ABSTRACT
It was a survey research conducted in 2013 at ultrasound Laboratories of Ugochukwu Hospital and maternity, St Charles Hospital Boromm, General Hospital Onitsha and Toronto hospital and maternity all in Onitsha. Four research questions of at least. Three items each were used to obtain data from 120 respondents using convenient sampling.
Hygiene is commonly understood as preventing infection through cleanliness. In broader call, Scientifically hygiene is the Maintenance of health and healthy living. Hygiene ranges from personal hygiene. Through domestic up to occupational hygiene and public health.
It is a prospective non experimental survey study design. The non experimental design is chosen because it is suited design in involving human beings
Indicated that 30 sonographers responded that they clean their ultrasound transducer after the examination, 15 sonographers the examination, 10 sonographers say that they only clean as soon as they remember, while 10 sonographers said that they only clean their transducer when soiled.
Hygiemic practices like proper hand washing cleaning of ultrasound transducer with disinfectants by the end of the examination of each patient the protective barriers.
TABLE OF CONTENTS
Title Page … … … … … … … … … … … ii
Approval Page … … … … … … … … … … … iii
Certification … … … … … … … … … … … iv
Dedication … … … … … … … … … … … v
Acknowledgement … … … … … … … … … … vi
Abstract … … … … … … … … … … … .. vii
Table of Contents … … … … … … … … … … viii
List of Tables … … … … … … … … … .. … xi
CHAPTER ONE
1.1 Introduction … … … … … … .. … … … 1
1.2 Theories on Hygiene … … … … … … … … … 3
1.3 Statement of the Problem … … … … … … .. … 6
1.4 Purpose of Study … … … … … … .. … … 7
1.5 Significance of the Study … … … … … … .. … 7
1.6 Scope of Study … … … … … … .. … … … 7
CHAPTER TWO:
- Review of Literature … … … … … … .. … … 8
- Control of Principles of Infection … … … … … … .. 14
2.3 Techniques in Ultrasound Practices for Hygiene … … … … … 16
CHAPTER THREE: RESEARCH METHODOLOGY
- Research Methodology … … … … … … .. … 18
- Sample size and Sampling Method … … … … … .. 18
- Source of Data … … … … … … .. … … … 18
- Data Collection … … … … … … .. … … 19
- Data Presentation … … … … … … .. .. … 19
CHAPTER FOUR: DISCUSSION, SUMMARY OF FINDINGS, RECOMMENDATIONS, AREAS OF FURTHER STUDY, CONCLUSION AND LIMITATIONS OF STUDY
4.1 Discussion … … … … … … .. … … . 26
4.2 Summary and Finding … .. … .. … … … .. .. 27
CHAPTER FIVE:
- Conclusion … … … … … … … … … 28
- Recommendations … … … … … … … … … 28
- Areas of Further Study … … … … … … … … 28
- Limitations of the Study … … … … … … … … 28
References … .. .. .. .. .. .. .. .. .. 29
Appendix
LIST OF TABLES
Table 1: Pie charts and bar charts … … … … … … …. 20
Table 2: Cleaning of Ultrasound transducer … … … … … 22
Table 3: The Barriers for infection control projection … … … … 23
Table 4: Sonographers exposure to infection … … … … … 24
Table 5: Sonographers protect to Infections … … … … … 24
INTRODUCTION
1.1. BACKGROUND OF STUDY
According to Garner et al1 the term hygiene originates as a reference to Hygieia, who was a daughter of Asclepius and the goddess of health, cleanliness and sanitation. Hygine is commonly understood as preventing infection through cleanliness. In broader call, scientifically hygiene is the maintenance of health and healthy living. Hygiene ranges from personal hygiene, through domestic up to occupational hygiene and public health.
Outward signs of good hygiene include the absence of visible dirt (including dust and stains on clothing) or of bad odour/smells. Good hygiene is an aid to health, beauty, comfort, and social interactions. It directly aids in disease prevention and/or disease isolation.
Hygienic practices, such as frequent hand washing or the use of autoclaved and sterilized water/equipment in surgery/medical operations has a profound impact on reducing the spread of disease. This is because they kill or remove disease- causing microbes in the immediate surroundings. For instance, washing one’s hands after using the toilet and before handling food reduces the chance of spreading E. coil bacteria and Hepatitis A, both of which are spread from fecal contamination of food. Adequate hygiene requires an adequate and convenient supply of clean water.
Clinically hygienic practices include use of bandaging and dressing of wounds, Use of protective clothing such as masks, gowns, caps, eyewear and gloves, sterilization of instruments used in surgical procedures, safe disposal of medical waste etc.
In ultrasound examinations, there is a close contact of the probe with the patients’ body and sometimes insertion of the probe into body orifices of the patient is done. This contact therefore is a fertile ground for transfer of infection of hygienic practices is not ensured.
The level of hygienic practices in ultrasound laboratories depend on the knowledge, skill and importance attached to the prevention of personnel contamination as well as transfer of infection among different patients. The government/public ultrasound laboratories are assumed to have well trained professionals who are expected to practices hygienic procedures. On the other hand private ultrasound laboratories are expected to undertake high quality services to ensure satisfaction of their clients and improve their patronage. Assessment of the attainment of these expectations is the gap to be filled with this study.
