ISBN: 978-80-7422-896-4 | ISBN online: 978-80-7422-896-4 | DOI: 10.32725/zsf.2022.74228964

Vybrané aspekty prevence infekcí spojených se zdravotní péčí v ošetřovatelství

Martin Krause, František Dolák

Preventing healthcare-associated infections is essential to providing safe and quality healthcare to patients. The emergence of conditions associated with health care requires adherence to various principles, especially hygienic hand disinfection, decontamination of used objects and areas, and aseptic procedures in implementing individual nursing interventions (WHO, 2018).
This research aims to describe the specifics of selected measures in the prevention of infections associated with health care in nursing practice, according to the latest scientific knowledge. We also analysed risky objects and areas used in the provision of nursing care regarding the possible transmission of pathogens. Furthermore, we analysed the knowledge of general nurses about the disinfection of objects and areas in the provision of nursing interventions. We studied the microbial effectiveness of the applied antibacterial nanolayer on selected objects and areas in nursing practice. We also examined the microbial contamination of selected objects and areas in clinical practice.
We used qualitative and quantitative research methods. We processed theoretical findings using reviews and syntheses and national and international relevant sources, including the recommendations of major professional institutions dealing with the prevention of healthcare-associated infections. We conducted qualitative research through unstructured observation to identify risky objects and areas. We used ATLAS.ti software to analyse qualitative data. Quantitative research consisted of two parts. We used a questionnaire to ascertain the general nurses’ knowledge of disinfecting objects and areas. The research group comprised 184 (100.0%) general nurses working in standard internal medicine and surgery workplaces. We analysed and statistically evaluated quantitative data from the questionnaires.
We used the experimental technique to determine the microbial effectiveness of applied antibacterial and hydrophobic nanolayers on selected objects and surfaces in nursing practice. We chose two groups for the experiment: the experimental group (application of antibacterial and hydrophobic nanolayers) and the control group (without surface treatment). Objects and surfaces were emitting bowls, work trays, and boxes intended for storing medical supplies. We used microbiological methods to determine microbial contamination and verified it in an accredited microbiological laboratory. We analysed and statistically evaluated quantitative data from the experiment. The research was partly financed by a competition grant. We carried out the individual stages of the research at standard workplaces of selected hospitals in the Czech Republic.
The research revealed a variety of objects and surfaces that general nurses use in clinical practice, e.g., stethoscope, tonometer cuff, medical documentation, work tray, and others. We found that general nurses have limited knowledge in some areas of object and surface disinfection, e.g., in using Spaulding’s classification or during object and surface decontamination with the presence of biological material. We found that 65.2% of general nurses have knowledge about diluting the disinfectant solution, 79.9% about the procedure for diluting the disinfectant solution, 85.9% about the reason for performing mechanical cleaning, 51.1% about the procedure for decontamination of a work tray stained with biological material, and 45.1% about first aid in the case of eye contact with disinfectant.
Based on the research results with the experimental technique, we found that selected objects and surfaces with nanomaterial (antibacterial and hydrophobic nanolayer) showed bacterial contamination. It was impossible to prove a statistically significant difference between bacterial contamination of objects and surfaces with and without nanomaterial. Further analysis revealed that emission bowls would be contaminated with bacteria in 31.3% of cases or work trays in 38.1%. We also found that some objects and surfaces were contaminated with pathogenic bacteria, e.g., Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacter cloacae or Serratia rubidaea. The analysis revealed that 36.4% of objects and surfaces had already been contaminated with various bacteria, including those that are pathogenic, before their actual use. This is one of the essential findings of the research, which may impact the possible transmission of healthcare-associated infections.
Based on selected aspects of the research, we found that general nurses play an essential role in preventive interventions, especially concerning compliance with preventive measures for healthcare-associated infections. Bacteria and other microorganisms are undetectable on objects and surfaces without specific means and represent a clinically relevant place for ensuring compliance with basic hygienic-epidemiological principles. The research results show selected aspects that must be systematically followed up in the future. The results can be used within educational institutions and health service providers. Education is essential for minimizing adverse impacts related to the daily provision of nursing care, within which new knowledge should be applied. The findings laid the foundation for future research focusing on the above aspects, including using simulation teaching methods in the context of healthcare-associated infections. The research findings also support other parts of the infection prevention and control programme.

1.. edition, Published: 2022, online: 2022, publisher: NLN, s. r. o., Praha