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Universal Precautions That Surgical Nurses Are Taken for Preventing from Diseases Transmitted by Blood and Body Fluids in Istanbul

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Universal Precautions That Surgical Nurses Are Taken for Preventing from Diseases Transmitted by Blood and Body Fluids in Istanbul International Journal of Caring Sciences January – April 2016 Volume 9 | Issue 1| Page 111 Original Article Universal Precautions that Surgical Nurses are taken for Preventing from Diseases Transmitted by Blood and Body Fluids in Istanbul Sabriye Sibel Taze RN, MSc Istanbul University Cerrahpaşa Medical Faculty Istanbul/Turkey Ikbal Cavdar, BSN, MSc, PhD Associate Professor, Istanbul University,Florence Nightingale Faculty of Nursing Surgical Nursing Department, Correspondence: Sabriye Sibel Taze, Istanbul University Cerrahpaşa Medical Faculty Istanbu,Turkey E-mail: [email protected] Abstract Background: Human Immunodeficiency Virus (HIV), Hepatitisis B (HBV), Hepatitisis C (HCV) infections which are infected through blood and body fluids pose great risks for healthcare workers and the exposure frequency to blood and body fluids is especially more common among medical doctors and nurses working in surgical units. Aim: The aim of this study is to determine the universal precautions that surgical nurses are taken for preventing from diseases transmitted by blood and body fluids. Methodology: It was conducted with the participation of 410 surgical nurses working in two big university hospitals. Universal check-list containing 27 universal precautions was used and additional demographic information was collected (n=410). Results: In this study 34.1 % of the participants were aged between 26 and 31 and 73.2 % of them received education about diseases infected through blood and body fluids. It was also found out that 50.2 % of them (n=206) didn’t take enough precautions regarding being protected against diseases and 61.6 % of those who didn’t take precaution didn’t do so because of the lack of equipment. Lastly, the nurses who work in operating room were found to have high scores in implementing universal precautions. Conclusion: Healthcare workers working under risk should be informed about universal precautions in order to protect themselves from the diseases infected through blood and body fluids. Key Words: Universal precautions; diseases infected through blood; surgical nurse Introduction regarding occupational viral infections such as HIV, Hepatitis B, Hepatitis C which are Human Immunodeficiency Virus (HIV), transmitted through blood ( Mohebati et al. Hepatitisis B (HBV), Hepatitisis C (HCV) 2010) infections which are infected through blood and body fluids pose great risks for Luo et al., (2010) found out that wounding healthcare workers. Nurses come first among by sharp objects and exposure rate to blood the healthcare workers who are affected most and body fluids are greater in nurses working intensely by risky situations caused by in surgical units compared to other units. working conditions (Göçer et al., 2001; According to the data announced by The Joseph, 1997; Aktaş, 2001; Gücük et al., Ministry of Health, 2254 cases of HIV took 2002; Tayran, 2001). Health care employees place in Turkey in 2006. Moreover, various working in surgical units are under risk studies conducted in different parts of www.internationaljournalofcaringsciences.org International Journal of Caring Sciences January-April 2016 Volume 9 | Issue 1| Page112 Turkey showed that on average 3, 5 % of the Turkey. The study was conducted. Two of healthcare workers were found to have the hospitals are large-capacity university Hepatitisis B surface Antigen (HBs AG) hospitals. The study sample was composed positive and 17,9 -52,9 % of them have Anti- of those who work day shift on the surgical HBs Ag positive (Akçam et al., 2005). 1- 3 wards of the hospitals. Participants included % of the population in Turkey is estimated to 410 surgical nurses. be Hepatitisis C vector (Demirtürk, 2003). Instruments Centers for Disease Control and Prevention (CDC) announced universal precautions Data were collected on a questionnaire that towards preventing infections of HIV, HBV, was prepared based on the literature and and HCV in 1988 (Knight, 1998). The main checklist including universal precautions was principle of universal precautions in that all also used. the healthcare workers regard all patients as The first section included nurses’ being infected with HIV, HCV, HBV and demographic information, their status for diseases infected through blood and take receiving education about being protected preventive precautions (Aktaş, 2001; CDC, against diseases infected through blood and 1998). Infections observed among body fluids and also whether they have been healthcare workers are known to take place wounded by stinging or sharp objects in the through contact with blood and body fluids. last 6 months, precautions they have taken As for the reasons for this, pricking the used against such diseases and 24 questions injection to himself/herself, getting wounded prepared with the aim of determining factors by sharp objects which have been infected by which influence taking precautions. blood and entrance of infected material into mucous membrane and impaired skin due to In the second section, the checklist that scratch, cut, and lesion can be mentioned. contains 27 statements about universal According to the studies conducted in precautions reported by CDC was designed Turkey, it has been found that most of the by the researcher. Each question in the healthcare workers do not report wounding, checklist which includes universal are not well-informed about safeguard precautions has three options: yes, no and measures and do not take precautions due to sometimes. 