Female Surgical Ward Research Articles

Antibiotic resistance and plasmid profile of bacteria associated with nosocomial infections: A case study of Ekiti -State Teaching Hospital

Many serious health problems resulting in an enormous burden of morbidity and high health care costs are traceable to infections caused by the nosocomial pathogens; major victims are relatives of patients, the care givers who are doing their legal duties and at times the patients whose conditions could be complicated. The causative organisms of these infections and their sensitivity to antibiotics need to be ascertained. This study investigated the antibiotic sensitivity and plasmid profile of bacteria associated with nosocomial infections. A total of 45 samples were collected from children, male and female surgical wards in Ekiti State Teaching Hospital, Ado-Ekiti by using swab sticks and settling plates method. Isolation of bacteria, antibiotic sensitivity and plasmid profiling of the isolates were carried out using standard microbiological methods. The results showed that a total of 56 bacterial isolates were obtained from the 3 different wards, this includes Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Lactobacillus fermenti, Bacillus subtilis, Bacillus cereus and Micrococcus luteus. Staphylococcus aureus had the highest frequency of occurrence with 30(53.6%), followed by Staphylococcus epidermidis 10(17.7%), Escherichia coli 7(12.5%), Lactobacillus fermentii and Micrococcus luteus 3(5.4%) and Bacillus subtilis 2(3.6%) respectively, while Bacillus cereus 1(1.8%) had the least frequency of occurrence. The gram positive isolates were more resistant to the antibiotics compare to the gram negative isolates, Staphylococcus aureus was the most resistant of all the isolates followed by Staphylococcus epidermidis, the five representative resistant isolates harbored plasmid of different sizes. The findings of this study suggests that patients, care givers and visitors to the hospital should maintain good personal hygiene and proper sanitary measures to avoid nosocomial infections, therefore, surveillance of nosocomial pathogens is important to reduce hospital stay, cost, morbidity and mortality rate.

Methicillin Resistant Staphylococcus Aureus Isolates From Bed Surface Contacts And Bed Sheets Of Surgical Wards In A Secondary Healthcare Facility In Gombe, Nigeria

Background: Methicillin resistant Staphylococcus aureus (MRSA) has become one of the most important human pathogens associated with hospital infections globally. It is responsible for a considerable number of infections but has received inadequate attention in our local communities. Objective: To determine the occurrence of Methicillin Resistance Staphylococcus aureus (MRSA) isolates from bed contact surfaces and bed sheets in the male and female surgical wards of State Specialist Hospital Gombe, Nigeria. Results: A total of 100 samples were collected purposively for the study. Overall, 79/100 (79%) were positive for S. aureus, and out of these, 42/50(84%) were from the male surgical ward and 37/50 (74%) from the female surgical wards (χ2=1.5, p=0.22). The Male surgical ward bed contact surfaces had the highest S. aureus colonization (92%), and the least affected was the female surgical ward bed contact surfaces (72%), and the difference was not statistically significant (χ2=3.388, p= 0.07). Out of the 79 samples that yielded S. aureus, 56(56%) were positive for MSRA while the remaining 23(23%) were MSSA. Comparing the two wards, we found that the rate of MRSA in the FSW (60%) was higher than that of the MSW (56%), but the difference was not statistically significant (χ2=0.65, p=0.42). The antibiotic sensitivity of the S. aureus isolated from the bed sheet of the MSW was higher (78.3%) compared to those isolated from the bed sheets of the FSW (38.9%) with χ2=6.58 and p value=0.01. However, there was no significant difference in the antibiotic sensitivity to (cefoxitin and ampicillin) of S. aureus isolated from the bed surface contacts of the MSW and FSW. Conclusion: This study reports a high occurrence rate of both S. aureus and the MRSA variant among the two wards studied. Regular fumigation and disinfection may help control the transmission via contact surfaces. Staff training on hospital sanitation and occupational safety will serve as an additional effort to ensure patients and visitors safety.

