Evaluation of a program implemented to reduce surgical wound infection in an acute care hospital in India : a clinical practice improvement project

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dc.contributor Ancheril, Alphonsa Sr en_AU
dc.date.accessioned 2007-03-14T01:53:17Z
dc.date.accessioned 2012-12-15T03:52:43Z
dc.date.available 2007-03-14T01:53:17Z
dc.date.available 2012-12-15T03:52:43Z
dc.date.issued 2004
dc.identifier.uri http://hdl.handle.net/2100/311
dc.identifier.uri http://hdl.handle.net/10453/20206
dc.description University of Technology, Sydney. Faculty of Nursing, Midwifery & Health. en_AU
dc.description.abstract This research project investigated the impact of an action research intervention implemented to reducing surgical wound infection in one of the acute care hospitals in India. The study aimed to develop and implement a clinical practice improvement program in reducing surgical wound infection by improving the hand washing and wound dressing practices of nurses. The study also aimed to identify the important contributing factors to a model that predicts surgical wound infection. Pre-post evaluation measures were taken to compare the results of surgical wound infection rate before and after the implementation of the intervention. Surgical wounds of two thousand patients (one thousand before the intervention and another one thousand after) were assessed to determine the wound infection rate and severity of wound infection. The hand washing and wound dressing practices of forty nurses were observed. These same nurses were involved in the intervention using a participatory action research process. The results of the study suggest that there was a marked, significant reduction in the rate and severity of wound infection following the implementation of the intervention. By increasing the hand washing facilities in the ward, educating nurses on the importance of better hygiene, pre-operative shaving and post-operative wound care, the hand washing and wound dressing practices of nurses improved considerably. These improvements resulted in a reduction in the number and severity of patients' surgical wound infections. The study also examined the contribution of different factors to surgical wound infection in a Indian hospital. Significant predictive factors were the patients' age, longer pre-operative hospital stay, extended pre-operative shaving time before surgery, wound class, and co-morbidity of the patient. The identification of risk factors that contributed to increased surgical wound infection for example pre-operative skin preparation, pre-operative hospital stay of the patient would help in taking appropriate measures at the ward level and organisation as a whole. Nosocomial infections extends to an unnecessary lengthy hospital stay, additional treatment increased mortality and morbidity, and increased cost to the patients and the nation as a whole. This project proved that educational mentoring, data surveillance processes and involving the nurses in an action research process were effective in enabling participants to improve their clinical practice and thereby reduce the incidence of patients' surgical wound infections. Establishing infection control teams, ongoing surveillance and feedback to staff of nosocomial infection rates is an urgent need in all Indian hospitals. Organisational management, as a priority, need to provide funding and staff dedicated to undertaking this essential work. Health care professionals can no longer plead ignorance of a situation for which all have a moral and professional responsibility. en_AU
dc.format.extent 152327 bytes
dc.format.extent 817494 bytes
dc.format.extent 2525357 bytes
dc.format.mimetype application/pdf
dc.language en en_AU
dc.language.iso en_AU
dc.rights http://www.lib.uts.edu.au/disclaimer.html en_AU
dc.rights Copyright Alphonsa Ancheril en_AU
dc.subject Hospitals. en_AU
dc.subject India. en_AU
dc.subject Clinical practice. en_AU
dc.subject Surgical wound infections. en_AU
dc.subject Nosocomial infections. en_AU
dc.title Evaluation of a program implemented to reduce surgical wound infection in an acute care hospital in India : a clinical practice improvement project en_AU
dc.type Thesis (PhD) en_AU
utslib.copyright.status Open Access

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