الفهرس 
BurnOnly 14 pages are availabe for public view
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Abstract
The nurse is at the center of the burn care team, the coordinator of all patient care activities. The complexity and multisystem involvement of the burn patient demand that the burn nurse possess a broad-based knowledge of multisystem organ failure, critical care techniques, diagnostic studies and rehabilitative and psychosocial skills. At the same time, the burn nurse is also a specialist in wound care. As a burn wound heals, either spontaneously or through excision and grafting, the nurse is responsible for wound care and for noting subtle changes that require immediate attention, prevention of infection and pain management (Greenfield, 2010).
Aim of the Study
This study was carried out to assess nurses’ performance for prevention of infection in burn unit.
Research questions
1) What is the nurses’ knowledge regarding prevention of infection in the burn units?
2) What is the nurses’ performance for caring of patients in the burn units?
3) Is there a relation between nurses’ knowledge, performance and infection control in the burn units?
4) Is there a relation between barriers affecting nurse’s performance and infection control in the burn units?
Methodology:
Research design:
A descriptive design was used in this study.
Setting
The study was conducted in burn units at Ain Shams, El- Monufia, and Cairo University, Egypt.
Subjects
Purposive sample composed of all nurses (n=50) working three shifts in the previous mentioned setting.
Tools of data collection
Data collected through used the following tools:
The first Tool: an interviewing questionnaire was used to collect data about:
Part 1:
Demographic’ characteristics of nurses e.g. (age, years of experience, qualification, (any training courses regarding infection control).
Part 2:
A nurses knowledge about Nosocomial infection definition, causes, source, mode of transmission, infection control measures. Also their knowledge about burn (e.g. definition, causes, degree, and calculation of burn surface area).
Scoring system for knowledge questions: The right answers were scored one, and those wrong were scored zero. These scores were summed-up and converted into a percent score. Satisfy answer if the percent score was 75% or more and unsatisfied if less than 75%.
The second tool: An observational checklist, it was designed for assessment of nurses’ practice in the burn unit. The observational checklist was (a safe environment, initial care of burn wound, changing burn dressing, starting I.V infusion). Each nurse was observed for three consecutive times (to maintain consistency & avoid subjectivity).
Scoring system for observational checklist: The meet step was scored one, and that not meet step was scored zero. These scores were summed-up and converted into a percent score. Satisfy performance if the percent score was 80% or more and unsatisfied performance if less than 80%.
Results
The main study findings can be summarized as follows:
Half of the studied nurses (50.0 %) were between age 40 years old. More than half (56.0%) of them were females, more than two thirds (66.0%) were married, more than one third (44.0 %) were had technical institute degree, more than one third (36.0%) had experience for 10-20 years and two thirds (60.0%) of them were not attend training courses.
Two thirds (60.0%) of the studied nurses had unsatisfactory knowledge regarding infection control measurements, while more than one third (40.0%) of them had satisfactory knowledge regarding infection control measurements.
More than two thirds (68.0%) of the studied nurses had unsatisfactory knowledge regarding burn, while more than one third of them (32.0%) had satisfactory knowledge regarding burn.
More than half (54.0%) of the studied nurses had total unsatisfactory knowledge, while more than one third (46.0%) of them had total satisfactory knowledge.
More than two thirds (66.0%) of the studied nurses were doing prepare waste management and disposal, while more than one third (34.0%) of them were not doing prepare waste management and disposal.
More than two thirds (68.0%) of the studied nurses were not doing prepare sharp management and disposal, while more than one third (32.0%) of them were doing prepare sharp management and disposal.
More than two thirds (70.0%) of the studied nurses were not do prepare care for first degree of burn, while one third (30.0%) of them were doing prepare care for first degree of burn.
More than two thirds (76.0%) of the studied nurses were not do prepare care for second and third degree of burn, while more than one fifth (24.0%) of them were doing prepare care for second and third degree of burn.
More than two thirds (72.0%) of the studied nurses were not do prepare clean wound by irrigation, while more than one fifth (28.0%) of them were do prepare clean wound by irrigation.
More than two thirds (78.0%) of the studied nurses were not do prepare clean of the wound by dry dressing, while more than one fifth (22.0%) of them were doing prepare clean of the wound by dry dressing.
More than two thirds (70.0%) of the studied nurses were not apply personal protective equipment, while one third (30.0%) of them were applying personal protective equipment.
More than two thirds (74.0%) of the studied nurses were not remove gloves with right manner, while more than one fifth (26.0%) of them were removing gloves with right manner.
More than two thirds (76.0%) of the studied nurses were not remove goggles and face shield with right manner, while more than one fifth (24.0%) of them were removing goggles and face shield with right manner.
More than two thirds (68.0%) of the studied nurses were not remove gown with right manner, while more than one third (32.0%) of them were removing gown with right manner.
The majority (80.0%) of the studied nurses were not remove mask with right manner, while one fifth (20.0%) of them were removing mask with right manner.
More than two thirds (72.0%) of the studied nurses had total unsatisfactory practices, while more than one fifth (28.0%) of the studied nurses had total satisfactory practices.
There was a statistically significant differences between, age, qualification, years of experiences and attending training course of the studied nurses and their total knowledge (p<0.05), while there is no statistically significant difference between gender and marital status of the studied nurses and their total knowledge (p> 0.05).
There was a statistically significant differences between age, qualification, years of experiences and attending training course of the studied nurses and their total practices (p<0.05), while there is no statistically significant difference between gender and marital status of the studied nurses and their total practices (p > 0.05).
There was a statistically significant positive correlation between total knowledge and total practices of the studied nurses (P< 0.05).
Conclusion
On light of the current study results, it can be concluded that more than half of the studied nurses had total unsatisfactory knowledge, while more than one third of them had total satisfactory knowledge. Also, more than two thirds of the studied nurses had total unsatisfactory practices, while more than one fifth of the studied nurses had total satisfactory practices. Nearly half of nurses show that un availability of hand drying materials, un availability of detergents and disinfectants and un availability of cleaners (Housekeeping) in the unit are the common barriers that affecting the nurses’ performance to prevent and control of infection during caring of patients respectively. There is statistically significant positive correlation between total practice and total knowledge of nurses.
Recommendations
The main recommendations can be summarized as follows:
• An in-service training / continuing education must be stressed and provided for nurses working in such critically units.
• Well infection control manual should be available in burn units and to be well known to all heath team members working in every unit particularly nurses.
• Nurses should be updated on their knowledge through attending seminars, workshops, lectures and reviewing researches.
• Further research studies are needed for ongoing assessment of students including large sample for generalization of results.