AN ASSESSMENT OF THE ROLE OF NURSES IN THE PREVENTION OF SURGICAL SITE INFECTIONS IN THE SURGICAL UNITS OF IRRUA SPECIALIST TEACHING HOSPITAL (ISTH), IRRUA

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Healthcare-associated infections remain a primary threat to patient safety, and their prevention constitutes a crucial component of care quality and patient protection (Wilson, 2016). These infections are significant concerns within healthcare settings and pose serious patient safety challenges (Hypes, 2012). Among these, surgical site infections (SSIs) are identified as the second most common type of healthcare-associated infections (Diaz & Newman, 2015). SSIs typically occur within thirty days following a surgical procedure and are marked by symptoms such as redness, fever, pain, and swelling. They represent one of the most serious complications that can follow surgical intervention (Hochbaum, Rosenstock, & Kegels, 2016). According to the Centers for Disease Control and Prevention (CDC), approximately 500,000 SSIs are recorded annually. These infections contribute to nearly one-third of surgery-related mortalities, extended hospital stays, and increased healthcare costs (Diaz & Newman, 2015). The economic implications are substantial and pose a financial burden on health systems (Joshi, 2014). The frequency of SSIs varies significantly across countries. In developed nations such as the United States, the United Kingdom, and Sweden, the incidence rate ranges between 2% and 6.4%. Conversely, in developing countries like Pakistan, India, and Turkey, the rate is considerably higher, ranging from 5.5% to 25% (Sickder, Sae-Sia, & Petpichetchian, 2014). Nurses serve as the cornerstone of infection prevention practices in healthcare. Their pivotal role in minimizing the risk of hospital-acquired infections stems from their proximity to patients and consistent engagement in direct care. By leveraging their clinical expertise, nurses significantly contribute to faster patient recovery and the reduction of infection-related complications (Teshager, Engeda, & Worku, 2015). Within the context of SSI prevention, nurses hold a comprehensive and continuous role in care delivery. They are in a position to influence key risk factors, such as inadequate hand hygiene and improper skin preparation, which are commonly associated with SSI incidence. Several international organizations—including the CDC, World Health Organization (WHO), and the National Institute for Health and Clinical Excellence (NICE)—have issued extensive guidelines over the past decade aimed at reducing SSI occurrences (Wilson, 2016). However, despite the availability of these guidelines, the adherence rate among nurses remains suboptimal. Numerous studies have highlighted that nurses’ adherence to recommended practices is often hindered by challenges such as insufficient knowledge, lack of resources, and limited access to up-to-date SSI prevention protocols. In the Nigerian context, there remains a notable gap in empirical evidence on nursing practices related to SSI prevention, including the barriers and enablers that influence such practices. Given this lack of localized research, this study aims to explore the role of nurses in the prevention of surgical site infections within the surgical units of Irrua Specialist Teaching Hospital (ISTH), Irrua. 1.2 Statement of the Problem Infection prevention remains a critical concern for all healthcare professionals, especially nurses, who are at greater risk of both acquiring and transmitting infections during patient care. The incidence of surgical site infections is notably high in Nigeria. For instance, a study conducted by Zaidi, Javed, Naz, and Mumtaz (2016) in Islamabad reported an SSI rate of 8.6%, while another study by Fashafsheh, Ayed, Eqtait, and Harazneh (2015) in Nawab Shah found a rate of 9.3%. It has been observed that in many public hospitals, nurses frequently fail to follow standardized guidelines and modern sterilization techniques adequately, thereby compromising efforts to prevent SSIs (Zaidi et al., 2016). Substandard nursing practices, particularly during surgeries involving open wounds, significantly increase the risk of infection transmission. This gap in practice raises serious concerns regarding patient safety and outcomes. Accordingly, this research seeks to investigate the specific roles nurses play in the prevention of surgical site infections within the surgical units at ISTH, Irrua. 1.3 Objective of the study The broad objective of the study is to assess the Role of Nurses in the Prevention of Surgical Site Infections in the Surgical Units of Irrua Specialist Teaching Hospital (ISTH), Irrua. The specific objectives is as follows i.To identify the factors contributing to surgical site infection in surgical units in ISTH, Irrua ii.To evaluate the knowledge of nurses regarding surgical site infection (SSI) prevention in ISTH, Irrua iii.To assess the role of nurses in mitigating surgical site infection in surgical units in ISTH, Irrua. iv. To ascertain the factors affecting the effectiveness of nurses in preventing surgical site infection in ISTH, Irrua 1.4 Research questions The following questions have been prepared to guide the study i.What are the factors contributing to surgical site infection in surgical units in ISTH, Irrua? ii.What is the knowledge of nurses regarding surgical site infection (SSI) prevention in ISTH, Irrua? iii.What is the role of nurses in mitigating surgical site infection in surgical units in ISTH, Irrua? iv. What are the factors affecting the effectiveness of nurses in preventing surgical site infection in ISTH, Irrua 1.5 Research hypotheses The stated hypotheses have been formulated to further guide the study H0: Nurses do not play a role in the prevention of surgical site infection in surgical units in ISTH, Irrua Ha: Nurses do play a role in the prevention of surgical site infection in surgical units in ISTH, Irrua 1.6 Significance of the study The study will be significant to medical schools as it will help the organization, develop and organize training programs to increase nurses’ knowledge and practices for the prevention of surgical site infection. The study will also provide information, guide to development of nursing curriculum and nursing coursesrelated to prevention of surgical site infection. Furthermore, the study will be significant ot the academic community as it will contribute to the existing literature and library resources. 1.7 Scope of the study The study focus on the Role of Nurses in the Prevention of Surgical Site Infections in the Surgical Units of Irrua Specialist Teaching Hospital (ISTH), Irrua. Empirically, the study will identify the factors contributing to surgical site infection in surgical units in ISTH, Irrua, evaluate the knowledge of nurses regarding surgical site infection (SSI) prevention in ISTH, Irrua, assess the role of nurses in mitigating surgical site infection in surgical units in ISTH, Irrua and ascertain the factors affecting the effectiveness of nurses in preventing surgical site infection in ISTH, Irrua. Geographically, the study is delimited to Irrua Specialist Teaching Hospital, Benin Edo State. 1.8 Limitation of the study Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraints are: Time: The researcher encountered time constraint as the researcher had to carry out this research alongside other academic activities such as attending lectures and other educational activities required of her. Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process. Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study. 1.9 Definition of terms Surgical Site Infection (SSI): An infection that occurs after surgery in the part of the body where the surgery took place. SSIs can be superficial involving the skin only, or more serious involving tissues under the skin, organs, or implanted material. Nurse: A licensed healthcare professional who is trained to care for patients, provide education, and support surgical teams. Nurses play a crucial role in patient care before, during, and after surgery. Prevention: Actions or measures taken to stop something from happening or arising. In this context, it refers to strategies and practices used to avoid the occurrence of SSIs. Surgical Units: Specialized hospital departments where surgical procedures are performed. These units include operating rooms and postoperative recovery areas. Hand Hygiene: Practices such as handwashing or using hand sanitizer to reduce the spread of infections. It is a critical component in preventing SSIs. Preoperative Preparation: Procedures and care provided before surgery to prepare the patient, including skin cleansing and other measures to reduce the risk of infection. Postoperative Wound Care: The management and care of surgical wounds after an operation to promote healing and prevent infections.