Importance of handwashing prior to wound dressings in prevention of nosocomial infection in surgical wards

Abstract

Background: Nosocomial infections have been recognized for more than a century as a critical problem affecting the quality of health care provided in hospitals. In this study we are assessing the nosocomial infection in surgical wards and creating awareness among resident doctors about the same.Methods: All 3 years surgery residents were taken for the study. Study was done from July 2015 to August 2017. They were given KAP questionnaire before and after the study to assess the basic knowledge about nosocomial infection and handwashing (1 mark for each correct answer). From each resident doctor 3 swab samples will be taken after doing dressing of the same patient having significant wound discharge. The first swab sample will be taken immediately after dressing without doing any type of handwashing. The second swab sample will be taken after doing dressing of the same patient and after handwashing with soap and water. The third swab sample will be taken after doing dressing of the same patient and handwashing with sterilium. All these reports were compared with patient’s wound swab to assess the role of doctor’s hand in spreading nosocomial infection. At the end of study proper knowledge hand hygiene and hand washing was spread.Results: We observed that out of 58 surgery residents total of 47 residents were having positive microbiological swabs without any type of handwashing; 24 residents were having positive swabs even after washing hands with soap and water; 3 residents were having positive swab after washing hands with sterilium. Which suggests that resident doctors were not maintaining hand hygiene. In our KAP based assessment only 31% resident doctors could give >50% correct answers before the study and 96% resident doctors could give >50% correct answers after the study.Conclusion: At the end of the study ideal method of handwashing was taught. We have also assessed basic knowledge of resident doctors regarding hand hygiene and nosocomial infection. We have spread the knowledge and awareness of appropriate type of handwashing among resident doctors.