Assesment Of Factors Contributing To Surgical Wound Infection In Kampala International Teaching Hospital

TABLE OF CONTENT

DECLARATION…………………………………………………………………………………………I

SUPERVISOR’S APPROVAL…………………………………………………………………………..II

ABBREVIATIONS………………………………………………………………………………………III

DEFINITIONS……………………………………………………………………………………………IV

DEDICATION…………………………………………………………………………………................V

ACKNOWLEDGEMENT……………………………………………………………………………….VI

CHAPTER ONE………………………………………………………………………………………….1

1.0 INTRODUTION……………………………………………………………………………………..1

1.1 BACKGROUND INFORMATION………………………………………………………………….1

1.2 RPOBLEM STATEMENT…………………………………………………………………………...2

1.3 RESEARCH QUESTIONS…………………………………………………………………………...3

1.4 OBJECTIVES…………………………………………………………………………………………3

1.5 JUSTIFICATION OF THE STUDY………………………………………………………………….4

CHAPTER TWO……………………………………………………………………………………….....5

2.0 INTRODUCTION………………………………………………………………………………….....5

2.1 LETERATURE REVIEW………………………………………………………………………….....6

2.2 DEFINITION OF SEPSIS………………………………………………………………………….....8

CHAPTER THREE…………………………………………………………………………………….....9

3.0 METHODOLOGY…………………………………………………………………………………...9

3.1 STUDY AREA……………………………………………………………………………………….9

3.2 STUDY DESIGN…………………………………………………………………………………….9

3.3 STUDY POPULATION……………………………………………………………………………..9

3.4 INCLUSION CRETERIA…………………………………………………………………………...10

3.5 EXCLUSION CRETERIA…………………………………………………………………………..10

3.6 SAMPLING METHODS……………………………………………………………………………10

3.7 SAMPLE SIZE CALCULATION…………………………………………………………………..10

3.8 DATA COLLECTION……………………………………………………………………………....11

3.8.1 DATA COLLECTION TOOLS…………………………………………………………………...11

3.8.2 QUALITY CONTROL…………………………………………………………………………....11

3.9 ETHICAL CONSIDERATIONS……………………………………………………………………12

3.10 STUDY LIMITATION………………………………………………………………………….....12

3.11 DISSEMINATION OF RESULTS………………………………………………………………...12

CHAPTER FOUR……………………………………………………………………………………….13

PRESENTATION AND DISCUSSION OF FINDINGS………………………….……………………13

4.1 INTRODUCTION…………………………………………………………………………………...13

4.2 FINDINGS ON THE FACILITY DEMOGRAPHIC INFORMATION…………………………....13

4.3. FINDINGS ON FACILITY WARD………………………………………………………………..14

4.4. FINDINGS ON FACILITY WATER SUPPLY…………………………………………………....17

4.5. FINDINGS ON FACILITY DRUGS…………………………………………………………….....18

4.6. FINDINGS ON PRE-OPERATIVE ANTIMICROBIAL PROPHYLAXIS......................................20

4.7. FINDINGS ON REPROCESSING OF SURGICAL INSTRUMENTS..................................…......23

4.8. FINDINGS ON PREOPERATIVE SCRUB BY SURGICAL PERSONNEL……………………..25

4.9. FINDINGS ON SURGICAL AREA VENTILATION……………………….……………………28

4.10. FINDINGS ON SURGICAL AREA TRAFFIC………………………………..…………………29

4.11. FINDINGS ON THEATRE ATTIRE……………………………………………………………..31

4.12. FINDINGS ON DECONTAMINATION AND CLEANING OF INSTRUMENTS……………..32

4.13. FINDINGS ON PROCEDURES ON SURGICAL WARD………………………………………35

4.14. FINDINGS ON HAND HYGIENE EQUIPMENT AND SUPPLIES……………………...…….36

4.15. FINDINGS ON WOUND DRESSING………………………………………...…………………38

CHAPTER FIVE…………………………………………………………………..……………………40

SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS………………….….40

4.0 Introduction…………………………………………………………………………………………40

5.1 Discussion…………………………………………………………………………………………..40

5.1.1: The risk factors associated with surgical wound infections in KIU-TH………………………....40

5.1.2: The infection control measures available in KIU-TH.............................................................…...41

5.1.3: Whether health workers are practicing infection control………………………………………...42

5.2 CONCLUSIONS……………………………………………………………………….…………..42

5.3 Recommendations .....................................................................................................................…...43

5.3.1. To Hospital administration………………………………………………....……………………43

5.3.2. To Doctors (medical officers and Surgeons)…………………………………………………....43

5.3.3. To Nurses……………………………………………………………………………….……….43

REFERENCES………………………………………………………………………………………....44

APPENDIX I: Consent form…………………………………………………………………………...45

APPENDIX II: Questionnaire………………………………………………………………………….46

APPENDIX IV: Map of Uganda showing location of Bushenyi district………....................................51