INTRODUCTION:

A range of strategies of Hygiene promotion and improvement have been proposed, and the WHO First Global Patient Safety Challenge, “Clean Care is Safer Care”, was launched in October 2005 was focusing on improving hygiene standards and practices in health care along with implementing successful interventions. Approximately, 1.4 million people worldwide suffer from infectious complications acquired in hospital. The highest frequencies of nosocomial infections were reported from hospitals in the Eastern Mediterranean and South-East Asia Regions (11.8 and 10.0% respectively), with a prevalence of 7.7 and 9.0% respectively in the European and Western Pacific Regions. The WHO study, and others, have also shown that the highest prevalence of nosocomial infections occurs in intensive care units and in acute surgical and orthopaedic wards.

Curtis and Wiseman (1982) indicate that the maintenance of these elements through care is a fundamental responsibility of nursing professionals because they have a significant impact on the clinical outcomes and satisfaction of critically ill patients.

Nursing care for critically ill patients includes the implementation of basic care tasks intended to enable patients to perform daily life activities as well as advanced care tasks that support health recovery or the maintenance of clinical conditions. Nursing care includes, among other elements, providing an atmosphere of comfort and physical and mental ease by promoting factors such as rest, sleep, nutrition, hygiene, and dignity.

NEED FOR STUDY:

Burns (1972), mentions that while quoting Nightingale who claimed that good basic nursing care is at the heart of care practices, which is why it is essential to resume the implementation of these practices. Sung-Hyun (2009), state that more and better involvement in care activities is expected with a greater number of nursing professionals and show the importance of basic nursing care, the need to prevent its delegation, and the urgent need to reclaim these tasks as core activities of this professional role.Coyer, Wheeler, Wetzig, and Couchman (1992), state that professionals should use all of their abilities to observe, protect, and provide safe care and thus promote comfort and well-being. Given its continued omission or delegation, some basic care is considered lost, including the encouragement of walking, feeding, teaching, discharge planning, emotional support, hygiene, surveillance, mobilization, oral cavity care, and catheter care, among others. The timely completion of these care tasks by professionals decreases the occurrence of negative results, such as acquired infections or skin lesions, both of which are significantly associated with morbidity, mortality, and health system costs.

A study by McGuckin, Shubin, and Hujcs (1968), demonstrated the relationship between the implementation of basic care by nursing professionals and positive patient outcomes. The study showed that nursing professionals possess extensive knowledge regarding the implementation of measures, such as hand hygiene, oral hygiene, preoperative skin preparation, bed baths, and incontinence-related care, and less knowledge related to documentation or the impact of the results of these actions. Similarly, Vollman, and Kalish (1971) indicated the necessity that nursing professionals resume basic care tasks and measure their impact on patients, as well as the results derived from the delegation or non-performance of these tasks.

The provision of the patient bed-bath is a fundamental nursing care activity yet few quantitative data and no qualitative data are available on registered nurses' (RNs) in the intensive care unit (ICU). The aim of this study was to describe ICU RNs current practice with respect to the timing, frequency and duration of the patient bed-bath and the cleansing and emollient agents used. The study utilised a two-phase sequential explanatory mixed method design. Phase one used a questionnaire to survey RNs and phase two employed semi-structured focus group (FG) interviews with RNs. Data was collected over 28 days. During the 28-day study period the four ICUs had 77.25 beds open. The bed-bath was given between 02.00 and 06.00h in 161 episodes (30%), took 15-30min to complete (n=195, 36.2%) and was completed within the last 8h in 304 episodes (56.8%). Cleansing agents used were predominantly pH balanced soap or liquid soap and water (n=379, 71%) in comparison to chlorhexidine impregnated sponges/cloths (n=86, 16.1%) or other agents such as pre-packaged washcloths (n=65, 12.2%). In 347 episodes (64.4%) emollients were not applied after the bed-bath. (sheetal, 2002)

Descriptive studies of the dynamics of bacterial hand contamination demonstrate an association between patient care activities that involve direct patient contact and hand contamination (Pessoa-Silva et al, 2004, Pittet et al, 1999). In an observational study of hand contamination during routine patient care in a large teaching hospital, high levels of hand contamination were associated with direct patient contact, respiratory care and handling body fluids (Pittet et al, 1999). A further descriptive study of healthcare workers hand contamination during routine neonatal care demonstrated that hands become increasingly contaminated and that gloves do not fully protect workers’ hands from contamination (Pessoa-Silva, 2004).

