Öz
Introduction: Healthcare Associated Infections (HAIs) are infections that develop during the provision of care or healthcare services to the patient in a healthcare institution and are not present or are not in the incubation period at the time of admission to that institution. The frequency of HAIs varies in the world and in our country. All healthcare institutions should take standardized measures to control these infections. Hygienic practices of hospital cleaning staff have an important role in the prevention of person-to-person and environmental transmission. This study was conducted to evaluate the compliance of cleaning staff of Muğla Training and Research Hospital with standard precautions in hospital hygiene and the factors affecting them.
Methods: In this cross-sectional study, the population consisted of the cleaning staff of Muğla Training and Research Hospital. The sample was not selected, 85.3% (n:257) of the population was reached. The questionnaire form includes questions on sociodemographic characteristics, working conditions, hygiene education and the Standard Precautions Scale of Hospital Hygiene: Version of Cleaning Staff (HHSP). The questionnaire form was administered between September 29 and October 17, 2023 using the self-completion method. Descriptive statistics were given as number and percentage, mean and standard deviation. The data were evaluated for conformity to normal distribution using the Kolmogorov-Smirnov test. In the analysis of the data, Independent groups t test, One-way analysis of variance (ANOVA) and Pearson test were used. The limit of significance was accepted as p<0.05.
Results: The mean age of the participants was 41.5±9.4 years, 63.8% were female. The participants' working time as cleaning staff was 10.4±7.5 years, the weekly working time was 50.7±7.9 hours, and 81.7% worked in very high and high risk areas. Of the participants, 86.0% stated that they received regular training, 35.0% of those who received regular training stated that they received training once a year and 85.4% stated that the hygiene training they received was sufficient. HHSP total mean score was 89.0±6.6, and mean scores for subscales were as follows: hand hygiene 9.8±0.7, general cleaning 14.5±1.0, compliance with personal precautions 14.0±1.9, use of personal protective equipment 26.8±3.7, waste management 23.9±1.8.
Conclusion: The compliance of cleaning staff with standard precautions in hospital hygiene was found to be high. It can be said as the most important result of the study that those who received regular training on hospital hygiene during their employment had higher compliance with standard precautions related to hospital hygiene. It should be aimed to ensure full compliance of cleaning staff with standard precautions, and training programs should be planned accordingly. Participation of all cleaning staff, especially those working in high risk areas, should be ensured, and deficiencies should be identified and completed by receiving feedback on the training.
Anahtar Kelimeler
Hospital Hygiene Standard precautions Healthcare associated infections
Etik Beyan
For the study, written permission was obtained from the Chief Physician's Office of Muğla Training and Research Hospital and ethical approval was obtained from Muğla Sıtkı Kocman University Medical and Health Sciences Ethics Committee (Decision date: 28.09.2023 and Number: 92).
