Date of Award

Winter 8-1-2017

Document Type

Thesis

Degree Name

M.Sc. Nursing

Department

Department of Medical Surgical Nursing

First Advisor

Mrs Leena Sequira

Second Advisor

Mrs Prima JJ D'Souza

Abstract

ABSTRACT (SIJIMOL S) A cross sectional study to assess the practices of postoperative surgical site dressing among the health care professionals in a tertiary hospital of Udupi district was conducted by Mrs Sijimol S in partial fulfilment of the requirements for the award of Master of Science in Nursing at Manipal College of Nursing Manipal, Manipal University. The objectives of the study were to assess the postoperative surgical site dressing practices and explore the perceived barriers to follow infection control measures in the dressing practices among the health care professionals. The conceptual framework of the study was based on Rosenstock, “Health Belief Model”. The sample for observation of practice were the events of postoperative surgical site dressing practice and for perceived barrier, the health care professionals of general surgery wards of KH, Manipal who were involved in surgical site dressing. The data collection instrument used for observation of practice was structured observation checklist and instrument for perceived barrier were demographic proforma and self-administered tool on perceived barriers to follow infection control measures. To ensure the content validity the instruments were submitted to seven experts. For pretesting of observation checklist five events were observed and the perceived barrier tool was pretested among five health care professionals. Reliability for practice checklist was established by inter rater reliability (r=0.95) and perceived barrier tool by test-retest reliability (r=0.92). The pilot study was conducted by observing 10 events and administering perceived barrier tool to 10 health care professionals. Administrative permission was obtained from the Dean, Manipal College of Nursing Manipal, Medical Superintendent, Kasturba Hospital, Manipal, Chairperson, Hospital Infection Control Committee, Kasturba Hospital, Manipal, Professor and HOD of General Surgery, Kasturba Hospital, Manipal, Institutional Ethics Committee (IEC 771/2016), Kasturba Hospital, Manipal, Institutional Research Committee, Manipal College of Nursing Manipal. Informed consent was obtained from the participants of the study. The data was collected from 2nd January to 5th February 2017. The data collected were analysed using SPSS version 16. Descriptive statistics were used to analyse the data. Sample characteristics showed that 55.3% of the health care professionals were between the age group of 20 and 25 years, 52.6% were male doctors, 63.2% had educational qualification of MBBS, 52.6% had less than 1year of experience and majority 60.5% had attended course, seminar or workshop concerning surgical site dressing or infection. Observation of postoperative surgical site dressing practices showed that majority of the dressings 68.2% were done immediately by not exposing the wound for a longer period. 84.1% of health care professionals wore sterile gloves without contamination. Majority (75%) of the health care professional had not practiced hand hygiene after opening the wound and 53.4% had not practiced hand hygiene after the procedure. The perceived barrier to practice infection control measures showed that majority (60.5%) of the health care professionals perceived surgical wound dressing is a time consuming task, 63.2% perceived heavy workload as a barrier, 39.5% perceived that there is lack of adequate staff to assist in dressing procedure, 39.5% perceived that inadequate cooperation from the patient during wound dressing as a barrier to follow infection control measures and only 15.8% perceive the lack of sufficient supplies as a barrier. Thus, the study concluded that the health care professionals had noncompliance in following infection control measures during postoperative surgical site dressing practice which can be reinforced through motivation and awareness and thereby reduce the burden of surgical site infection.

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