Characterization of Genomic Diversity among Carbapenem-Resistant Escherichia coli Clinical Isolates and Antibacterial Efficacy of Silver Nanoparticles from Pakistan.

The emergence of carbapenem-resistant Escherichia coli (E. coli) is considered an important threat to public health resulting in resistance accumulation due to antibiotics misuse and selection pressure. This warrants periodic efforts to investigate and develop strategies for infection control. A total of 184 carbapenem-resistant clinical strains of E. coli were characterized for resistance pattern, resistance genes, plasmids, sequence types and in vitro efficacy of silver nanoparticles (AgNPs). Carbapenem resistance was prevalent in E. coli isolated from female patients (64.7%), urine samples (40.8%) and surgical wards (32.1%). Polymyxin-B showed higher susceptibility. ESBLs and carbapenemases were produced in 179 and 119 isolates, respectively. Carbapenemase-encoding genes were observed among 104 strains with blaNDM-1 (45.1%), blaOXA-48 (27%), blaNDM-7 (3.8%), blaNDM-1/blaOXA-48 (15.4%), blaNDM-7/blaOXA-48 (2.9%), blaOXA-48/blaVIM (3.8%) and blaNDM-1/blaVIM (2%). ESBL resistance genes were detected in 147 isolates, namely blaSHV (24.9%), blaCTX-M (17.7%), blaTEM (4.8%), blaSHV/blaCTX-M (29.2%), blaSHV/blaTEM (15%) and blaCTX-M/blaTEM (8.8%). ST405 (44.4%) and ST131 (29.2%) were more frequent sequence types with ST101 (9.7%), ST10 (9.7%) and ST648 (7%). The replicon types IncFII, IncFIIK, IncA/C, IncN and IncL/M were detected. The combination of MEM/AgNPs remained effective against carbapenemase-positive E. coli. We reported genetically diverse E. coli strains coharboring carbapenemases/ESBLs from Pakistan. Moreover, this study highlights the enhanced antibacterial activity of MEM/AgNPs and may be used to manage bacterial infections.

An Overview Evaluation of Bacterial Infection and Bacterial Contamination at the Hospital Environment and Antibiogram for the Isolated Pathogens at Al Kufra Teaching Hospital, Libya

Background/Aims: Infectious diseases are the major public health problem worldwide. The medical services into the Southern Libyan sub-Saharan hospitals do not receive much attention in knowing the infection rates of pathogenic bacteria coming to the hospital, as well as there is not much information available about the hospital infection control application system. This study was performed to evaluate the infectious disease received to Al Kufra teaching hospital and determination the hospital risk factors involved in hospital-acquired infection. Materials and Methods: The screening was performed to investigate the distribution of potential pathogens among 157 samples collected from the four hospital wards including intensive care unit, the pediatric ward, male and female surgical ward from the hospitalizes patients, medical staff and hospital workers, and across different hospital facilities. Results: The bedsores swabs and urine samples showed 100% of infection, followed by sputum, stool, surgical wounds, and cerebrospinal fluid (85.8%, 67%, 62.5%, and 42.9%), respectively. Most of the hospital facilities showed 100% of contamination. The results showed Staphylococcus aureus colonized 40 (77%) of the total nasal swabs, other samples detected Bacillus cereus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis, Escherichia coli 0157. The sensitivity of Gram-positive organisms to the antibiotics showed resistance to Penicillin G (90.1%) and Amoxicillin + Clavulanic acid (82.7%), Methicillin (65.5%) and Vancomycin (65.5%). For Gram-negative organisms, the isolates showed resistance to tetracycline and colistin (62.5%) for each. Conclusion: The bacterial outbreak in the clinical and environmental samples of Al Kufra Teaching Hospital was relatively high. To control bacterial infection and hospital contamination, several instructions need to be carried out to protect the hospital staff and patients from being infected.

Perception of music and its cultural elements on acute post-mastectomy pain management among Nigerian women: an exploratory qualitative study.

