Thesis:

Determinants of surgical site infections among post laparotomy patients in the surgical units at Thika level 5 hospital in Kiambu county, Kenya

A surgical site infection (SSI) is a common complication of surgical procedures and represents one form of healthcare-associated infection (HAI) acquired by patients before, during, or after receiving surgical intervention. It is the second most common HAI, and it is responsible for the rise of antibiotic resistance and the deaths of millions of people every year. This research examined patients’ performed laparotomy procedure at Thika Level 5 Hospital (TL5H), which forms a good representation of study population to identify risk factors for surgical site infections. The research took the form of analytical cross-sectional study. Post laparotomy Patients at the hospital throughout the research period made up the study's primary population. One hundred and sixty-one patients from the gynecology and surgery departments were selected at random. Quantitative data on patient-related variables and institutional factors as predictors of SSIs was collected using a questionnaire designed in accordance with Centers for Disease Control and prevention(CDC) guidelines and a formulated SSI Surveillance checklist tool. Pretesting of data tools were conducted in Kiambu level 5 hospital in Kiambu County to ensure validity and reliability of data tools. Data was analyzed using the Statistical Program for the Social Sciences (SPSS) computer program, version 25.0 and a chi-square test was used to test for associations between variables with a p-value less than 0.05, and participants' privacy was protected at all times. The study found that factors such as delay in seeking treatment, age, nutritional status, smoking habits, existing medical conditions, transfusion after surgery, and length of hospital stay before surgery were significantly associated with SSIs. Institutional factors such as timing of prophylaxis antibiotics, length of hospital stay after surgery, hand hygiene practices observed by healthcare workers, and the duration of the operation influence the Prevalence of SSIs significantly. The healthcare facilities should implement strict protocols for pre-operative and post-operative care, including timely administration of prophylaxis antibiotics. Healthcare workers should adhere to proper hygiene practices, including hand hygiene and the use of personal protective equipment. Patients should be educated on the importance of seeking timely medical care and adopting healthy lifestyle practices to reduce the risk of SSIs. The results of this research will be published, and utilized to close the knowledge gaps associated with SSIs prevention and management.