Abstract Background: Nurses are healthcare workers that play an essential role in the control of hospital infection, protect patients from hospital required infection and leads to better control of diseases. As long as, nurses, midwives, and healthcare support workers. Healthcare staff should have an adequate level of performance regarding hospital infection. Aim: Assess the effect of evidence-based guidelines on Nurse's performance in respect to nosocomial infection at medical-surgical and obstetrician department. Subjects and Methods: A pretest-posttest questionnaire design was used in this study to assess the effect of evidence-based guidelines on performance among nurses for infection control at Benha University Hospital. Sample: the total 110 nurses enrolled in this study (60) nurses in the internal medicine department, (30) nurses in the surgical department and (20) nurses in the obstetric department, nurses who their experience at least one year. With different, Age 20- 50 years old had been selected .Results: The present study showed that there were statistically significant differences in the level of knowledge, the practice of infection control methods, nurses attitude regarding nosocomial infection control before and immediately after induction of the guidelines,( MH7.220, P<0 MH=5.555, P=0.003* MNP=0.012*) r=0.547, r=0.308, r=0.170,>0.05), knowledge and attitude were (0.012, p>0.05), practice and attitude were (r=0.324, p<0>
1.1. The Aim of the Study The current study was aimed to evaluate the effect of evidence-based guidelines on Nurse's performance in respect to nosocomial infection control at medical-surgical and obstetrician department. 1.2. Research Hypothesis 1. The post means knowledge scores of the nurses who follow the evidence-based guidelines toward nosocomial infection control measures will be increased. 2. The post means practices scores of the nurses who will follow the evidence-based guidelines toward nosocomial infection control measures will be improved. 3. The attitude of the nurses who will be following the evidence-based guidelines toward nosocomial infection control measures will be improved. 4. There are strong positive correlations among knowledge attitude and performance will show after following nosocomial infection control measures 5. There is a positive correlation between hospital capability and nurses performance 2.Materials and Methods 2.1. Research Design & Setting Quasi-experimental study design was used 2.2. Setting This study was carried out at Benha University Hospital in The Internal Medicines, surgical and obstetric departments. 2.3. Subjects and Sample Staff nurses working at the previously mentioned departments at Benha University Hospital within the period of the study. In total 110 nurses enrolled in this study (60) nurses in the internal medicine department, (30) nurses in the surgical department and (20) nurses in the obstetric department. They had been selected according to the following criteria:- Inclusion criteria:- nurses who their experience at least one year. With different, Age 20- 50 years old. Exclusion criteria:- Whom aged more than 50 years and less than 20 years. 2.4 Tools of Data Collection The tools of this study were two tools which included:- The first tool: it includes two parts. 1st part; recorded nurses’ demographic and professional characteristics (age, gender, educational level, qualifications, marital status, unit of activity, a history of infection control training, etc.);
509 American Journal of Nursing Research
2nd part The interview questionnaire sheet: was designed by the researchers after reviewing related literature Also it helped the researchers to develop the guidelines. It was conducted in a simple Arabic form in order to prevent misunderstanding. The 2nd part consists of three subsections: the 1st subsection; nurses knowledge about nosocomial infection including four items about the nature of infection, mode of transmission, prevention of infection and nursing role. The 2nd subsection, nurses practice including, including 35 items measuring practice about the adoption of preventive behaviors; hand washing, dressing skills, when to use eye protector and facial mask, precautions with needles and sharp materials and how to collect contaminated sheets. The 3rd subsection; nurses attitude, including ten items measuring perceived threat by nurses about HAI (healthcare-associated infections) of nurses and patients and perceived benefits by patients about the observation of standard precautions. Scoring system:- In the knowledge subsection, each correct answer to the items was scored 3, each wrong answer was scored 2, and I do not know the answer was scored 1. The practice subsection was comprised of 35 items rated on a 3-point Likert scale from 1 to 3 (not applicable=1, Disagree=2, Agree=3). Items in the attitude subsection