This study aimed to explore the cultural elements of music in relation to pain management among women who have undergone mastectomy. An exploratory qualitative study with in-depth interviews. Using the purposive sampling technique, 20 participants were recruited for the study. The interviews were conducted face to face at the surgical out-patient clinic and female surgical ward. Data collection continued until data saturation was reached. The inductive approach was used to analyse the data, and the concepts were organised into themes. The consolidated criteria for reporting qualitative research guidelines (COREQ) were used to report this study. The participants were between 28 and 83years old and mostly diagnosed with stage III breast cancer. Three main themes emerged from the data analysis, including pain experienced after mastectomy, culture and music, and the perception of music for postoperative pain management after mastectomy. In this study, the knowledge of participants and the utilisation of music for pain management remains inadequate, but the participants perceived that music could be useful for pain control after mastectomy when the language and religion of the patient and the meaningfulness of the music were considered when introducing and selecting the music. This study will help open and extend the conversation about the utilisation and cultural elements of music that can be used clinically for pain management after mastectomy.

Pengaruh Guided Imagery Terhadap Skala Nyeri Pada Pasien Kanker Payudara Di Ruangan Rawat Inap Bedah Wanita RSUP Dr. M.Djamil Padang

ABSTRACTBreast cancer is the abnormal growth of cells that occurs in breast tissue. The problem often arises in patients with breast cancer is pain. Guided Imagery is a nonpharmacological strategi that can reduce pain. The aimed of this research was to identify the effect of Guided Imagery to the scale of pain in breast cancer patients admited in female surgical wards Dr. M. Djamil hospital Padang. The study design was quasi experimental using pretest-posttest with control group and using a consecutive sampling. The number of samples was 30 people (15 control group and 15 the intervention group). Pain was measured by the Numeric Rating Scale (NRS). The statistical test was two different test mean. The result was a significant effect on the pain scale Guided Imagery in breast cancer patients (P Value = 0.000; α = 0.05). There was a significant relationship between the age with the pain scale (P Value = 0.000; α = 0.05), and there is no relationship between the tribe with the pain scale. The results of this study recommends Guided Imagery being implemented as nursing interventions to reduce the pain of breast cancer.

Bacteriological and Mycological Surveillance of Bed Linens at a Major Tertiary Hospital in North-Central Nigeria

Knowledge of the microbial diversity on hospital bed linens has implicit significance for infection control because bed linens are likely reservoir and vehicles for healthcare-associated Infections (HAIs). In this study, the diversity of microorganisms that persist on bed linens at Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria was evaluated. Patients’ bed and surface areas on bed linens were chosen at random from ten different wards and the swab sampling method employed. Of the 30-bed linens sampled, bacteria were more prevalent at 63.3%, and fungi at 34.48%. We identified both bacteria and fungi from eight wards, only fungi from the antenatal ward and no contamination from the amenity ward. Staphylococcus aureus, Escherichia coli, Klebsiella, and coagulase-negative Staphylococcus dominated the bacterial profile. Similarly, Aspergillus niger, Candida albicans, and Microsporium ferrugenium fungi were also recovered from the bed linens. Amongst the bacteria identified, Escherichia coli gave the highest prevalence at 36.84%, whereas, Candida albicans revealed the highest among the fungi isolates with 50%. Chi-square analysis showed a significant relationship (χ2 = 68.48, df =8, P<0.05) between the microbial contamination and the wards sampled. The mean bacterial count (cfu/ml) was checked for each ward and the female surgical ward showed the highest count of 31.3 × 103 and the paediatric ward had the least count of 2.3 × 103. Control beddings were also contaminated with 1.3 × 103. These results suggest that the bed linens from the hospital wards were contaminated with pathogenic microbes which can contribute to HAIs.