Kaynakça
- 1. Republic of Turkey Ministry of Health. National healthcare associated infections surveillance guidelines. Ankara; 2017. ISBN: 978-975-590-662-1. [Internet]. Available at: https://hsgm.saglik.gov.tr/depo/birimler/bulasici-hastaliklar-ve-erken-uyari-db/Dokumanlar/Rehberler/Ulusal_Saglik_Hizmeti_Iliskili_Enfeksiyonlar_Surveyans_Rehberi_Versiyon_1.pdf (Access Date: September 3, 2024)
- 2. World Health Organization. Patient safety [Internet]. Available at: https://www.who.int/news-room/fact-sheets/detail/patient-safety (Access Date: March 12, 2023)
- 3. World Health Organization. WHO launches first ever global report on infection prevention and control. Available at: https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control (Access Date: March 12, 2023)
- 4. Kepenekli E, Soysal A, Yalindag-Ozturk N, Ozgur O, Ozcan I, Devrim I, et al. Healthcare-associated infections in pediatric intensive care units in Turkey: a national point-prevalence survey. Jpn J Infect Dis. 2015;68(5):381-6. https://doi.org/10.7883/yoken.JJID.2014.385
- 5. Bedir Demirdag T, Koc E, Tezer H, Oguz S, Satar M, Saglam O, et al. The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: a multicenter point- prevalence study. Pediatr Neonatol. 2021;62(2):208-17. https://doi.org/10.1016/j.pedneo.2021.01.001
- 6. Erdem HA, Sipahi OR, Kepeli N, Dikis D, Kucukler ND, Ulusoy B, et al. [Point prevalence of hospital-acquired infections in Ege University Hospital] (in Turkish). Mediterr J Infect Microb Antimicrob. 2015;4(4):12. http://dx.doi.org/10.4274/mjima.2015.12
- 7. Alanlı R, Besirbellioglu BA. [Evaluation of Hospital-acquired infections in adult patients in intensive care unit: retrospective study] (in Turkish). Akd Tıp D. 2023;9(1):37-43. https://doi.org/10.53394/akd.980548
- 8. Iskender S, Yılmaz G, Koksal I. An examination of healthcare-associated infections in elderly patients. Turk J Med Sci. 2017;47(6):1693-8. https://doi.org/10.3906/sag-1706-92
- 9. Republic of Turkey Ministry of Health General Directorate of Public Health. Turkey healthcare associated infections prevention and control program 2019-2024 [Internet]. Ankara: Publications of Republic of Turkey Ministry of Health. Available at: https://hsgm.saglik.gov.tr/depo/Yayinlarimiz/Programlar/Turkiye_Saglik_Hizmeti_Ile_Iliskili_Enfeksiyonlari_Onleme_ve_Kontrol_Programi.pdf (Access Date: September 3, 2024)
- 10. Sehulster L, Chinn R, Arduino M, Carpenter J, Donlan R, Ashford D, et al. Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) [Internet]. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm (Access Date: March 14, 2023)
- 11. Center for Disease Control and Prevention. İnfection control basics- standard precautions for all patient care [Internet]. Available at: https://www.cdc.gov/infection-control/hcp/basics/standard-precautions.html (Access Date: September 3, 2024)
- 12. Bed treatment ınstitutions operation regulations. Issue number: 17927, Date: 13 January 1983. Available at: https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=85319&MevzuatTur=3&MevzuatTertip=5 (Access Date: September 4, 2024)
- 13. Medical waste control regulation. Issue number: 29959, Date: 25 January 2017. Available at: https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=23273&MevzuatTur=7&MevzuatTertip=5 (Access Date: September 4, 2024)
- 14. Edmond MB, Wenzel RP. Special problems. In: İnfection prevention in the health care setting. Holland: Elsevier; 2015:3286-93. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151977/pdf/main.pdf (Access Date: September 3, 2024)
- 15. Inpatient treatment institutions infection control regulation. Issue number:25903, Date: 11August 2005. Available at: https://www.mevzuat.gov.tr/File/GeneratePdf?mevzuatNo=9285&mevzuatTur=KurumVeKurulusYonetmeligi&mevzuatTertip=5 (Access Date: September 4, 2024)
- 16. Republic of Turkey Ministry of Health Mugla Training and Research Hospital. Hospital cleaning instruction. Document Number: DS.TL.001. Date: 25 October 2021.
- 17. Demirel S. Development of standard precaution scale of hospital hygiene: Version of cleaning staff. PhD Thesis, Health Sciences University Gülhane Health Sciences Institute, Public Health Nursing Department PhD Program, Ankara; 2022.
