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Abstract SUMMARY Urinary catheter is a commonly used device for different patients in various healthcare settings. Their use may put patients at increased risk of urinary tract infection, urinary catheter as a foreign body, allows bacteria to colonize and enter the body. The rate of acquisition of bacteriuria is approximately 5% per day with an indwelling urinary catheter (Phipps et al., 2009). The uses of indwelling urinary catheter increase the risk of developing catheterassociated urinary tract infections (CAUTIs). CAUTIs account for a significant proportion (up to 30-40%) of healthcare-associated infections which in turn may have great financial impact to the healthcare system. (Burke & Piley, 2004) The Nurses can be very proactive for patients with indwelling catheters, whether short- or long-term. The nurse must follow general guidelines for controlling infection and use program according to hospital policy. In addition, parrier protection must be used by nurse to prevent occurrence of infection for patient and themselves (Potter & Perry, 2005). Despite infection control policies and procedures, catheter associated urinary tract infection (CAUTI) rates remain a significant problem in the hospitals especially in the intensive care units (ICUs) according to statistical reports derived from microbiology department in Mansoura university at 2010 indicated that (CAUTI) 17.97% among healthcare-associated infections. Therefore, this study will clarify the relation between critical nurse level of knowledge and level of practice in the care for patients with urinary catheter. Summary 92 The present study aims at assessing the performance of nurses regarding infection control for patients with indwelling urinary catheter through: 1-Assess nurses’ knowledge regarding care for female patients with indwelling urinary catheter. 2-Assess nurses’ practice regarding care for female patients with indwelling urinary catheter. Study sample All available nurses were involved in the study composed of seventy (70) nurses working at the intensive care units with the inclusion criteria of being provide direct care to female catheterized patients and they have no previous training regarding urinary catheter care. Data were collected by the usage of two Tools: Tool (I) self -administered questionnaire sheet used to assess level of nurses’ knowledge. It was developed by the researcher and guided by the review of literature. Tool (II) A Standardized Observational Checklist used to assess nurses’ practice regarding indwelling urinary catheter’s care for female patients. This checklist is adopted from (Robinson, 2008) Data collection phase The researcher have met nurses and obtained their agreement to participate in the study, the researcher explained what is needed to be done and filled in the questionnaire sheet. All of the study Summary 93 subjects were given the same instructions, the researcher has personally met each of them, and each interview lasted for 30-45 minutes. The researcher met about 4-6 nurses every time in intensive care units from 10.00 am to 2.00 pm. This time was suitable because the most nursing activates are done in this time. The researcher observed each nurse during her actual practice of urinary catheter (insertion, care, removal, and\or obtaining sterile urine sample) without here attention. The researcher was available with nurses in ICU 3 days weekly. The time which is taken for the total numbers (70 nurses) to complete data collection was 6 months; from July to December 2011. Summary of the result 1. The personal characteristics of the studied nurses revealed that (68.6%) of the studied sample age was less than 30 years, with mean 27 years. As for nursing qualification; (41.4%) of the studied samples have bachelor degree. However (72.8%) of the studied sample had less than ten years of experience. with mean 7.39 years of experience. 2. Slightly more than tow thirds (67.19%) of the studied nurses have satisfactory knowledge regarding infection control. 3. More than the half (54.68%) of the studied nurses have satisfactory knowledge regarding indwelling urinary catheter. Summary 94 4. Nurse’s levels of total knowledge (60.9%) of the studied nurses have satisfactory level of total knowledge as regarding indwelling urinary catheter and its related infection. 5. Nurse’s level of total practice (18.6%) of the studied nurses have Competent level of total practice as regarding indwelling urinary catheter, and the majority (81.4%) of nurses have Incompetent levels of total practice regard indwelling urinary catheter. 6. There is statistically significant relation between nurse’s level of knowledge about indwelling urinary catheter and its infection control measures and their age. P<0.05. 7. There is a high statistically significant relation between nurse’s level of knowledge about indwelling urinary catheter and its infection control measures and nursing qualification. (F = 20.8, 13.9) respectively at P<0.0001. 8. There is a statistically significant relation between nurse’s level of knowledge about indwelling urinary catheter and its infection control measures and their years of experience. (F = 3.9, 8.3) respectively at P<0.05. 9. There is no significant relation between nurse’s level of practice during insertion of indwelling urinary catheter, ongoing care, collecting sterile urine sample, or removal of indwelling urinary catheter and their age P >0.05. Summary 95 10. There is a high statistically significant difference between nurse’s level of practice during insertion of indwelling urinary catheter, ongoing care, collecting sterile urine sample, and removal of indwelling urinary catheter and their qualification. (F = 27.3, 18.3, 15.3, 17.4) respectively at P<0.0001. 11. There is no significant relation between nurse’s level of practice during insertion of indwelling urinary catheter, ongoing care, collecting sterile urine sample, or removal of indwelling urinary catheter and their years of experiences P >0.05. 12. There is a weak positive correlation between nurse’s level of knowledge and level of practice regarding infection control measures for female patients with indwelling urinary catheter from the result of the present study, it could be concluded that: More than half of nurses had satisfactory level of knowledge about indwelling urinary catheter and its related infection and the majority of the studied nurse had incompetent level of performance regarding indwelling urinary catheter care. Also the current study found that there is a high statistically significant relation between nurse’s level of knowledge and the practice regarding indwelling urinary catheter infection control measures and their qualification and years of experiences. And there is a weak positive correlation between nurse’s level of knowledge and level of practice regarding Summary 96 infection control measures for female patients with indwelling urinary catheter. Based on these findings, the following recommendations are suggested: 1- All health care providers should have routine educational updates about prevention of nosocomial infection especially CAUTI. 2- Hand book about CAUTI prevention or nosocomial infection control measures should be available to nurses to give them knowledge at any time. 3- Educational program concerning invasive devices and their management should be applied regularly. 4- Posters about infection control program and protocol of nurse’s role regarding indwelling urinary catheters care must be available at the intensive care units. 5- Before inserting indwelling urinary catheters, the benefits of its use should be weighted against its hazards. |