Nosocomial Infections

Nosocomial infections are infections acquired in the hospital or other health care facilities that were absent at the time of the client’s admission. It is also known as hospital acquired infections. It includes those infections that become symptomatic after the client is discharged as well as infections among medical personnel. Most nosocomial infections are transmitted by medical service staff who fails to practice proper hand washing or change gloves between client’s contact.

Standard safety measures are based on the principle that all blood, body fluids, secretions, discharges, excretions, non-contact skin, and mucus membrane may contain transmissible infectious agents. These standard precautions include hand washing, use of appropriate protective equipment, use of aseptic technique to lessen patient exposure to microorganisms and management of sharps, blood spills, linen, and waste to maintain a safe environment.

Compliance on the part of health workers including health students with standard precautions has been recognized as being an efficient means to prevent and control hospital acquired infections. These measures not only protect the patient but also the health care worker and the environment. Among the standard precautions advocated, hand hygiene is considered in itself the most important one. Adequate use of gloves; whose purpose is to protect the health worker as well as the patient is another important measure. A preventive measure also worthy of mention is the adoption of safe measures for the handling of needle sticks and other sharp objects in view of the possibility of outbreaks, especially of hepatitis b and c.

In Ghana, where few data is available on the prevalence of nosocomial infections, assessing the necessary knowledge, attitude and perception on the skill of infection prevention in health facilities as early as possible can give way to manage the limited resources available in the sector for health providers and clients.

The high prevalence of HIV and multi drug resistant tuberculosis, deficiency of resource allocation and disinfectants and widespread resistance of antimicrobials create major risks for health care associated infections. With the increasing rate of infectious diseases including HIV, the environment of health workers can be unsafe, risky, and stressful which could interfere with the proper and appropriate provision of health care.

Globally, world health organization(WHO) approximates that every year unsafe injections and needle stick injuries cause at least 8-16 million HBV infections, 2.3-4.7 million HCV infections and 160000 HIV/AIDS infection. WHO estimates that no less than 50% of the 12 billion injections administered each year in low income countries are unsafe posing serious health risk to patients, health workers, health students and the general population. Injuries from sharp devices have been linked with the transmission of more than 40 pathogens including Hepatitis B and C and HIV. The International Nosocomial Infection Control Consortium also estimates that 16.8 out of 1000 patients on ventilators acquire Pneumonia in Latin America, Asia and Africa. The risk of catheter associated urinary tract infection was likewise 5.5 per 1000 patients.

Standard precautions are practiced in high income countries to protect health care workers from occupational exposure to blood and the resulting risk of infection with blood borne pathogens. The situation is different in low income countries where standard precautions are partially practiced. In the African setting, sub Saharan Africa harbors the biggest populace of people living with infectious diseases. Ethiopia, Nigeria and South Africa are three countries with the most number of people living with HIV/AIDS.