- 18. Demir NA, Kolgelier S, Kucuk A, Ozcimen S, Sonmez B, Demir LS, et al. [Level of knowledge and compliance to hand hygiene among health care workers] (in Turkish). Nobel Med. 2013;9(3):104-9. https://www.nobelmedicus.com/tr/article/416
- 19. Musu M, Lai A, Mereu NM, Galletta M, Campagna M, Tidore M, et al. Assessing hand hygiene compliance among healthcare workers in six intensive care units. J Prev Med Hyg. 2017;58(3):E231-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5668933/
- 20. Sili U, Ay P, Bilgin H, Hidiroglu S, Korten V. Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit. J Infect Dev Ctries. 2019;13(8):744-7. https://doi.org/10.3855/jidc.10916
- 21. Sax H, Uckay I, Richet H, Allegranzi B, Pittet D. Determinants of good adherence to hand hygiene among healthcare workes who have extensive exposure to hand hygiene campaigns. Infect Control Hosp Epidemiol. 2007;28(11):1267-74. https://doi.org/10.1086/521663
- 22. Chau JP, Thompson DR, Lee DT, Twinn S. Infection control practices among hospital health and support workers in Hong Kong. J Hosp Infect. 2010;75(4):299-303. https://doi.org/10.1016/j.jhin.2009.10.014
- 23. Gungordu N, Kurtul S. An evaluation of hand hygiene practices and beliefs of hospital cleaning workers. Karaelmas Journal of Occupational Health and Safety. 2023;7(3):139-47. https://doi.org/10.33720/kisgd.1284345
- 24. Artan Y, Sozeri I, Durmaz Akyol A. [Evalution of hand hygiene compliance of auxiliary service staff in intensive care] (in Turkish). Journal of İntensive Care Nursing. 2018;22(1):10-8. https://dergipark.org.tr/en/pub/ybhd/issue/37979/386342
- 25. Tekingunduz S, Kurt AO, Ayhan HT. [The evaluation of the risk and practices of infectious diseases of the cleaning workers of a training and research hospital] (in Turkish). Life Sciences (NWSALS). 2015;10(4):15-28. https://doi.org/10.12739/NWSA.2015.10.4.4B0006
- 26. Isıklar Ozberk D, Kutlu R. [Evaluation of healthcare workers to safe use of sharp-penetrating medical devices and prevention from infectious diseases attitudes] (in Turkish). TJFMPC. 2021;15(2): 261-8. https://doi.org/10.21763/tjfmpc.840085
- 27. Dokumcu G, Yıldızeli Topcu S. [Surgical nurses’ compliance with standard precautions and related factors] (in Turkish). Journal of Nursing Science. 2023;6(3):151–6. https://doi.org/10.54189/hbd.1302598
- 28. Capacı B, Abacıgil F, Okyay P, Er H, Beser E. [Awareness of biomedical waste management among health care personnel at a tertiary healthcare centre, Aydin, Turkey] (in Turkish). Health and Society. 2017;27(2):70-6. https://ssyv.org.tr/wp-admin/uploader/std2017-2/Bir.pdf
- 29. Hascuhadar M, Kaya Z, Serbetcioglu S, Arslan T, Altınkaya S. [The awareness level among the employees working in Ankara Atatürk Training and Research Hospital about medical wastes] (in Turkish). Turkish Medical Journal. 2007;1:138-44. https://dergipark.org.tr/en/pub/tmj/issue/83943/1461384
- 30. McCoy KD, Beekmann SE, Ferguson KJ, Vaughn TE, Torner JC, Woolson RF, et al. Monitoring adherence to Standard Precautions. Am J Infect Control. 2001;29(1):24-31. https://doi.org/10.1067/mic.2001.111226
Öz
Giriş: Sağlık Hizmeti İlişkili Enfeksiyonlar (SHİE) hastaya bir sağlık kurumunda bakım ya da sağlık hizmeti sunulması sırasında gelişen ve o kuruma başvuru esnasında var olmayan ya da kuluçka döneminde olmayan enfeksiyonlardır. Yapılan çalışmalarda dünyada ve ülkemizde SHİE prevalansı değişmektedir. Sağlık hizmeti veren tüm kurumların bu enfeksiyonlarla mücadelede standart önlemler almaları gereklidir. Hastane temizlik personelinin hijyenik uygulamaları, kişiden kişiye ve çevreden bulaşın önlenmesinde önemli bir yer tutmaktadır. Bu çalışma Muğla Eğitim ve Araştırma hastanesi temizlik personelinin hastane hijyeninde standart önlemlere uyumu ve etkileyen faktörlerin değerlendirilmesi amacıyla yapılmıştır.
