Surgical handwashing practices of operating room staff: An observational study

Nurses' knowledge, perceived practice, and associated factors towards sterile techniques in major operation rooms at public hospitals in Addis Ababa, Ethiopia, 2022: a cross-sectional study

INTRODUCTION

A sterile technique is a standard to reduce microorganism transmission during surgery. Gaps in knowledge and practice in sterile techniques by nurses are common causes of surgical site infections for surgical patients. Even though surgical site infection is a global problem due to lack of knowledge and practice, almost no study has been done in Ethiopia regarding nurses' knowledge and practice of sterile techniques in the operating room. Therefore, this study aimed to assess nurses' knowledge, practice, and associated factors of sterile techniques in Addis Ababa public hospitals, Ethiopia.

METHOD

An institutional-based cross-sectional study was conducted on 423 nurses who were working in sixty-six operation rooms at seven public hospitals in Addis Ababa, Ethiopia, from May 11 to June 26/2022. A simple random sampling method was employed to select study participants. A pre-tested, self-administered questionnaire was used to collect data. Data were entered by Epi-data version 4.6 and analyzed by SPSS version 25. Descriptive statistics were presented by text, table, and figure. Multivariable analysis was used to identify the association between the dependent variable and independent variables. Variables with a P-value < 0.05 were considered statistically significant.

RESULT

Nearly three-fifths (58.1%; 95%CI: 53.2 to 63.7) of respondents had good knowledge, and 56.1% with 95%CI (51.5 to 61.1) had good practice with respect to sterile techniques in the operation room. Training [AOR = 1.989; 95%CI (1.120 to 3.530)], availability of guidelines [AOR = 6.4; 95%CI (3.773 to 10.856)], and supervision [AOR = 2.963; 95%CI (1.693 to 5.184)] were associated with nurses' knowledge about sterile techniques in the operating room. Availability of guidelines [AOR = 1.890, 95%CI (1.123 to 3.182)], presence of supervision [AOR = 4.732; 95%CI (2.643 to 8.471)], and having good knowledge of sterile techniques [AOR = 5.419; 95%CI (3.087 to 9.512)] were associated with nurses' practice of sterile techniques in the operation room.

CONCLUSION

Operative theater nurses' knowledge and practice of sterile techniques were found inadequate. Training, supervision, availability of guidelines, and knowledge of nurses towards sterile techniques are factors associated with sterile techniques in the operating room. So, it is better to strengthen training, equip wards with standardized guidelines, and provide supervision, which is crucial to enhancing their knowledge and practice.

Investigating Particulate Production in The Operating Suite Following the Use of Waterless Alcohol Based Dry Scrub Versus Traditional Hand Washing and Drying with Commonly Used Surgical Towels: An Experimental Study

BACKGROUND

An often-overlooked item that could cause contamination in the operating suite are the towels used for hand drying following surgical scrub. The purpose of this current study was to determine if there was a difference in the particulate count from different hand drying methods following surgical hand preparation.

METHODS

Three simulated hand drying groups were established: disposable sterilized surgical towels, reusable sterilized surgical towels, and a waterless alcohol-based dry rub. Particle size measurements of 0.3 µm, 5.0 µm, and 10.0 µm were collected at time zero and repeated every minute for 5 minutes for a total of 10 trials each.

RESULTS

Both the reusable and disposable towels produced significantly more particle matter in all size groups compared to the alcohol scrub control group. A comparison analysis and ANOVA testing demonstrated that alcohol dry scrub produced significantly fewer particles compared to both the disposable blue towels (P<0.01) and the reusable green towels (P<0.01). Disposable towels produced significantly more particles in the 0.3 µm count compared to reusable towels (P<0.05).

CONCLUSIONS

An alcohol-based dry rub without using a towel yielded the lowest amount of particulate formation in this experimental model, while reusable surgical towels produced the highest number of particles.

LEVEL OF EVIDENCE

Level II Experimental Study.