CHAPTER ONE

INTRODUCTION

The proper use of aseptic techniques is the single most important intervention to prevent transmission of infection and should be a quality standard in all health institutions (Damani et al., 2020). Reduction of infection by health care workers during patient care can be done by appropriate hand washing, use of gloves, effective waste management, safe disposal of sharps among health personnel’s involved in the provision of health care can reduce infection. Due to the admission of patients with different organisms, the hospital environment has become saturated with highly virulent organisms, namely: Staphylococcus aureus, Streptococcus pyogenic, Escherichia coli, Pseudomonas aureginosa and Hepatitis viruses that survive in a hospital (Ladner et al., 2018). These organisms cause diseases ranging from minor skin infections to life-threatening conditions such as sepsis (Sydnor and Perl, 2019).

1.1 Background to the Study

Globally, the World health organization (WHO) estimates that every year unsafe injections and needle stick injuries cause at least 8-16 million HBV infections, 2.3-4.7 million HCV infections and 160,000 HIV/AIDS infection among health care workers (WHO, 2016). The European Centre for Disease Prevention and Control (ECDC) reported that the prevalence of HAIs in European industrialized countries ranged from 3.5% to 10.5%, with a mean of 7.1% based upon data collected during period 1996 to 2007 (CDC, 2016). In USA, a cross sectional study conducted by Jain et al.  (2016) aimed at assessing prevalence survey of 183 nurses in an acute care hospital in the USA conducted showed that 4.0% of over 11,000 nurses use gloves during patient care in the administration of drugs. However, results from the study showed that, 55% of the nurses followed the hospital guidelines in the prevention of infection. This helped to improve patient care and reduce the transmission of infection among health care workers.

In Africa, the burden of healthcare associated infections is high, the risk is two to twenty times higher than risks in developed countries and the proportions of infected patients frequently exceed

25% (Allegranzi et al., 2011). A Study conducted in Kilifi district, Kenya indicated that the prevalence of HAI was 45.6% amongst patients (Aiken et al., 2011). In Ethopia, health care associated infections are among major challenges in public health facilities. About 11.6% of HCWs were occupationally exposed to HIV infection; this proportion was much higher than the proportions in Sabatia Sub County (8.5%), Hamisi Sub County (9.8%), Emuhaya/Luanda (9.4%) and the County proportion of 10%. In Nigeria, showed that the prevalence HAI in ICUs was 9.1%, as compared to 2.9% on general wards. Statistically, about 66.3% of the nurses in the health care workers follow the hospital guidelines in the prevention of hospital acquired infection. This helped to reduce the prevalence of HAI among health care workers and patients.

In Cameroon, infection control activities are severely constrained by numerous problems. Most hospitals have no effective infection control program and there is lack both of awareness of the problem and of personnel trained in infection control practices (Dixon et al., 2018). In a Study done in the two hospitals in the Center Region of Cameroon by Elvis et al (2016) aimed at assessing the prevalence of NI showed the prevalence of nosocomial infection was 12.03% with the Central Hospital (CH) recording 5.6% while District Hospital at Ifoulan recording 6.5% (Elvis et al., 2018). Lack of knowledge, bad attitudes and poor practices amongst nurses in the prevention and control of infections can lead to hospital-acquired infections.

This study was oriented on the environmental theory of Florence Nightingale on infection control. The theory explains the important of carrying out infection control measures such as damp dusting, use of sterile technique during procedures and use of personal protective equipment. Nightingale was the first nurse to identify the relationship between nursing and infection control. She comes out with her philosophy of improving hygiene conditions to reduce the mortality cases as the conditions in the hospitals were terrible. Lawrence, chairperson of the infection control nurses’ association (ICNA) believed that Nightingale was probably the first infection control nurse without actually realizing it. Nowadays nurses play a key role to ensure the survival of infection control practices. This would happen by maintaining proper infection control, sterile technique principles as well as continuous education on infection control through in-service training and induction courses (Chipfuwa et al., 2019)

1.2 Statement of the problem

Hospital nurses form the backbone of infection prevention and control, therefore possibly, will either contribute to infection transmission or prevent and control infection. In principle, all health care professionals including nurses are supposed to be practicing infection control measures across the globe, unfortunately it is not the case in our context, where 25% of nurses do not follow infection control guidelines to enhance patient care. During my internship at the Regional Hospital Buea, I observed cases where nurses and other health care workers handle contaminated linen with bare hands, put needles in the patient’s mattress after giving injections, do not clean thermometers between patients and do not wash hands regularly in the clinical environment. This therefore persuaded the investigator to carry out this study aimed at assessing the methods used by nurses in reducing infection in enhancing patient care at the Regional Hospital Buea.

1.3 Research Questions

1. What are the methods used by nurses to reduce infection in enhancing patient care at the Buea

Regional Hospital?

1.4 Objectives of the study

1.4.1 General Objectives

The study was aimed at assessing the methods used by nurses in enhancing patient care at the Buea Regional Hospital.

1.4.2 Specific Objectives

1. To assess the methods used by nurses to prevent infection in enhancing patient care the Buea

Regional hospital.

2. To assess the challenges faced by nurses in the prevention of infection at the Buea Regional

Hospital.

1.5 Significance of the study

To health workers: There is no documented effort to highlight infection prevention and control practices among health care workers in the health facility. Thus, result from this study will help to promote evidence based practices in the prevention of hospital acquired infection among health personnel’s.

To the hospital Administration: The results of this study will be used by policy makers to design appropriate policies with respect to infection control among health workers.

To nurse researchers: This study focused on the nurses at Buea Regional Hospital only and so the results will also act as a point of reference to future researchers on infection control.