Evaluation of Nurses’ Knowledge and Attitudes toward Pain Management at Baghdad Teaching Hospitals

Poorly managed or unmanaged pain is a problem that affects individuals, entire healthcare systems and societies throughout the world . Objectives: To assess nurses’ knowledge and attitudes about patient’s pain management and to find out the relationship between knowledge , attitudes and their demographical characteristic. Methodology: A descriptive cross sectional design study was carried out among 100 nurses working in male and female surgical wards, ICU, surgical ward, emergency and operating theatre of four teaching hospitals, Baghdad city. Census method was used to select the participants, in which all the nurses working in the selected wards who agreed to participate in the study were selected. Data was collected by distributing structured self-administered questionnaire which was a modified form of a standard tool, that is, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP) developed by Ferrel and McCaffery. Results: The majority of the study were male who accounted for (63%) of the total participants while female constituted (37%). Most of participants (49%) were ages between (18 – 27) years old, a high percentage of them were have institute graduate (40%), (50%) of the nurses were single and the remainder was married. Majority of them (37%) were employee (1-5) years in employment in nursing. Majority of them (45%) were employee (1-5) years in intensive care unit, and finally majority of nurses (77%) have training session about patient’s pain management. Conclusions: This study indicated that nurses’ have poor knowledge about pain management, as well as study indicated overall nurses’ have positive attitudes toward pain management.

The Effect of Chemotherapy on Clinical, Haematological and Biochemical Profile in Breast Cancer Patients Undergoing Chemotherapy at Cape Coast Teaching Hospital; A Longitudinal Study

Background: People with primary invasive breast cancer receive both local (surgery and radiation therapy) and systemic treatment (chemotherapy and hormonal therapy). However, there are substantial short-and long-term side effects from chemotherapy as documented in several studies. This study assessed the effects of chemotherapy on clinical, haematological and biochemical profile of breast cancer patients undergoing chemotherapy in the Cape Coast Teaching Hospital.
 Methods: This longitudinal study was conducted in the female surgical ward of the Cape Coast Teaching Hospital (CCTH). We randomly sampled 51 patients diagnosed with breast cancer and scheduled to start chemotherapy and recorded their demographic, clinical and therapeutic data. Blood was collected for haematological profiles [haemoglobin (Hb), white blood cell (WBC) count, platelets (PLT) and biochemical analysis (lipid profile, uric acid and creatinine) for day 1, day 21 and day 42 of their chemotherapy cycles.
 Results: Majority of the participants were within 46-60 years, married, overweight and had informal employment. Throughout chemotherapy cycles, systolic blood pressure (SBP) significantly decreased till after the third cycle (P=0.026), diastolic blood pressure (DBP) significantly decreased after second cycle but increased slightly after the third cycle (P=0.029). Hemoglobin though insignificant, decreased after the second cycle but increased sharply after the third cycle (P=0.281). White blood cells (WBC) significantly decreased throughout cycles (P=0.008) whereas high density lipoprotein (P=0.014) increased throughout cycles- Uric acid (P=0.852) and creatinine (P=1.000). were maintained throughout cycles
 Conclusion: Throughout cycles, chemotherapy had significant adverse effect on the clinical profile (systolic and diastolic blood pressure), white blood cells (WBC) and high density lipoprotein (HDL) in patients undergoing treatment.

