Adherence to world health organization guidelines on prevention of surgical sites infections among nurses in Karatina sub-county hospital in Nyeri, Kenya

Abstract

Surgical Site Infection (SSI) is the leading cause of morbidity and mortality. A surgical site infection (SSI) occurs within 30 days of surgery or one year if an implant is used. The invasive nature of the procedures break the first line of defense for the body making the patient vulnerable to infections especially by pathogens such as Escherichia coli, staphylococcus aureus , and klebsiella. A study by US department of health reported 2-4% cases develop SSI with 3% resulting in mortality and a study by Tarwadi 2016, in AKU, Kenya revealed 4.9%cases resulted in SSI. The levels of the morbidities have not had significant decline since the inception of guidelines on their prevention. Therefore, this study sought to assess the adherence to WHO blueprints on the prevention of SSIs among nurses and to establish the nurse-related as well as facility-associated factors that influence the protocols to the compliance. This study was based upon the following specific objectives; to assess the level of adherence to WHO Guidelines on prevention of SSIs among nurses working in Karatina sub-county hospital, Nyeri County, to assess the nurse-related factors influencing the adherence to WHO Guidelines on prevention of SSIs among nurses working in Karatina sub-county hospital, Nyeri County, to assess facility-linked factors that influence adherence to WHO Guidelines on prevention of SSIs among nurses working in Karatina sub-county hospital, Nyeri County. To accomplish this, the study was shaped by the theory of planned behavior. On methodology, a descriptive cross-sectional design was employed to help in describing variables under study. The study population entailed nurses working in surgical, outpatient, theatre, and maternity departments at Karatina Sub County Hospital in Nyeri, Kenya with a total of 98 nurses sampled through proportional stratified purposive method taking part in the study. The data was gathered through an observational checklist as well as a self-administered questionnaire. A pre test was conducted at Mukurweini Sub-county hospital in Nyeri which offers similar services to Karatina sub-county hospital. Data analysis was realized through descriptive statistics which incorporated calculating frequencies, percentages, mean, as well as standard deviation using data from SPSS version 25.0. The results showed that there were more male nurses who adhered to the SSI prevention guidelines than female(p<.001), the availability of hospital policies on SSI prevention significantly contributed to high level of adherence(p <.001).These outcomes were presented in tables, pie charts, and bar graphs. The results will be vital to informing strategies that need to be adopted to lower the cases of SSIs based on identified areas of non compliance or recommendations. On analysis, it was observed that the majority of the nurse’s level of adherence was low at 55.1% (n=54). Increase in age was found to be significantly associated with low adherence level to the guidelines. The nurses’ age, gender, has advanced training, more years of experience and nurses knowledge on infection prevention influence adherence level to WHO guidelines on infection prevention. The study recommended that the human resource management to evaluate their staffing and employ younger nurses as their work force.