CHAPTER FIVE

5.0 Discussion of Findings

This chapter discussed the major findings of the research work under these sub headings

Discussion of findings

Implication for nurses

Summary of findings

Conclusion from findings

Limitations of the study

Recommendations

Suggestion for further study

5.1 Discussion of Findings

The major findings from the study were discussed with respect to the research questions set for

the study and in relation to the findings from previous related studies.

Research Question 1

This concerned with the staff nurse’s knowledge on nosocomial infection. From the analyzed

data, it showed that all the respondents (100%) had good knowledge of the nosocomial infection

and their sources of their information varies. Majority of the respondents 58.6%got theirs from

school, 37.6% got theirs from seminar/workshop while 3.5% got theirs from magazines
This finding is in line with the work by Fashafsheh, Ayed, Eqtait and Harazneh, (2015) which

found out that the majority of the correspondents (91.10 %) have heard and were quite familiar

with the concept of nosocomial infection but in contrast with the research study carried out by

Teshage, Engeda and Worku (2015) which indicated that more than half of the nurses who

participated in the survey had adequate knowledge about the prevention of surgical site infection,

moreover, more than half of them were practicing inappropriately.

Research Question 2

This was concerned with the perception of the staff nurses regarding the causes of nosocomial

infection. From the result of Table 8, it showed that 100% of the respondent were of the opinion

that one can get infected with a nosocomial infection which is in disagreement with the work

done by Dasgupta, Das, Chawan and Hazra, (2015) which discovered nosocomial infection rate

to be 11.98%.

Figure 4 shows that 38.4% of the respondents that the highest cause of nosocomial infections

was from a suppressed immune system owing to a prolonged hospital stay which contradicts the

study of Assar et al, (2012) which stated that gram negative bacteria were the most common

cause of nosocomial infection, with urinary tract infection (UTI) being the most common type of

a bacterial infection with 43.6%.

Research Question 3:

This was concerned with the nurses’ preventive and control measures should there be a spread of

nosocomial infection. Findings based on Table 9, Figures 6 and 7 were used to discuss the

objectives which the research question inquired for. It revealed that all the respondents supported

that nosocomial infection could be prevented, 29.4% said it could be prevented by the adoption
of an aseptic technique, 19.6% agreed that nosocomial infection could be prevented by

cleanliness and a strict observation of hand hygiene respectively while the rest of the respondents

15.7% said that they comply with cleanliness of hospital environment and the isolation of

already infected patients as their respective method of nosocomial infection prevention.

This affirms that nurses in Murtala Muhammad Specialist hospital exhibit good preventive

measures of nosocomial infection. This is in line with the study carried out by Mehta et al,(2014)

on the guidelines for the prevention and control measures of hospital acquired infections where

they stated that isolation, observation of hand hygiene and the use of personal protective

equipment are the single most effective measure of infection control in the hospital settings.

Figure 7 showed that majority, 45.1% of the respondents indicated that nosocomial infection can

be controlled by the development of an infection control program, 25.8% indicated the practice

of isolation, 9.7% opted for surveillance, 9.7% also went for measurement and comparison of

infection rates, while 9.7% thought that vaccination could be a measure of control. This is in line

with Khan, Ahmed and Mehboob, (2015) who stated that measurement and comparison of

infection rates, development of infection control programs and the surveillance of nosocomial

infection are three major control measures adopted by a nurse in a health care setting.

5.2 Implication to Nursing

The study highlights the prevention and control of nosocomial infection in general. Infection

prevention and control continues to be a point of concern in health care settings. As a result of

their priority to patients and their pivoted role in healthcare delivery, nurses are in unique

position to make studies in and enforce infection control practices in order to reduce the rate of

transmission of nosocomial infection among hospitalized patients.

 Nurses should ensure that patients, their relatives, other staff and the public are well

protected from nosocomial infections. To ensure this, an effective knowledge on the prevention

and control of nosocomial infection among staff nurses are of absolute priority.

Nurse Managers should take leadership roles to ensure safe practices in care of patients.

Nurse Managers in their capacity should advice the hospital management on the need for the

provision of personal protective equipment and other logistics that will curtail the spread of

nosocomial infections e.g. provision of portable water, disinfectants, gloves, face masks, barrier

gown, etc.

5.3 Limitation of the Study

Some potential limitations the researcher encountered during the course of study were;

Financial constraint: This was as a result of the high cost of writing materials, posing a major

challenge to the researcher.

Time: Also, time was a great constraint to the thorough investigation because the time lap was

very short and the researcher had to deal with a tight academic schedule.

5.4 Summary

Infections acquired in the healthcare settings raise a great risk for patients, leading to high rates

of morbidity and mortality. Nosocomial infection could be prevented by following evidence-

based guidelines. It was observed that staff nurses in Murtala Muhammad Specialist hospital

have good knowledge on the prevention and control of the spread of nosocomial infection. The

single most effective preventive measure for all nosocomial infection is the adoption of aseptic
techniques and all efforts to reduce the rate of hospital acquired infection must focus on

enhancing compliance with this measure.

Nosocomial infection affects hundreds of millions of peoples worldwide and in major global

issues for patient safety. It complicates between 5 and (10%) of admission in acute care hospital

in industrialized countries the incidence rate is 20% and it has become increasingly obvious that

infection acquired in the hospital lead to increase morbidity and mortality which has added

noticeable to economic burdens. However, after about three (3) descends of hospitals infection

surveillance and control worldwide it still remains an important problem for hospital today.

