AMELİYATHANE HEMŞİRELERİNİN CERRAHİ EL YIKAMA UYGULAMALARININ İNCELENMESİ

Amaç: Ameliyathanelerde cerrahi el yıkama zorunlu bir işlem olmasına rağmen evrensel olarak uygulanan standart bir el yıkama tekniği bulunmamaktadır. Bu çalışmanın amacı ameliyathane hemşirelerinin cerrahi el yıkama uygulamalarının belirlenmesidir. Gereç Yöntem: Bu çalışma 04- 08 Eylül 2007 tarihleri arasında Gaziantep’te yapılan Türk Cerrahi ve Ameliyathane Hemşireliği Kongresi’ Cerrahi El Yıkama Kursu’nda yapılmıştır. Araştırmanın örneklemini 18 il ve 35 farklı hastaneden katılan 96 ameliyathane hemşiresi oluşturmuştur. Kursa katılan hemşirelerin tümü soru kağıdını doldurmuşlardır. Veriler 6 açık soru ve 19 çoktan seçmeli toplam 25 sorunun yer aldığı soru kağıdı aracılığı ile toplanmış ve SPSS 11.0 programı kullanılarak sayı ve yüzde olarak sunulmuştur. Bulgular: Hemşirelerin %45.8’i cerrahi el yıkamaya yönelik hizmet içi eğitim almadığını, %53.1’i el yıkaması sırasında fırça kullandığını, %69.7’si el yıkamasında povidone-iodine kullandıklarını ve %95.8’i cerrahi el yıkama süresinin 2- 6 dakika olduğunu belirtmişlerdir. Sonuç: Cerrahi el yıkamasına ilişkin uygulamaların literatürle uyumlu olmakla birlikte; kullanılan antiseptik, yıkama yöntemi ve süresi açısından bireysel ve kurumsal farklılıkların olduğu saptanmıştır

INVESTIGATION OF SURGICAL HAND WASHING PRACTICES OF OPERATING ROOM NURSES

Objectives: Although surgical hand washing is an imperative procedure in operating room, there is no a standard surgical hand washing technique applied universally. The aim of this study was to determine the surgical hand washing practices of operating room nurses. Methods: The study was performed during the hand washing course of Turkish Surgical and Operating Room Nursing Congress, 04- 08 September Gaziantep, Turkey. The sample was consisted of 96 operating room nurses from 18 city and 35 different hospitals. All the nurses 96 attended the session completed the questionnaire. The data were collected using a questionnaire consists of 6 open-ended and 19 multi-choices totally 25 questions and were presented number and percentage using SPSS 11.0. Results: Of the nurses 45.8 % stated that they had not received in-service education related to surgical hand washing, 53.1 % stated that they used brush for hand washing, 69.7% stated that they used povidone-iodine for hand washing and 95.8% stated that the duration of hand washing were 2-6 minutes. Conclusion: It has been determined that although surgical hand washing practices are in accordance with literature, there are some differences individual and organizational about antiseptic, washing method and time