Symptom Index of Ovarian Cancer

Introduction: Ovarian cancer accounts for four percent of all cancer in women worldwide. It is considered as the silent killer, because symptoms do not develop until the disease reached advanced stages. Majority of women are diagnosed at advanced stages when prognosis is poor. This study was carried out with an aim to find out association of Symptom Index with ovarian cancer.
 Methods: A hospital based case control study was conducted over one year in department of Obstetrics and Gynecology, TUTH, Kathmandu. All patients visiting to Gynecology OPD or admitted to Female Surgical Ward with histopathology confirmed ovarian cancer were included. Age matched women with benign ovarian tumor at the ratio of 1:2 were taken as controls. All women were inquired regarding the occurrence of eight symptoms associated with ovarian cancer. A symptom index was considered positive if any of those symptoms occurred >12 times per month but were present for <1 year.
 Results: There were 30 cases and 60 controls. Twenty-nine (96.7%) cases and 56 (93.4%) controls presented with abdominal pain but it was not statistically significant. However, abdominal bloating in 56.7% vs 8.3% [OR-14.4 (4.5-46.2)], increased abdominal size in 40% vs 11.6% [OR- 5.04 (1.7-14.8)], difficulty in eating in 30% vs 1.7% [OR- 25.3 (3.02-211.7)], and feeling full in 23.3% of vs 1.7% [OR-17.9 (2.09-154.1)], all were statistically significant.
 Conclusions: Symptoms are present in a significant number of women with ovarian cancer. So, evaluating women with specific symptoms of recent onset helps to make the early diagnosis of ovarian cancer.

A PILOT STUDY ON BREAST CANCER AWARENESS AND ITS RELATIONSHIP TO ABO BLOOD GROUP AMONGST NIGERIAN WOMEN

Breast cancer is a major global health problem and a leading cause of death among women of all ethnic and racial background. With an estimated 1.15 million new cases diagnosed worldwide per year, there is an urgent need to develop a global strategy to reduce the burden of breast cancer. Based on this, a pilot study was conducted with the aim of accessing the level of its awareness in the Nigerian adult females and its relationship to ABO blood group and genotype. Two hundred and thirty-nine adult (239) females within the age range of 20-80 were used for this study. Of the 239 females, 100 of them (married and single) were issued questionnaires so as to ascertain their awareness of breast cancer in the society. These hundred females were mostly students of the University Of Port Harcourt, Nigeria. The remaining 139 females were adults diagnosed of breast cancer as revealed by their accessed files from the Department of female Surgical Ward of the University Of Port Harcourt Teaching Hospital, Rivers State- Nigeria. The blood group and genotype of the patients were thereafter noted. The retrieved data was then presented in a tabular form based on age range, breast cancer and ABO blood group. Of the 100 subjects issued questionnaires, 85% agreed of been aware of breast cancer. All the patients with breast cancer were seen to fall within the blood group A, B and O of which all were rhesus positive. Of blood group A, 55 and 14 of the patients had genotype AA and AS respectively. Unlike other studies, the age range of breast cancer recorded was from 20-29 with the least age of breast cancer subject noticed being 26 years. The age range of 30-39 years recorded the highest no of 39 patients while the least was 70-79 years with only 4 of the patients diagnosed with breast cancer. No patient with blood group AB was observed to have been linked to breast cancer in the interim so far in this study. However, blood group A+, B+ and O + revealed breast cancer patients to be 69, 22, and 48 respectively with blood group A+ being the highest.

Assessment of Medical Waste Generation at a Medical Center in Keffi Metropolis

Healthcare waste represents an important stream of pollutants that impacts on medical personnel and attendees of such facilities. This study examined the quantities of waste generated among 14 different wards and units at the federal medical center, Keffi in Nasarawa state, Nigeria. It also evaluated crucial factors that influence the selection of hospitals by patients as well as the methods employed in waste treatment. The results from the study revealed that an average volume (Kg/bed/day) of 1.97 (Accident & Emergency), 2.27 (Male Medical), 1.71 (Female Medical), 1.79 (Female Surgical), 1.98 (Pediatric), 2.11 (Orthopedic), 1.91 (Lying-in), 1.42 (Amenity), 2.53 (Main theatre), 1.17 (Pediatric surgical), 0.41 (Intensive care unit), 2.03 (Pharmacy), 2.34 (Laboratory) and 4.82 (Labour room). It was established that infectious waste represented the highest rate of hazardous waste (21.3%), while pathological (18.0%), sharp objects (15.8%) and pharmaceuticals (11.4%) represented the sum total of the non-hazardous waste stream. Very strong correlations existed between the Male Medical Ward and Main Theatre (rs 0.9), Female Medical and Female Surgical wards (rs 0.94), Pediatric and Pediatric Surgical wards (rs 0.90), Lying-in and Amenity wards (rs 0.88), Accident & Emergency and Orthopedic units (rs 0.86), with strong correlation between the pharmacy and the laboratory (rs 0.65) and a moderate correlation between the intensive care unit and the Labour room (rs 0.46). The study showed that financial capability was the most important factor that influenced public decision on the choice of the medical center ranked 1, with a relative important index (RII) of 10 in the choice of facilities and methods used to manage waste generated. Other factors in order of importance were ownership of the medical center (2) with an RII of 9 with cultural and social bias ranked as 7 with an RII of 4.

