Effect of an infection control programme in enteral feeding bacterial contamination in nursing homes

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Effect of an infection control programme in enteral feeding bacterial contamination in nursing homes


Author: Ho, Suk-ki
Title: Effect of an infection control programme in enteral feeding bacterial contamination in nursing homes
Degree: M.Sc.
Year: 2011
Subject: Hong Kong Polytechnic University -- Dissertations
Enteral feeding
Older people -- Nursing home care
Department: Faculty of Health and Social Sciences
Pages: xii, 126 p. : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2426767
URI: http://theses.lib.polyu.edu.hk/handle/200/6078
Abstract: Objectives: 1. To explore any enteral feed contamination in patients and the hands of nursing home staff in nursing homes. 2. To explore the correlation of enteral feed contamination among nursing home staff, residents and the feeding equipment devices. 3. To examine the knowledge of nursing home staff about infection control measures in enteral feeding. 4. To investigate the effectiveness of an infection control education programme in knowledge and practice of nursing home staff regarding enteral feeding. Design: A quasi- experimental pretest posttest control design was used in the study. Subjects: There were 30 older persons aged 65 or above and 20 nursing home staff recruited from three elderly centres. They were divided into experimental and control group according to the nursing homes. There were 15 older persons in the experimental group and 15 in the control group. There were 10 nursing home staff in the experimental group and 10 in the control group. Intervention: A two consecutive week's infection control programme related to enteral feeding was taught to the nursing home staff in the experimental group in June, 2010 and September, 2010. The control group provided standard care to elderly in the nursing home during the same period.
Outcome measures: A questionnaire was used to measure the knowledge and clinical practice skill in relation to enteral feeding among nursing home staff in the nursing home before and after the infection control programme. The knowledge assessment in the questionnaire included 20 True or False questions related to the enteral feeding. The practical assessment form included 32 items of enteral feeding skills in handling of the delivery systems, preparation of the feed, disinfection of the equipment, personnel, patients, and environment hygiene. The higher the scores, the higher the knowledge and practical skill in enteral feeding and infection control. In addition, bacterial counts and culture of MRSA were taken from various sites during the enteral feeding procedures. These sites were: hands of the nursing home staff, enteral feed from the distal end of the administration set before and after being decanted to the patient, milk flow regulator before and after nursing home staff manipulation, residents' nasopharyngeal swabs and gastric fluid, and the hub of the enteral tube before and after the enteral feeding procedure. The pretest and posttest bacterial counts and of MRSA culture result was compared to the effectiveness, if any, of the enteral feeding infection control programme. There was significant improvement with p-value < 0.05 noted in knowledge and clinical practice skill in the experimental group after the infection control programme, but there was no improvement in the control group. In addition, bacterial counts of nursing home staff’s hands, feeding tubes' hubs, enteral milk and residents' gastric fluid before the enteral feeding procedure, as well as the nursing staff's hands, tubes' hubs, feeding sets' regulators and enteral milk after the enteral feeding procedure were significantly reduced at p <0.05; while there was a significant rise in the bacterial counts of the nursing home staff's hands in the control group. Moreover, there were significantly difference of reduction of MRSA culture on tubes' hubs and residents' gastric fluid before the feeding procedure and the nursing home staff's hands after the procedure between two groups upon completion of the infection control programme. Conclusion: In the present study, the results demonstrated significant improvement in knowledge and clinical practice skill in enteral feeding in the experimental group. There was significant reduction in bacterial counts in various sites in an enteral feeding procedure in the experimental group. A tailor made infection control programme may therefore reduce contamination of the enteral feed.

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