Nurses’ Surgical Site Infection Prevention Practices in Bangladesh

Abstract

Nurses play a significant role in providing quality care and in preventing surgical site infection. However, a thorough literature review revealed a lack of empirical studies regarding surgical site infection prevention in Bangladesh.  The objectives of this study were to identify nurses’ practices and their barriers and facilitators for surgical site infection prevention, and to propose direction for improving nurses’ practices for such prevention.  A mixed method design was used, using the Social Ecological Model as a framework.  The quantitative phase of the study was conducted using a questionnaire survey with 233 randomly selected registered nurses who were working in 3 tertiary-level hospitals.  The descriptive qualitative phase was conducted with 22 registered nurses utilizing focus groups, and with 3 nurse administrators utilizing in-depth interviews. The data were analyzed using descriptive statistics for quantitative data and content analysis for qualitative data. The findings showed that less than half of the nurses always practiced surgical site infection prevention.  Four barriers were insufficient knowledge, insufficient resources and budget supply, insufficient performance monitoring system, and lack of a surveillance system.  Two facilitators were team willingness and team support of nurses’ practices. Nurses should adhere to surgical site infection preventive practices in aspects of preoperative shaving; prophylactic antibiotic administration; and hand hygiene.  The PEAK Model is proposed for improving nurses’ practices for surgical site infection prevention but requires further testing in Bangladeshi hospitals.