Yöntem: Kesitsel tipteki araştırmanın evrenini Muğla Eğitim ve Araştırma Hastanesi temizlik personeli oluşturmaktadır. Örneklem seçilmemiş, evrenin %85,3’üne (n:257) ulaşılmıştır. Anket formunda, sosyodemografik özellikler, çalışma koşulları, hijyen eğitimi ile ilgili sorular ve Hastane Hijyeninde Standart Önlemler Ölçeği (HHSÖ): Temizlik Personeli Versiyonu bulunmaktadır. Anket formu kendi kendine doldurma yöntemiyle, 29 Eylül-17 Ekim 2023 tarihleri arasında uygulanmıştır. Tanımlayıcı istatistikler; sayı ve yüzde, ortalama, standart sapma olarak verilmiştir. Verilerin normal dağılıma uygunluğu Kolmogorov-Smirnov testi ile değerlendirilmiştir. Verilerin analizinde Bağımsız gruplarda t testi ve Tek yönlü varyans analizi (ANOVA), Pearson testi ile değerlendirilmiştir. Anlamlılık sınırı p<0,05 kabul edilmiştir.
Bulgular: Katılımcıların yaş ortalaması 41,5±9,4, %63,8’i kadındır. Temizlik personeli olarak çalışma süresi 10,4±7,5 yıl, haftalık çalışma süresi 50,7±7,9 saattir ve %81,7’si çok yüksek ve yüksek riskli alanlarda çalışmıştır. Katılımcıların %86,0’sı düzenli eğitim aldığını, düzenli eğitim alanların %35,0’i yılda bir eğitim aldığını ve %85,4’ü aldığı hijyen eğitiminin yeterli olduğunu belirtmiştir. HHSÖ toplam puan ortalaması 89,0±6,6, alt boyut puanı ortalamaları; el hijyeni 9,8±0,7, genel temizlik 14,5±1,0, kişisel önlemlere uyum 14,0±1,9, kişisel koruyucu ekipman kullanımı 26,8±3,7, atık yönetimi 23,9±1,8’dir.
Sonuç: Temizlik personellerinin hastane hijyeninde standart önlemlere uyumu yüksek bulunmuştur. Çalıştığı süre içerisinde hastane hijyeni ile ilgili düzenli eğitim alanların hastane hijyeni ile ilgili standart önlemlere uyumunun daha yüksek olması çalışmanın en önemli sonucudur. Temizlik personelinin standart önlemlere uyumunun tam olması hedeflenmeli, buna yönelik eğitim programları planlanmalıdır. Başta yüksek riskli alanlarda çalışanlar olmak üzere tüm temizlik personelinin katılımı sağlanmalı, eğitimle ilgili geri bildirimler alınarak eksikler belirlenmeli ve tamamlanmalıdır.
