CHAPTER ONE

INTRODUCTION

1.1 Background

Nosocomial infections (NIs) also known as hospital-acquired infections (HAIs) represent the most frequent and serious complications of health care (BELLO AL et al., 2011, Pittet D, 2005). They are defined as infection occurring in a patient 48hours or more after admission to a hospital, that was not present or incubated at the time of admission (Khan et al., 2017) and (Bag, 2018). The infection can be acquired during the process of care in a hospital or other health care facility (primary care, nursing home care of and outpatient services) (Bello AL et al., 2011). Nosocomial infections affect primarily patients and less often hospital staff ¸Students and trainees (Epicentro, 2016) nurses and students that perform invasive procedures are particularly at risk. Epidemiological studies report that Nosocomial infections are caused by pathogens such as bacteria, viruses, fungi or parasites already present in the patient body or may come from the environment, other patients, contaminated hospital equipements, health workers (Trick ,2002 Lepelletier 2005; de oliveria 2005). The most common types of Nosocomial infections are those associated with urinary tract, surgical wounds, respiratory tract, and blood stream (WHO, 2002) which have been recognized as a problem affecting the quality of health care and a principal source of adverse health care outcomes. Overall estimates on Nosocomial infections indicate that more than 1.4 million patients worldwide in developed and developing countries are affected at any time (Vincent ,2003). In the united states alone, Nosocomial infections results in more than 2 million hospitalizations every year (Pittet ,2005; WHO ,2008). In Africa, according to the 2011WHO report the prevalence of Hospital – acquired infections(HAIs)varied between 2.5% and 14% and its magnitude will be much than in developed Countries (Bagheri et al., 2011). In poor resource setting such as most developing countries including Ghana rates, Nosocomial infections can exceed 20 % (Pittet, 2005; WHO, 2008). Hospital-wide, Nosocomial infections prevalence varied between 2.5% and 148% of Tanzania (WHO, 2011). In Cameroon, in Yaoundé, 307 patients included, the cumulative incidence and specific mortality rate of Nosocomial infections were 19.21% and 28% respectively, septicemia (20.34%) infection of the skin and soft tissues. Urinary tract infections were the most frequent type of Nosocomial infections (Julienne et al., 2016). In addition to this, hospitals are poorly equipped to handle pathogens. Patient, students suffering from nosocomial infections are severely traumatized.

Therefore, this study seeks to assess the knowledge of student nurses on Nosocomial infections and its prevention during clinical experience in order to reduce the rate of Hospital-acquired infections (HAIs) and enhance future good practice.

1.2 Statement of Problem

Nurses are responsible for providing medications, dressing, sterilization, disinfection and are also involved in more contact with patient than other healthcare workers (HCWs). Students nurses who are early exposed to activities carried out by nurses in the hospital. Students do not comply to standard precautions of preventing Hospital-acquired infections (HAIs) such as proper hand washing, proper disposal of hospital waste, aseptic technique, sterilization of equipment before and after used. Students play an important role in the transmission of Nosocomial infections and their compliance with infection control measures seems to be necessary for preventing and controlling Nosocomial infections. Accordingly, they should be aware of how to prevent transmission of Nosocomial infections and be knowledgeable of its potential risk to patients, other staff and as visitors during clinical rotations. Cameroon has not yet adopted a national policy on surveillance, prevention and management of nosocomial infections. And no data on the incidence of cases is asked from health facilities during the routine national surveillance. The situation in each facility depends on the knowledge of health authorities on the issue, their motivation and the availability of resources to integrate this activity into their action plan. In Cameroon, in Yaoundé, 307 patients included, the cumulative incidence and specific mortality rate of Nosocomial infections were 19.21% and 28% respectively, septicemia (20.34%) infection of the skin and soft tissues. Urinary tract infections were the most frequent type of Nosocomial infections (Julienne et al., 2016).

To attract the attention of policy makers on the magnitude of problem and possible solutions, this study will be carried out to determine the incidence of NI in one of the district hospital in Cameroon (Bota District Hospital Limbe).

1.3 Research Question

1) What is the knowledge of the level one student nurses on nosocomial infections?

2) Are level one student nurses of Bota Hospital Knowledgeable of the causes of nosocomial infections?

3) What is the knowledge of the level one student nurses on the prevention of nosocomial infections?

1.4 Research Objectives

1.4.1 General objectives

The aim of this study is to assess the knowledge of level one student nurses of Bota District Hospital Limbe on nosocomial infection and it’s prevention and to propose solution based on the results of the study.

1.4.2 Specific objective

1)To assess the level one student nurse’s knowledge of the concept on nosocomial infections

2) To assess the knowledge of the Level One student nurses on causes of nosocomial infection in the Limbe Bota Hospital.

3) To determine the Level One student nurses’ knowledge on the prevention of nosocomial infections