection control measures.
The total score for the 5th surgical critical care unit was )103( which
is unsatisfactory score (<70%) regarding application of infection
control measures in critical care units, also the total score for neurosurgery critical care unit was (110) which is unsatisfactory score
(<70%) regarding application of infection control measures in
critical care units; where students spent their practice period.
There was no statistically significant difference between the
students‟ qualifications and their level of knowledge regarding
infection control measures. There was no statistically significant difference between the
students‟ educational qualifications and their level of application of
infection control measures.
All students (100%) who applied unsatisfactory application of
infection control measures in critical care units were graduated from
general secondary school.
Conclusion
Based on the results of the present study, it can be concluded that:
The study indicated that more than three quarters (78.6%) of the
students under study had unsatisfactory level of knowledge
regarding infection control measures.
The majority (85.7%) of students under study had unsatisfactory
level of practice regarding the application of infection control
measures in critical care units.
The study indicated that both critical care units (5th surgery
critical care unit and neuro-surgery critical care unit) had
unsatisfactory level regarding the application of infection control
measures according to their structure, resources, policy and
procedures.
There is no statistically significant difference between the
students‟ qualifications and their level of knowledge and practice
regarding infection control measures.
There is no statistically significant difference between the
students‟ level of knowledge and their level of practice regarding
infection control measures.
Recommendations
The important recommendations inferred from the study results
were:
In the light of the study results, the following is recommended:
Increasing the knowledge and understanding of students regarding
infection control measures by creating appropriate curriculums and
providing standardized infection control manual booklet. Educational programme about infection control should be organized
for students at technical nursing institute at the time commencement
of their clinical training and before their graduation.
The involvement of students in different activities regarding
infection control should be encouraged such as exhibitions, poster
making, quizzes, debates and other competitions regarding infection
control should be organized consistently.
Qualified exam concerning infection control should be
implemented for Technical Nursing Institute-Ain Shams University
students before beginning their registered duties.