27 questions were considered as ignorance (Aktaş, 2001; Ayrancı and raw scores and standardized to the score of Köşgeroğlu, 2004). 100. This study was planned to determine the Scores were calculated by scoring “correct universal precautions that surgical nurses are answer” as 1 point, “wrong answer” as -1 taken for preventing from diseases point and “sometimes” as 0. Questionnaire transmitted by blood and body fluids. form was first implemented with 50 nurses as a pilot study. Comprehensibility of the Research Questions questions was evaluated in the pilot study as Do nurses working in the surgical well as whether there was something missing units implement the universal precautions? or not. Necessary changes were made Which factors affect the afterwards. implementation of the universal Data Collection precautions taken by the nurses working in the surgical units? Nurses working in surgical units were informed about the aim, content and method Methodology of the study and those who accepted to Study Design participate were included in the sample group. The data were collected one time in The cross-sectional and descriptive study an appropriate room on the ward where was conducted at two hospitals in Istanbul, www.internationaljournalofcaringsciences.org International Journal of Caring Sciences January-April 2016 Volume 9 | Issue 1| Page113 participants worked. The form took Only 3.7% of them out of 84.3% (n=346) use approximately 25 minutes to complete. protective glasses in practices with the risk that patient’s blood and body fluid might Ethical Considerations splash and 32.7% (n=134) wear masks and Prior approval for the study was received 33.2% (n=136) wear protective apron. A from the ethics Committee of Istanbul 96.6% (n=396) of them wash with water and University’s Faculty of Medicine Hospitals. soap immediately if blood or body fluid of the patient splashes onto their eyes or faces. Data Analysis As for uses, 71.7% (n=294) of them put the Data were collected in numbers and plastic tap on before throwing away the percentages as descriptive statistics whereas injector, 92.7% (n=380) of them throw the scores were obtained as mean ± standard injector into needle box after using it. What deviation. Statistisca 10.0 statistical software is more, 90.2% (n=370) of them behaved was used for statistical analysis. A P value of cautiously to avoid being wounded while < 0.05 was considered statistically using injector and 94.9% (n=389) of them significant. make sure that needle box is thrown away Results safely by covering it properly when it is full, 75.9% (n= 311) of them make certain part of In this study 34.1% of the participants were their body bleed by squeezing if they are aged between 26 and 31 and 98.8% of wounded by an object contaminated by participant nurses were female. It was found patient’s blood or body fluid and 96.8% out that 73.2% (n=300) of the participants (n=397) of them wash that wounded part by received special training about protection cleansing with water and soap and then anti- against diseases infected through contact septic. A 59.3% (n=243) of them avoided with blood, 19.5% (n= 80) of them suffered direct contact with the patient if they have from such diseases, and 97.5% of them had any open wound and 84.6% (n=347) of them Hepatitisis B infection (n= 78). Moreover, 30 did the same if the patient have to be % of the nurses have been wounded by resuscitated. A 87.3% (n= 358) of them try to stinging or sharp objects in the last 6 months make sure that laundry be sent to laundry (n=123), 44.7% of them were wounded while service properly and 97.3% (n=399) of them putting on injector tap (n=55), and 30% of throw infected waste away into specially- them while preparing for (n=37) intravenous allocated waste bins and 89.8% (n=368) of (IV) and intramuscular (IM) treatment (Table them take necessary precautions carefully 1). taking serology test results of their patients It was found out that 83.6% (n=343) of the into consideration (Table 2). sample group regard blood and body fluids When nurses’ status of taking universal as infective whatever the diagnosis is, and precautions in accordance with their duties in 87.1% (n=357) and 97.3% (n=399) stated their working units is considered, their score that they wash their hands after touching averages have been found to be high and each patient and taking samples of blood and statistically significant (Table 3), (p= 0.001).
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