Comparative Assessment of Indoor Air of a Tertiary Hospital and a Public Secondary School in Ilorin, Kwara State, Nigeria

Air bone transmission is one of the routes of spreading diseases responsible for a number of nosocomial infections [1]. Airborne microbial particles have negative effects especially on the health of immunocompromised people [2]. The infections are caused by aerosols which are small, viable and may remain suspend in the air stream over long period of time. This study was aimed at investigating and comparing the quality of indoor air of a tertiary hospital and a secondary school in Ilorin, Kwara state, Nigeria. Air samples were collected in the hospital and school using settle plate techniques. Bacteria isolated from different wards in the hospital were Staphylococcus aureus, Coagulase negative Staphylococcus, Bacillus spp., Klebsiella spp., Micrococcus spp., Escherichia coli, Pseudomonas spp., Acinebacter spp. The female surgical ward (FSW) had the highest degree of contamination of bacterial and fungal air borne while the bacterial isolates gotten from the school were heavy growth of Coagulase negative Staphylococcus and Bacillus spp., and few growths of Klebsiella spp. and Acinebacter spp. with highest bacterial count in J.S.S.2B class. For fungal growth Aspergillus spp. and Mucor spp. produced numerous growths in all the classes and in the hospital while Penicillium spp. gave scanty growth. The lowest bacterial count observed both in school and in hospital was still high when compared with British bacteriological standard.

Fomites: Possible vehicle of nosocomial infections.

Nosocomial infections (NI) are infections contracted during the cause of hospital treatments, which are secondary to the patients’ original condition. A retrospective survey of nosocomial infection rates was carried out, using patients’ medical files and diagnosis index. Surfaces of non-invasive fomites which frequently come in contact with patients were swabbed; drip stands, door knobs, fan switches, bed rails, bed linens, pillow cases, light-plug-ins, and sink knobs for microbial contamination. Microbes isolated from the 225 swabs samples were identified using standard microbiological methods. An overall prevalence of 11.9% nosocomial infections was recorded. The Intensive Care Unit (37.5%) and Children ward (7.6%) recorded the highest and lowest prevalence respectively. Prevalence of nosocomial infections in the sampled wards was significantly different at (P>0.05). Door knobs (22.76%) recorded the highest microbial contamination; while light-plug-ins (4.88%) and pillow case (4.88%) were the least contaminated fomites. The highest bacterial colony count of 9.6 × 106 cfu/ml which is higher than the infectious dose of 106 cfu/ml was recorded on the door knob of Female surgical ward while pillow case shows insignificant count across most wards. Surface contamination of fomites within healthcare setting is significant issue of concern in public health thus the need to implement strict policy to reduce the rate of surface bio-contamination of hospital environment.