A search, selection and critical review of scientific articles and other source documents related to the topic was conducted based on hygiene, comfort, critical care and nursing descriptors. The information-gathering inclusion criteria considered for the present review were as follows: 1. original published articles indexed in the ISI-Web of Knowledge, Scopus, Science Direct, Proquest, Ebsco, Medline, Ovid, and SCIELO databases as well as other sources, such as unpublished documents and web pages; 2. documents published in English and Spanish between 1990 and 2014; 3. sources that made reference to hygiene as a basic nursing care; and 4. sources that made reference to the relationship between hygiene and comfort.

Seventy-five articles that met the inclusion criteria were selected: 3 qualitative studies, 27 quantitative studies, 1 mixed study, 40 documentary works (e.g., theoretical descriptions, books, subject reviews, literature reviews, care guides), and 4 editorials published by nursing professionals and health professionals in other areas. (Clarke, Mueller, Duval, and Wilt 1978)

STATEMENT OF THE PROBLEM:

A descriptive study to assess the staff Nurses knowledge regarding basic hygiene needs among critically ill patients in ICU in Sardar Patel Hospitaland heart institute, Gujarat

OBJECTIVES:

1 To assess the knowledge of Staff Nurses regarding basic hygiene needs of critically ill patients.

2 To find out the association between the knowledge of Staff Nurses regarding basic hygiene needs with their selected demographic variables.

HYPOTHESIS:

H1: There will be an significant association between the demographic variables with the knowledge score of basic hygiene needs

MATERIALS AND METHODS:

Research approach and design:

Descriptive research design was used to collect the data from staff nurses those who are working in ICU

Setting of the Study:

The study was conducted at Sardar Patel Hospital, Ankaleshwar.

Population:

Staff nurses working in ICU at Sardar Patel Hospital, Ankaleshwar.

Sample and Sample technique:

30 staff nurses working in ICU were selected by Total enumerative sampling technique

DESCRIPTION OF THE TOOL:

The tool has two section A and B

Section A: Consist of demographic variables of Staff Nurses, those who are working in ICU.

Section B: Consists of dichotomous structured questionnaire related to staff nurses those who working in ICU.

Dichotomous structured questionnaire was formulated in the form of Nightingale Environmental theory, which consist of 12 items (Unmet = 0, Met =1).This components has divided into 8 aspects such as Air ventilation, Cleanliness, Bedding, Warmth, Diet, Hand washing, Skin integrity.

Dichotomous Structured Questionnaire:

S. No	Nightingale Nursing Components	Unmet	Met
1	Provision of adequate fresh air to the patient
2	Put of light during night
3	Maintains cleanliness of room
4	Provision of warmth to the patient
5	Nourishing Diet to the patient
6	Maintains proper bedding to the patients
7	Maintenance of personnel cleanliness to patients
8	Daily changing linen to the patients
9	Hand washing before and after procedure
10	Controls sound in the ward
11	Proper disposal of waste after procedure
12	Maintains skin integrity to the patient

Table 2: Association between knowledge score with their selected demographic variables

Demographic Variable	DF	CV	Table Value	Level of Significant
Age	6	2.52	2.45	Significant
Gender	2	1.05	4.30	Non Significant
Education	4	1.48	2.78	Non Significant
Marital Status	2	0.82	4.30	Non Significant
Religion	4	4.36	2.78	Significant
Monthly Income	6	6.32	2.45	Significant
Year of experience	4	10.77	2.78	Significant

Data in this table shows that there was Significant association between the knowledge score of staff nurses with Age, Religion, Monthly Income and Year of experience. There was no Significant association between the knowledge score with Gender, Education and Marital Status.

CONCLUSION:

The study was conducted to assess the knowledge regarding basic hygiene needs of critically ill patients in ICU among Staff Nurses at Sardar Patel Hospitaland heart institute, Ankaleshwar, Gujarat. In the present study 30 staff nurses were selected by Total enumerative sampling techniques. The major conclusion drawn from this study was the highest percentage (57%) of the staff nurses working in ICU having adequate knowledge regarding Basic hygiene needs of critically ill patients.

REFERENCES:

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Received on 07.02.2019 Modified on 20.03.2019

Int. J. of Advances in Nur. Management. 2019; 7(2): 103-106.

DOI: 10.5958/2454-2652.2019.00026.X

Area of Knowledge	Inadequate		Moderate		Adequate
Area of Knowledge	Frequency	%	Frequency	%	Frequency	%
Basic hygiene needs of critically ill patients	2	6%	11	37%	17	57%