were also rated on a three-point Likert scale. In evaluating the data in both sections of the knowledge and practice of nurses in the context of standard precautions, the scores of nurses were categorized as low, medium, and good. Scores less than 50 % were considered as poor, scores between 50 and 75 were considered as average, and scores more than 75 were considered as good. The second tool: consist of a questionnaire on the availability of the capabilities and needs of preventing infection within the unit including 20 items measuring the availability of the capabilities and needs of preventing infection within the medical, surgical and obstetric units each yes and enough answer was scored 3, each yes and not enough answer was scored 2 and no more answer was scored 1. Finally, the scores were calculated in percent - the number of correct answers multiplied by 60 divided by the total number of items. 2.5. Content Validity of the Tools Content validity comprehensiveness of tools was done to check the relevancy, coverage, and clarity of the questions, by five experts in the field of the study. One assistant professor, one lecturer of Medical-Surgical Nursing and one obstetrician in the Faculty of Nursing at Benha and Port Said Universities, and one professor, one lecturer of nursing administration in the Faculty of Medicine, Benha and Port Said University. Accordingly, modifications were done, and the final form was developed. 2.6. Pilot Study The questionnaire was pilot tested with a group of (10%) of nurses in order to evaluate the developed tools for the visibility, clarity, and applicability of the designed form in providing the required data and the necessary modification was done, and they excluded from the original data
The study was conducted after obtaining official permission to conduct this study was obtained from the heads of mentioned Units. The researchers explained the purpose of the study to heads of departments and nurses; to obtain their cooperation. Ethical consideration explained and ensured confidentiality after that nurses' oral informed consent obtained. Data were collected via interview questionnaires and the availability of the capabilities and needs of preventing infection. Collection of data for this study was carried out in the period from the starting of the may2017to end of September 2017. A convenient sample according to the previous criteria was selected. The researchers developed tools after reviewing of related literature and were tested for content validity by experts’ in Nursing. The pre-test was done for ten days, then guideline implementation was done for two months, and immediate post-test was done. The time needed for the completion of the interview was between 20 – 30 minutes. The guidelines included different sessions developed by the researchers to improve nurses' performance related to nosocomial infection control. The guideline involved (3) sessions, each session had repeated for three times per week. The guideline was implemented for a group of nurses entailing (12 nurses) according to working circumstances. After the implementation of the guidelines, the immediate post-test was done to the studied nurses' performance by the same format of the pre-test using tools to evaluate the effect of the implemented guidelines. 2.8. Ethical Consideration Before the start of data collection, ethical approval for the conduction of the research was obtained. Informed consent of nurses participation was taken, and they informed that participation was voluntary and they may and confidentiality of privacy of the nurse). 2.9. Statistical Analysis The original data were analyzed by using SPSS system files (SPSS package version 19, Chicago, USA). Analysis and interpretation of data were conducted. The following statistical measures were used: Descriptive statistics including frequency, distribution, mean and standard deviation were used to describe different characteristics. Kolmogorov – Smirnov test was used to examine the normality of data distribution. Univar ate analyses including Chi-Square test, Monte Carlo test and Fisher's Exact test were used to test the significance of results of qualitative variables. Moreover, Marginal Homogeneity test and Mac Nemar test were used to test the significance of the paired qualitative variables. The linear correlation was conducted to show a correlation between knowledge, practice and attitude scores among the studied nurses. The significance of the results was at the 5% level of significance. The significance of the results was at the 5% level of significance tested.
محتويات مواقع أعضاء هيئة التدريس بما فيها من نصوص وملفات وصور وأبحاث وأية مواد أخرى هي مسئولية عضو هيئة التدريس بالكامل بصفته صاحب الموقع وبما له من صلاحية مطلقة في الإضافة والحذف، وتخلي الجامعة مسئوليتها عن محتويات تلك المواقع.
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