Pattern and Outcome of Paediatric Surgical Admissions in a New Tertiary Hospital in Northwestern Nigeria

The pattern and outcome of pediatric surgical admissions may be crucial to policy formulation in a new tertiary hospital. This study reports the pattern and outcome of pediatric surgical admissions in Northwestern Nigeria. This is a retrospective review of all medical records of patients admitted with pediatric surgical pathologies over a 14 months period. Data was extracted from the admission records and case notes of children admitted in the hospital during the study period. Information obtained included the patients’ age, sex, diagnosis, duration of admission and outcome. The data obtained was analyzed using SPSS version 15.0 for Windows. There were 191 pediatric surgical admissions representing 12.5% of the total pediatric admissions with a mean age of 71 months and a male to female ratio of 1.2:1 (M 105: F86). Sixty percent of the patients were admitted to female surgical ward, others were admitted to neonatal intensive care unit, male surgical ward, pediatric medical ward and emergency pediatric unit due to shortage of manpower and lack of pediatric surgical facilities. The most common diagnostic categories were congenital anomalies 35.1% (67/191), trauma 30.9% (59/191) and surgical infections 29.8% (57/191). Eighty percent of our patients did well and were discharged. However, we recorded a mortality rate of 9.9%. Our report shows that wide spectrums of pediatric surgical conditions are seen in our hospital with congenital anomalies being the most common. Most of our patients were treated and discharged.

Surveillance of Antibiotic-Resistant Bacteria in King Khalid Hospital, Hafr Al-Batin, Saudi Arabia, During 2013.

BackgroundResearch to understand and control the emergence and spread of antimicrobial resistance has become a public health priority.ObjectivesThis study was conducted to study epidemiology and resistant pattern of bacteria causing infection in different King Khalid hospital units.Patients and MethodsAll samples were sent to the lab and routinely processed according to the standard microbiological procedures. Then, the cultures yielding growth were selected for the study. Identification and antibiotic susceptibility test for all clinical isolates were processed by using MicroScan instrumentation. A total of 428 clinical samples were collected within 8 months; out of them, 300 clinical isolates were subjected to validation test.ResultsEscherichia coli, Klebsiella pneumonia, and Pseudomonas aeruginosa were the commonly identified Gram-negative bacteria. Staphylococcus aureus was the only identified Gram-positive bacterium. The most common infections were taken from the wounds (39.0%), urinary tract (32.3%), and bloodstream (17.8%). The most common antibiotic-resistant bacteria were found on female surgical ward (100%) followed by ICU (90.2%), and male surgical ward (88.2%). The overall results of antibiotic resistance were 100% for S. aureus, 93.3% K. pneumonia, 75.7 % E. coli, and 100% for P. aeruginosa. Staphylococcus aureus showed high resistance to ampicillin and linezolid (94.1%). High (86.95%) and full resistance (100%) against ampicillin were observed from E. coli and K. pneumonia, respectively. P. aeruginosa was fully resistant to 4 antibiotics of cefazoline, cefoxitin, tetracycline, and trimethoprim-sulfamethoxazole.ConclusionsThe study was useful in determining the risk factors and defining different hospital units which should be targeted for measures to prevent infection.

Knowledge and Attitudes of Nurses Working at King Abdulaziz University Hospital toward Cancer Pain Management

Objective: This survey aims to identify the levels of knowledge and attitudes among nurses regarding cancer pain management. Methods: This cross-sectional survey was undertaken at King Abdulaziz University Hospital, Jeddah, between September 4 and September 27, 2015. The survey instrument was a pre-set questionnaire comprising 39 closed-ended format questions. Participants were asked questions to assess their knowledge and attitudes about cancer pain management and adherence to frequent misconceptions regarding opioid therapy. The chi-square test was used to compare differences between variables. Results: One hundred twenty-eight questionnaires were completed and analyzed. A mean sample score of 41.3% was achieved on pain-related knowledge questions. The average score on all 39 questions was 16.1 ± 4.6 (range, 0 - 24). Nurses on the male medical ward were most knowledgeable compared with those on other wards (p < 0.001). They were also most likely to score highest on questions that assessed knowledge of pain management (p < 0.001). Conversely, nurses on the female surgical ward were most likely to score highest on issues related to pain assessment (p < 0.001) and experience in managing breakthrough cancer pain (p < 0.001). Likewise, nurses on the male surgical and female medical wards appeared to be more knowledgeable on issues related to patient compliance (p = 0.002). Conclusion: Optimization of inpatient supportive procedures should be a specific task at King Abdulaziz University Hospital until an oncology unit with nurses specialized in cancer care is established.