Nevertheless, the prevention of infection is a major concern of all health workers and health

policy makers. Nursing is crucial to the success of any - Preventive program aimed at reducing

the incidence of infection in the health care facilities. Nurses therefore, must possess adequate

knowledge and demonstrate Practice towards achieving the goal of prevention of infections.

5.5 Conclusion

In conclusion, the study suggests that hospital acquired infections among nurses working in

surgical wards are caused by various factors and practices, these greatly cause an increase in

patients’ morbidity and mortality rate thereby increasing hospital stay and health service costs.

Good hand hygiene practice according to W.H.O., cleaning and disinfection of machines and

surfaces, good aseptic technique practices, good knowledge and practice of infection prevention

and control, proper waste management and disposal; when abided to, will go a long way in

preventing the incidence of hospital acquired infections among nurses.

Based on the analyzed and interpreted data in conjunction with the reviewed literatures, it was

concluded that there is a need to address the issues with reference to the barriers identified in the
study. The use of aseptic technique should be emphasized on. Therefore, periodic and in-service

trainings in this domain are suggested.

Education is a critical element in the training of all healthcare’s, workers, particularly where

there is jack of formal and well-organized infection programs. However, in spite of having

knowledge about infection control, their overall knowledge didn’t reach the goal level.

5.6 Recommendation

Following the findings and implications of the study, the researcher made the following

recommendations;

Keep soap/alcohol- based hand hygiene dispensers prominently placed, and make universal

precaution equipment such as gloves, available only near hand sanitation equipment.

Nurses should post reminder signs at the entry and exit to patients’ room (especially isolated

patients).

Create an environment in which reminding each other about hand hygiene is encouraged.

There should be a periodic organization of workshop and seminars to enlighten health workers

on current issues in infection prevention and control.

There is a need for the display of precautionary guidelines in the wards, outpatient department,

patients’ besides etc; this will serve as a reminder to health workers on the precautions and

actions to take in case of exposure.

5.7 Suggestions for Further Studies

 Based on the recommendations the researcher suggested that studies be conducted on;

The level of compliance of nurses on hand washing and use of aseptic techniques on prevention

and control of nosocomial infections among nurses in other health care institution.

Factors hindering the compliance of nurses, towards the practice of prevention and control of

nosocomial infection.

Comparative studies on the knowledge, attitude and practice of prevention and control of

nosocomial infections among nurses in the other healthcare institutions.

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APPPENDIX

QUESTIONNAIRE

SCHOOL OF POST BASIC PERIOPERATIVE NURSING STUDIES

UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL

Dear Respondent,

I am a student of the school of post basic perioperative nursing studies

University of Maiduguri teaching hospital I am conducting a research work on “the prevention

and control of nosocomial infection among nurses in Muhammad shuwa memorial hospital

Maiduguri. Please kindly respond to the questions that follow by ticking the space provided. All

information given will be treated confidentially and be used only for academic purpose. No

name is required.

Thank you.

INSTRUCTION
Do not write your name. Please tick (() the appropriate alternative.

SECTION A: BIO DATA

1. Sex: a. Male [ ] b. Female [ ]

2. Age (years): a. 20-30 [ ] b. 31-40 [ ] c. 41-50 [ ] d. 51 and above [ ]

3. Marital Status: a. Single [ ] b. Married [ ] c. Divorced [ ] d. Widowed [ ]

4. Religion: a. Christianity [ ] b. Islam [ ] c. Others ………………………….

5. Educational Qualification: a. RN [ ] b. RM [ ] c. RNM [ ] d. BSc [ ] e. MSc.

[ ]

SECTION B: NURSES KNOWLEDGE ON THE SPREAD OF NOSOCOMIAL INFECTTION

6. Have you heard of Nosocomial infection? a. Yes [ ] b. No [ ]

7. If yes, what was your source of your information?

a. Radio [ ] b. Television [ ] c. News print [ ] d. Magazines [ ] e. Seminars/Workshop [

f. school [ ] g. Others (specify) …………………………………………….

8. What do you understand by Nosocomial infection?

a. It is an infection caused by inadequate nutrition [ ]

b. An infection affecting the growth of an individual [ ]

c. An infection acquired in the hospital due to improper sterile procedures which the patient did

not formerly present with [ ]

d. An infection that makes one sleep too much [ ]

SECTION C: CONTROL MEASURES OF NOSOCOMIAL INFECTION

9. Can nosocomial infection be controlled? a. Yes [ ] b. No [ ]

10. If yes, how can it be controlled?

a. isolation b. observing hand hygiene c. use of PPEs

11. If there be a report of nosocomial infection, what would be the likely control measures?

a.. Practice isolation for already infected people [ ]

b. Development of infection control programs [ ] c. Surveillance [ ]

d. Measurement and comparison of infection rates [ ] e. Vaccination [ ]

SECTION D: PREVENTIVE MEASURES OF NOSOCOMIAL INFECTION

12. Can nosocomial infection be prevented? a. Yes [ ] b. No [ ]

13. If yes, how can it be prevented?

a. Isolation of patients who are already infected [ ] b. Strict observation of hand hygiene [ ]

c. Use of personal protective equipment’s like gloves [ ]

d. Maintenance of a clean hospital environment [ ]

e. Practice of aseptic technique while carrying out procedures [ ]