In a related study, Sanjay et al2 in their research work, Comparative performance of Private and Public Healthcare Systems in Low- and Middle- income Countries in USA: A Systematic Review. The Systematic review Does not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients .
Also Tuan et al3 in their study , comparative quality of private and public health services in rural Vietnam discovered that private providers are successfully competing with the public health centre system in rural areas but not because they provide cheaper or better services. Public sector infrastructure was superior to that of the private providers. The quality of service provided by public providers was poor and not controlled but significantly better than that of private providers patient satisfaction and cost of care were similar between the two groups.
Mary et al4 in influence of Role Models and Hospital Design on the Hand Hygiene of Health-care Workers found out that health –care Worker hand –hygiene compliance is influenced significantly by the behavior of other health-care workers. An increased number of hand –washing sinks , as a sole measure, did not increase hand –hygiene compliance .
1.2 THEORIES ON HYGIENE
The practice of hygiene is a process which we cannot overlook as far as health is concerned because hygiene is a science of health and it is of paramount importance in our everyday life. Hygiene is defined as a set of practices perceived by a community to be associated with the preservation of health and healthy living, while in modern medical sciences there is a set of standards of hygiene recommended for different situations. Hygiene refers as the science of health or the act of keeping yourself and the surrounding clean in attempt to prevent infection and diseases. Hygiene practices are employed as a preventative measures to reduce the incidence and spreading of diseases and it determines the extent one can live comfortably without infection or sickness.
Hospital is a place for bread of agents that causes infections and diseases which ultrasound room is not an exception. Therefore maximum medical hygiene practices should be considered as a very important factor for patient’s safety, sonographers and other health assistants. Patients should be protected from cross-infections. The sonographers and other health assistants should also be protected from acquiring infections as a result of poor hygiene.
Good hospital hygiene practice is vital to any strategy for preventing HealthCare Associated Infections(HCAI) in hospitals. They are based on cleaning the general hospital environment, training of staff, Cleaning items of shared equipment.
Association between poor environmental hygiene and the transmission of micro organisms causing HealthCare Associated Infections in hospital should be call to attention. The NHS Code of practice on the prevention and control of HealthCare Associated Infection which came into effect in October 2006 was developed to help Organizations to plan and implement strategies for the prevention and control of HCAIs. It set out criteria by which managers on NHS organizations and other healthcare providers should ensure patients are cared for in a clean environment, where the risk of HCAIs is kept as low as possible.
Transmission of micro organisms from the environment to patients may occur through direct contact with contaminated equipments or indirectly as a result of torching by hands. Nevertheless, the evidence that pathogens responsible for HCAIs can be widely found in the hospital environment and hence readily acquired on hands by touching surfaces does demonstrate the importance of decontaminating hands before every patient contact.
Shared clinical equipment used to deliver care in the clinical environment comes into contact with intact skin and is therefore unlikely to introduce infections. However, it can act as a vehicle by which micro organisms are transferred between patients through the use of non invasive clinical equipments including Stethoscope, lifting equipments and ultrasound probes
Staff education was lacking on optimal cleaning practice in the clinical areas. Knowledge deficits may hinder the application of cleaning practices and monitoring and evaluation was indicated. This is further reinforced by an observation study, which noted that lapses in adhering to cleaning protocol were linked with an increase in environmental contamination.
Medical hygiene practices include: sterilization of instruments used in ultrasound rooms, use of protective clothing and barriers, such as gowns and gloves, safe disposal of medical waste, disinfection of reusables scrubbing up hand-washing especially in ultrasound rooms.
It is obvious that successful prevention, control and elimination of cross-infection of disease in ultrasound centres are greatly dependent on observance of proper and effective hygiene practice.
This research will identify the level of hygienic practices in ultrasound centers in onitsha metropolis to establish their adequacy or otherwise. In this effect, it will be of a baseline information for interventions in the area of hygiene practices in radiological procedures.
1.3 STAEMENTS OF PROBLEMS
- Theresearch in the course of my clinical posting observed noticed that some sonographers do not adhere to hygiene practice during ultrasound examinations.
- The course of the clinical posting also observed that practiced in ultrasound laboratories in government and private clinics in Onitsha metropolis has not been documented
1.4 PURPOSE OF STUDY
- To determine hygiene practiced in ultrasound laboratories in government and private clinics in Onitsha Urbanmetropolis.
- To identify any regulatory guidelines for infection control in ultrasound laboratories and document – ion of nosocomial infections among sonographers.
1.5 SIGNIFICANCE OF STUDY
- It will enable sonographers to develop and strictly enforce an infection control guidelines to enable them fulfill the obligation of providing an infection control environment for the patients.
- This study will enlighten the public on the common nosocomial infection acquired in poor hygiene practice and ways to avoid them.
- It will enlighten clinical students on awareness of nosocomial infection and how to prevent cross- infection in ultrasound centers
1.6 SCOPE OF STUDY
This case is limited to ultrasound Centers in Onitsha metropolis. The selected hospitals with ultrasound laboratories include. General Hospital Onitsha, St Charle, Boronny, TorontoHospital and Maternity and UgochukwuHospital and Maternity. These hospitals were chosen because of large number of patient through put in this hospital for ultrasound scanning.
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