___

  • Aksoy A, Caglayan F, Cakmak M ve ark. (2005). An investigation of the factors that effect surgical hand disinfection with polyvidone iodine. Journal of Hospital Infection, 61, 15- 19.
  • Allen G. (2005). Hand hygiene, an essential process in the OR. AORN Journal, 82, 561- 562.
  • Association of Perioperative Registered Nurses. (2004) Recommended practices for surgical hand: antisepsis/ hand scrubs. AORN Journal, 79(2), 416- 431.
  • Berman M. (2004). One hospital's clinical evaluation of brushless scrubbing. AORN Journal, 79 (2), 349- 358.
  • Boyce JM, Pittet D. (2002). Guideline for hand hygiene in health-care settings. Recommendations of the healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Morbidity and Mortality Weekly Report, 51, 1- 45.
  • Bryce EA, Spence D, Roberts FJ. (2001). An in use evaluation of an alcohol-based pre surgical hand disinfectant. Infection Control and Hospital Epidemiology, 22, 635- 639.
  • Cheng SM, Garcia M, Espin S, Conly J. (2001). Literature review and survey comparing surgical scrub techniques. AORN Journal, 74, 218- 224.
  • Creedon SA. (2005). Health care workers’ hand decontamination practices: compliance with recommended guidelines. Journal of Advanced Nursing, 51 (3), 208- 216.
  • Dutch Working Party. (1999). Infection Prevention. Pre-operative hand disinfection. 17.12.2003.
  • Fogg D. (1999). Infection control (içinde). M.H. Meeker., J.C. Rothrock (ed). Alexander’s care of the patient in surgery, 11th ed. pp. 97- 110) Mosby-Year Book Inc Comp, St Louis.
  • Gardner D, Anderson-Manz E. (2004). How to perform surgical hand scrubs. Erişim tarihi: 22 Eylül 2004’de http://www.infectioncontroltoday.com/articles/151bpract. html adresinden indirildi.
  • Gruendemann BJ, Bjerke BJ. (2001). Is it time for brushless scrubbing with an alcohol- based agent. AORN Journal, 74, 859- 873.
  • Gupta C, Czubatyj AM, Briski LE ve ark. (2007). Comparison of two alcohol-based surgical scrub solutions with an iodine-based scrub brush for presurgical antiseptic effectiveness in a community hospital. Journal of Hospital Infection, 65, 65- 71.
  • Hsieh HF, Chiu HH, Lee FP. (2006). Surgical hand scrubs in relation to microbial counts: systematic literature review. Journal of Advanced Nursing, 55, 68- 78.
  • Jones RD, Jampani J, Mulberry, G, Rizer RL. (2000). Moisturizing alcohol hand gels for surgical hand preparation. AORN Journal, 71, 584- 599.
  • Kampf G, Ostermeyer C, Heeg P. (2005). Surgical hand disinfection with a propanol-based hand rub: equivalence of shorter application times. Journal of Hospital Infection, 59, 304-310.
  • Kaymakçı Ş, Demir F. (2004). Cerrahi el yıkama uygulamaları. Ege Üniversitesi Hemşirelik Yüksekokulu Dergisi, 20, 79-86.
  • Khan A, McLaren SG, Nelson CL. (2003). Surgical hand scrub practices in orthopaedic surgery. Clinical Orthopaedics and Related Research, 414, 65- 68.
  • Larson EL, Aiello A E, Heilman JM ve ark. (2001). Comparison of different regimes for surgical hand preparation. AORN Journal, 73, 412- 432.
  • Lung DC, Man JHK, Tang T ve ark.. (2004). Surgical hand washing. Annals of College of Surgeons of Hong Kong, 8, 71-75.
  • Mangram AJ, Horan TC, Pearson ML ve ark. (1999). Guideline for prevention surgical site infection, National center for infectious diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia.
  • Ogg M, Petersen C. (2007). Surgical hand antisepsis; hand lotions and creams; gel overlays as artificial nails; benchmarking. AORN Journal, 85, 815- 818.
  • Parienti JJ, Thibon P, Heller R ve ark.. (2002). Hand-rubbing with an aqueous alcoholic solution vs. traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study. JAMA, 14, 722- 727.
  • Royal Australasian College of Surgeons. (1998). Policies – infection control in surgery. 24 Temmuz 2003’de http://www.surgeons.org/about/publications/infection15.html adresinden indirildi.
  • Tanner, J., Khan, D., Walsh, S., Chernova, J., Lamont, S., Laurent, T. (2009). Brushes and picks used on nails during the surgical scrub to reduce bacteria: a randomised trial. Journal of Hospital Infection, 71, 234-238.
  • Tavolacci MP, Pitrou I, Merle V ve ark. (2006). Surgical hand rubbing compared with surgical hand scrubbing: comparison efficacy and cost.. Journal of Hospital Infection, 63, 55- 59.
  • Thurston A. (2004). Sacred rituals in the operating theatre: summarizing the science. Current Orthopaedics, 18, 135- 146.
  • World Health Organization (2006). Guidelines on hand hygiene in healthcare (Advanced Draft). 14 Kasım 2006’da http://www.who.int/patientsafety/information_ centre/ghad_download/en/index.html. adresinden indirildi.
  • Woodhead K., Taylor E, Bannister G ve ark. (2002). Behaviors and rituals in the operating theatre. A report from the Hospital Infection Society Working Party on in Infection Control in the Operating Theatres. Journal of Hospital Infection, 51, 241- 255.