Abstract of Dissertation

Agency : Hospital Acquired Infection, Infection Control

Objective : • To check the measures being followed for infection control. • To find infection rate of indicators. • To check and evaluate the training given to staff for hospital infection control.

Background : Hospital is an institute that provides medical as well as surgical treatment along with nursing care to patients so it is very important to keep the hospitals clean and free of infection. Prior to 1800’s, “Typhus” was recognized as hospital infection which was prevalent in both civil and military hospitals. In 19th century, surgery became more prevalent that lead to occurrence of other types of hospital infection. The combination of surgery and infection was over 80% for simple surgeries. James Simpson introduced the term “Hospital Acquired Infection” and called it “Hospitalism”, in the 1830s. Semmelwis came up with the idea of using hand washing techniques before every procedure to reduce infection but he faced resistance and after 2 years of his struggle, he died in asylum for being mentally unstable. Later on, Joseph Lister accepted the concept of hand washing that reduces infection after his study showed 47% to 15% reduction in infection. Hence the study was conducted to assess the knowledge and to know whether the practices are being followed to control the hospital acquired infection in civil hospital. To prevent the hospital acquired infection standard operating procedures should be strictly followed where hand washing techniques plays a major role in reducing infection which had given positive results as the study showed reduction in 32% of infection rate after implementing hand washing techniques.

Methodology : A prospective and record based study was conducted at Sir Takhtasinhji General Hospital on Hospital Acquired Infection. Hospital Infection Control committee’s approved form was taken for analysis. Based on results, practices were observed, assessed and improved. Sensitization and training was given to improve the practices which reduced the hospital acquired infection rate.

Findings : The cumulative infection rate of hospital of 3 months was 14.07%. Among the entire departments ventilator based pneumonia (VAP) was highest in the medicine department and surgical site infection (SSI) is highest in the surgery department which after implementing the safety procedures showed reduction and even the departments started under reporting the infections. February showed the highest percentage of infection rate which reduces to the month of April to 9.06%. Moreover, majority of patient got VAP as compared to the other indicators which indicate procedures should be followed strictly to reduce ventilator based pneumonia (VAP). After implementation of hand washing techniques and strictly following the procedures there were reduction in infection rate of all the indicators.

Recommendations : The data collected and its graphical representation provided a valuable method of presenting hospital infection rate which clearly identifies the high and low infection rates of different departments of the hospital and the cumulative infection rate of all the four indicators. The calculated results can be used to reduce hospital infection rate by applying local interventions and new techniques.