Anahtar Kelimeler
Hastane Hijyen Standart önlemler Sağlık hizmeti ilişkili enfeksiyonlar
Kaynakça
- 1. Republic of Turkey Ministry of Health. National healthcare associated infections surveillance guidelines. Ankara; 2017. ISBN: 978-975-590-662-1. [Internet]. Available at: https://hsgm.saglik.gov.tr/depo/birimler/bulasici-hastaliklar-ve-erken-uyari-db/Dokumanlar/Rehberler/Ulusal_Saglik_Hizmeti_Iliskili_Enfeksiyonlar_Surveyans_Rehberi_Versiyon_1.pdf (Access Date: September 3, 2024)
- 2. World Health Organization. Patient safety [Internet]. Available at: https://www.who.int/news-room/fact-sheets/detail/patient-safety (Access Date: March 12, 2023)
- 3. World Health Organization. WHO launches first ever global report on infection prevention and control. Available at: https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control (Access Date: March 12, 2023)
- 4. Kepenekli E, Soysal A, Yalindag-Ozturk N, Ozgur O, Ozcan I, Devrim I, et al. Healthcare-associated infections in pediatric intensive care units in Turkey: a national point-prevalence survey. Jpn J Infect Dis. 2015;68(5):381-6. https://doi.org/10.7883/yoken.JJID.2014.385
- 5. Bedir Demirdag T, Koc E, Tezer H, Oguz S, Satar M, Saglam O, et al. The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: a multicenter point- prevalence study. Pediatr Neonatol. 2021;62(2):208-17. https://doi.org/10.1016/j.pedneo.2021.01.001
- 6. Erdem HA, Sipahi OR, Kepeli N, Dikis D, Kucukler ND, Ulusoy B, et al. [Point prevalence of hospital-acquired infections in Ege University Hospital] (in Turkish). Mediterr J Infect Microb Antimicrob. 2015;4(4):12. http://dx.doi.org/10.4274/mjima.2015.12
- 7. Alanlı R, Besirbellioglu BA. [Evaluation of Hospital-acquired infections in adult patients in intensive care unit: retrospective study] (in Turkish). Akd Tıp D. 2023;9(1):37-43. https://doi.org/10.53394/akd.980548
- 8. Iskender S, Yılmaz G, Koksal I. An examination of healthcare-associated infections in elderly patients. Turk J Med Sci. 2017;47(6):1693-8. https://doi.org/10.3906/sag-1706-92
- 9. Republic of Turkey Ministry of Health General Directorate of Public Health. Turkey healthcare associated infections prevention and control program 2019-2024 [Internet]. Ankara: Publications of Republic of Turkey Ministry of Health. Available at: https://hsgm.saglik.gov.tr/depo/Yayinlarimiz/Programlar/Turkiye_Saglik_Hizmeti_Ile_Iliskili_Enfeksiyonlari_Onleme_ve_Kontrol_Programi.pdf (Access Date: September 3, 2024)
- 10. Sehulster L, Chinn R, Arduino M, Carpenter J, Donlan R, Ashford D, et al. Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) [Internet]. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm (Access Date: March 14, 2023)
- 11. Center for Disease Control and Prevention. İnfection control basics- standard precautions for all patient care [Internet]. Available at: https://www.cdc.gov/infection-control/hcp/basics/standard-precautions.html (Access Date: September 3, 2024)
- 12. Bed treatment ınstitutions operation regulations. Issue number: 17927, Date: 13 January 1983. Available at: https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=85319&MevzuatTur=3&MevzuatTertip=5 (Access Date: September 4, 2024)
- 13. Medical waste control regulation. Issue number: 29959, Date: 25 January 2017. Available at: https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=23273&MevzuatTur=7&MevzuatTertip=5 (Access Date: September 4, 2024)
- 14. Edmond MB, Wenzel RP. Special problems. In: İnfection prevention in the health care setting. Holland: Elsevier; 2015:3286-93. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151977/pdf/main.pdf (Access Date: September 3, 2024)
- 15. Inpatient treatment institutions infection control regulation. Issue number:25903, Date: 11August 2005. Available at: https://www.mevzuat.gov.tr/File/GeneratePdf?mevzuatNo=9285&mevzuatTur=KurumVeKurulusYonetmeligi&mevzuatTertip=5 (Access Date: September 4, 2024)
- 16. Republic of Turkey Ministry of Health Mugla Training and Research Hospital. Hospital cleaning instruction. Document Number: DS.TL.001. Date: 25 October 2021.
- 17. Demirel S. Development of standard precaution scale of hospital hygiene: Version of cleaning staff. PhD Thesis, Health Sciences University Gülhane Health Sciences Institute, Public Health Nursing Department PhD Program, Ankara; 2022.
