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也门荷台达市公立医院伤口及相关因素引起的手术部位感染的评估研究

作　者: Abdulsalam Mohammed Ali Nasser
导　师: 张新平
学　校: 华中科技大学
专　业: 社会医学与卫生事业管理
关键词: Surgical Site Infections Signs&Symptoms Associated Factors PublicHospitals Hudaidah city Yemen
分类号: R619
类　型: 硕士论文
年　份: 2013年
下　载: 2次
引　用: 0次
阅　读: 论文下载

内容摘要

BackgroundSurgical site infections (SSI’s) are still form a large health problem even in thedeveloped countries which are the2ndmost common hospitals acquired infections.(SSI’s)are so important because they contribute substantially to patient morbidity, mortality,prolonged hospitalization and prolonged therapy.(SSI’s) are also widely present in publichospitals of Hodeidah city especially in surgical wards reported seldomly.ObjectivesThe objective of this study is to explore (SSI’s) from clinical features (signs&symptoms) of the wound and associated factors in public hospitals of Hudeidah city, Yemenfor evidence to clinical decision.MethodsThe study have been conducted using cross-sectional study and the sample comprisedof600subjects among which300was patients and the other300was nurses. Structuredquestionnaire was used to collect data from patients as well as nurses in two publichospitals in Hodeidah city during the period of the1stof July,2012through the30thofSeptember,2012and the questionnaire was prepared in Arabic language.SPSS versions12have been used to analyze the data and univariate and multiplelogistic regressions was used to reflect the subjects’demographic characteristics and factorsassociated with surgical site infections.ResultsThe results in this study revealed that102(34%) of the subjects suffered frominfection, and the rest198(66%) not suffered from infection. And in the other sidecomparison of gender on the (SSI’s) showed that among114(38%) males patients27(26.47%) suffered from (SSI’s) and87(43.93%) not suffered from (SSI’s). And among186(62%) females patients75(73.53%) suffered from SSI and111(56.07%) not suffered from(SSI’s).The study revealed that “age”,“education status”,“socioeconomic” and “profession” P<.0001, P=0.0030, P<.0001and P<.0001respectively, show that, other diseases to thewound infection P=0.0251, some signs and symptoms of the wound revealed that ‘Fever’;‘Extend of wound breakdown’;‘Problems with the wound’(swelling, pain, heat);‘Problems with the healing of the wound’;‘Discharge from wound’ and some additionalsymptoms that applied to the patient; P<.0001, P<.0001, P<.0001, P<.0001, and P<.0001respectively, were found significant with (SSI’s).Binary logistic regression revealed that age,“other diseases (suffer from othersdiseases)”“problems with the healing of the wound” and “discharges from wound”;P=0.0006, P=0.0066, P<.0001, and P<.0001respectively, were associated with (SSI’s).ConclusionsThe study revealed that (SSI’s) are still serious and widely present in public hospitalsof Hudeidah city especially in surgical wards and many associated factors existed.Recommendations1. Offering patients and relatives’ clear, consistent information and advice throughout allstages of their care, this should include the risks of surgical site infections, what isbeing done to reduce them and how they are managed.2. Offer patients and carers information and advice on how to care for their wound afterdischarge.3. Offer patients and carers information and advice about how to recognize a surgical siteinfection and who to contact if they are concerned. Use an integrated care pathway forhealthcare associated infections to help communicate this information to both patientsand all those involved in their care after discharge.4. Always inform patients after their operation if they have been given antibiotics.5. To support this, enhanced education of healthcare workers, patients, relatives and carers,and sharing of clinical expertise will be required and finally reduce risk of surgical siteinfections by educating healthcare providers to improve understanding and complianceto prevent (SSI’s) and monitoring (SSI’s) and noting impact of these activities andreport to the OR and surgical staff. Limitations of the StudyThis study faces a number of difficulties that may be summarized as follows:1. Yemen is one of those countries in Asia that still lags behind in the area of internet use,the researcher, therefore, is faced with constraints in getting data.2. Cost prohibitive to collect data (financial cost) as Yemen is too far from China.3. Scarcity of similar scientific research in the Middle East in general and Yemen inparticular on the subject matter.4. Poor recording system of patients’ clinical history in public hospitals was also anobstacle to get or access secondary data of the patients.5. In light of the current difficult situation of the country and the lack of security in allcities. Therefore, there was a difficulty in the transportation within and outside cities andthe transportation was too expensive.

全文目录

Table of Contents  5-7
Abbreviations  7-8
ABSTRACT  8-11
Chapter One: Introduction  11-26
  1.1 Background  11-12
  1.2 Country’s Brief  12-13
  1.3 Definition of Surgical Site Infection  13-18
  1.4 Types of Surgical Site Infection  18-20
  1.5 Global Prevalence of Surgical Site Infection  20-21
  1.6 Health in Yemen, Terrifying Numbers and a Deteriorating Situation in Yemeni Hospital and Hospital Infections  21-24
  1.7 Statement of the Problem  24
  1.8 Significance of the Study  24-25
  1.9 Research Objectives  25-26
Chapter Two: Material and Methods  26-28
  2.1 Enrolment of Subjects  26
  2.2 Ethical Considerations  26-27
  2.3 Statistical Analysis  27-28
Chapter Three: Results  28-34
  3.1 Socio-demographic Variables  28-32
  3.2 Factors Associated with Surgical Site Infections  32-34
Chapter Four: Discussion  34-41
  4.1 Conclusion  38-39
  4.2 Recommendations  39-40
  4.3 Limitations of the Study  40
  4.4 Further Research  40-41
References  41-48
Chapter Five: Literature Review- Introduction  48-90
  Introduction  48-49
  5.1 Definitions of Surgical Site Infection  49-54
  5.2 Frequently Asked Questions (FAQ’s) on “Surgical Site Infections”  54-57
  5.3 What are the Risks Factors- before, during, and after Surgery?  57-60
  5.4 Risk Infection  60-62
  5.5 What are the Surgical Site Infection Preventing Techniques?  62-63
  5.6 Information for Patients and Carers  63-72
  5.7 Recommendations on Prevention of Surgical Site Infection  72-79
  References  79-90
Appendix  90-94
Publications  94-95
Acknowledgement  95

也门荷台达市公立医院伤口及相关因素引起的手术部位感染的评估研究

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