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Measures Utilized For Prevention Of Nosocomial Infection In The Labour Ward Of University Of Calabar Teaching Hospital (ucth), Calabar.
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Hospital-wide HAI prevalence varied between 2.5% and 14.8% in Algeria
(Vincent, Rello, Marshall, Silva, Anzueto & Martin, 2009), Burkina
Faso (DiA, Ka, Dieng, Diagne, Dia & Fortes, 2008), Senegal and the
United Republic of Tanzania (Atif, Bezzaoucha, Mesbah, Djellato,
Boubechou & Bellouni, 2006). Overall HAI cumulative incidence in
surgical wards ranged from 5.7% to 45.8% in studies conducted in
Ethiopia (Messele, Woldemedhin, Demissie, Mamo & Geyid, 2009) and
Nigeria (Kesah, Egri-Okwaji, Iroh & Odugbemi, 2009). The latter
reported an incidence as high as 45.8% and an incidence density equal to
26.8 infections per 1000 patient-days in paediatric surgical patients
(Kesah, Brewer, Yingrengreung & Fairchild, 2009). In a study
conducted in the surgical wards of two Ethiopian hospitals, the overall
cumulative incidence of patients affected by HAI was 6.2% and 5.7%
(Messele, Grottolo, Renzi, Paganelli, Sapelli, Zerbini & Nardi,
2009). In a study from Nigeria, the implementation of an infection
control programme in a teaching hospital succeeded in reducing the rate
of HAI from 5.8% in 2003 to 2.8% in 2006 (Abubakar, 2007).
In
Nigeria, nosocomial infection rate of 2.7 % was reported from Ife, while
3.8 % from Lagos and 4.2 % from Ilorin (Odimayo, Nwabuisi &
Adegboro, 2008). The cause of nosocomial infections might be endogenous
or exogenous. Endogenous infections are caused by organism present as
part of the normal flora of the patient, while exogenous infections
are acquired through exposure to the hospital environment,
hospital personnel or medical devices (Medubi, Akande & Osagbemi,
2006). Nosocomial infection rates vary substantially by body site, by
type of hospital and by the infection control capabilities of the
institution. The proportion of infections at each site is also
considerably different in each of the major hospital services and by
level of patient risk (Taiwo, Onile & Akanbi, 2005).This is
exemplified by surgical site infections (SSIs) which are most common in
general survey, whereas urinary tract infections and blood stream
infections are most frequent in medical services and nurseries. Rates
of nosocomial infection vary by surgical subspecialty, low in
ophthalmology and high in general surgery. The differences are largely
due to variations in exposure to high risk devices or procedures (Tolu,
2007).
Urinary tract infections (UTI) represent the most common (34%)
type of nosocomial infections. Indwelling catheters cause the majority
while others are caused by genito urinary procedures (Tolu, 2007).
Surgical wound infections represent 17% nosocomial infection and
are the second most common hospital acquired infections. The
classification of wound infections is based on the degree of bacterial
contamination, including clean, clean contaminated and contaminated.
Co-morbid and contamination of the surgical site contribute to the
infection rate. The risk factors for surgical wound infections include
age, obesity, concurrent infection and prolonged hospitalizations. The
origin of the bacterial agent is dependent on direct inoculation from a
host’s flora, cross-contamination, the surgeon’s hands, air-borne
contamination and devices such as drains and catheters (Odimayo,
Nwabuisi& Adegboro, 2008). Lower respiratory infection (LRI) or
pneumonia represents 13 % of nosocomial infections (Taiwo, Onile &
Akanbi II, 2005). This is the most dangerous of all nosocomial
infections with acase fatality rate of 30%. It manifests in the
intensive care unit or post-surgical recovery room. Endotracheal
intubation and tracheostomy dry the lower respiratory tract mucous and
provide entry for microbes.
This study therefore aims at
investigating nursing measures utilized for the prevention of nosocomial
infection in the labour ward of University of Calabar Teaching Hospital
(UCTH), Calabar, Cross River State, Nigeria.
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