- 18. Demir NA, Kolgelier S, Kucuk A, Ozcimen S, Sonmez B, Demir LS, et al. [Level of knowledge and compliance to hand hygiene among health care workers] (in Turkish). Nobel Med. 2013;9(3):104-9. https://www.nobelmedicus.com/tr/article/416
- 19. Musu M, Lai A, Mereu NM, Galletta M, Campagna M, Tidore M, et al. Assessing hand hygiene compliance among healthcare workers in six intensive care units. J Prev Med Hyg. 2017;58(3):E231-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5668933/
- 20. Sili U, Ay P, Bilgin H, Hidiroglu S, Korten V. Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit. J Infect Dev Ctries. 2019;13(8):744-7. https://doi.org/10.3855/jidc.10916
- 21. Sax H, Uckay I, Richet H, Allegranzi B, Pittet D. Determinants of good adherence to hand hygiene among healthcare workes who have extensive exposure to hand hygiene campaigns. Infect Control Hosp Epidemiol. 2007;28(11):1267-74. https://doi.org/10.1086/521663
- 22. Chau JP, Thompson DR, Lee DT, Twinn S. Infection control practices among hospital health and support workers in Hong Kong. J Hosp Infect. 2010;75(4):299-303. https://doi.org/10.1016/j.jhin.2009.10.014
- 23. Gungordu N, Kurtul S. An evaluation of hand hygiene practices and beliefs of hospital cleaning workers. Karaelmas Journal of Occupational Health and Safety. 2023;7(3):139-47. https://doi.org/10.33720/kisgd.1284345
- 24. Artan Y, Sozeri I, Durmaz Akyol A. [Evalution of hand hygiene compliance of auxiliary service staff in intensive care] (in Turkish). Journal of İntensive Care Nursing. 2018;22(1):10-8. https://dergipark.org.tr/en/pub/ybhd/issue/37979/386342
- 25. Tekingunduz S, Kurt AO, Ayhan HT. [The evaluation of the risk and practices of infectious diseases of the cleaning workers of a training and research hospital] (in Turkish). Life Sciences (NWSALS). 2015;10(4):15-28. https://doi.org/10.12739/NWSA.2015.10.4.4B0006
- 26. Isıklar Ozberk D, Kutlu R. [Evaluation of healthcare workers to safe use of sharp-penetrating medical devices and prevention from infectious diseases attitudes] (in Turkish). TJFMPC. 2021;15(2): 261-8. https://doi.org/10.21763/tjfmpc.840085
- 27. Dokumcu G, Yıldızeli Topcu S. [Surgical nurses’ compliance with standard precautions and related factors] (in Turkish). Journal of Nursing Science. 2023;6(3):151–6. https://doi.org/10.54189/hbd.1302598
- 28. Capacı B, Abacıgil F, Okyay P, Er H, Beser E. [Awareness of biomedical waste management among health care personnel at a tertiary healthcare centre, Aydin, Turkey] (in Turkish). Health and Society. 2017;27(2):70-6. https://ssyv.org.tr/wp-admin/uploader/std2017-2/Bir.pdf
- 29. Hascuhadar M, Kaya Z, Serbetcioglu S, Arslan T, Altınkaya S. [The awareness level among the employees working in Ankara Atatürk Training and Research Hospital about medical wastes] (in Turkish). Turkish Medical Journal. 2007;1:138-44. https://dergipark.org.tr/en/pub/tmj/issue/83943/1461384
- 30. McCoy KD, Beekmann SE, Ferguson KJ, Vaughn TE, Torner JC, Woolson RF, et al. Monitoring adherence to Standard Precautions. Am J Infect Control. 2001;29(1):24-31. https://doi.org/10.1067/mic.2001.111226
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Koruyucu Sağlık Hizmetleri, Çevre Sağlığı |
| Bölüm | Araştırma Makalesi (Original Article) |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2024 |
| Gönderilme Tarihi | 6 Eylül 2024 |
| Kabul Tarihi | 14 Aralık 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 9 Sayı: 4 |