The Challenges of Nigerian Hospital Ward Setting in Providing for Family Participation

Healthcare facilities design is a complex and dynamic process that considers meeting the needs of each of its stakeholders. The design becomes more complex when it involves building for particular user groups with non-standard specification. The Nigerian healthcare delivery system like many other health care systems in developing countries requires active participation of the patient's family member. However, the hospital setting in Nigeria has not been configured to accommodate their stay. This qualitative study is carried out to explore the extent of family participation in caring for their hospitalised ones with a view to identify design indices that will guide Nigerian hospital ward design. Data was obtained through observation and unstructured interview in a typical adult male and female surgical wards in one of the tertiary hospitals in Nigeria. Data was analysed using classical content analysis method. The result shows the design indices generated from patient's families involvement required in the Nigerian hospital ward configuration.

Prevalence of pain in hospitalized cancer patients in a Nigerian teaching hospital

BACKGROUND: Cancer has always been an important cause of pain in medical practice. In a specialized setting such as hospice, palliative care unit and hospital where such patients could receive adequate pain care, as many as 90.0% of cancer patients usually report pain relief. Therefore, the aim of this report is to determine the prevalence of pain in hospitalized cancer patients in our environmentMETHODS: This is a cross sectional study involving adult cancer patients, who were hospitalized in surgical wards of Ahmadu Bello University Teaching Hospital Zaria, in the month of June, 2009. Patients completed a structured questionnaire regarding the presence or absence of pain, its degree of severity, treatment protocol he/she was currently on. Data obtained was analyzed using SPSS version 11.5.RESULTS: In the month of June, 2009, a total of 67cancer patients were admitted in both male and female surgical wards. There were 27 (40.3%) males and 40 (59.7%) females. Age range was 17-75years (44.9mean). Fifty eight (86.6%) of the cancer patients admitted having pain as at the time of the study while 9(13.4%) had no pain. Assessment of the form of analgesia commonly used for cancer patients, revealed that 25(37.3%) were on Non Steroidal Anti-Inflammatory Drugs (NSAIDs), 18(26.9%) were not on any form of analgesia, 17(25.4%) were on weak opioids while 7(10.4%) were on strong opioids.CONCLUSION: The prevalence of pain in hospitalized cancer patients in our environment is high and NSAIDs are the analgesic agents that are commonly used in them. Analgesia should be dictated and proportional to the intensity of pain in these patients.

English

Edwin Cade Hospital of Anglogold, Ashanti, had been experiencing high levels of surgical site infections, but the causes of these were unknown. This study aimed to investigate environmental contamination and postoperative wound infections in the hospital. Wound samples were collected from infected surgical sites and also environments of operating theatre and the surgical wards and cultured for bacteria. Growths on culture media were identified. Antimicrobial susceptibility of the isolates was tested. Culture results indicated bacterial infections of 86% of the surgical site wounds sampled. Wounds in female surgical ward had 92%, male surgical ward had 84.2% and the maternity ward had 81.4% wounds infected with various bacterial types. The most occurring isolate was Staphylococcus aureus (54.3%) followed by Escherichia coli (16.3%), Coagulase-negative Staphylococcus (15.5%), Proteus mirabilis (7.8%) and Pseudomonas aeruginosa (6.2%). Similar isolates were obtained from the environmental samples with Bacillus sp. (43.9%) dominating followed by S. aureus (24.9%). There was strong correlation between wounds isolates and environmental isolates (OR=.678, P&gt;0.05). Post-operative wound infection in the hospital was high recording 86% probably due to environmental contaminants. Stronger infection control measures are advocated for the hospital. &nbsp; Key words: Surgical site, postoperative wound infection, surgical wound, environmental contamination.