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Pre-intervention
Post-intervention
Out-come
n= (zpq/d) 2 .
THEN n= (1.96) (1.96) (0.40) (0.60)/ (0.10) (0.10) =92
Sample size was then multiplied 2 =184 (to decrease design effect when
using cluster sample).
Sample design:
Given the study objectives and structure of the population outlined above, the
appropriate sample design chosen was stratified cluster sampling.
Selection procedures of the study subject:
Khartoum state is divided in to seven localities .These localities were considered as a
stratum but one of these localities did not fulfill the criteria of selection. Teaching
Hospitals in Khartoum state were considered as clusters. One cluster from each locality
was withdrawn and studied.
Then equal numbers of midwives from each selected cluster were taken, by division of
sample size/six giving number 30.(Total number 180 nurse/midwives).
Data collection technique and tools:
Data collection technique:
Observation
Administration of a written questionnaire.
Data collection tools:
Training Package
Teaching universal precautions (UPS) Best Practices or
protocol of Safe labor: to be applied during delivery
(TP) (H2O) -1
(H2O) =
.5% Dilute
-1=9 (H2O.
.5% Concentrate
Practical stations application of steps of UPs and protocol of the safe labor was applied
The instruments were pre-tested in the pilot study (n= 30) before final data collection
For reliability, the test-retest at a three week interval period yielded a Pearson correlation
coefficient of 0.6713
This result confirmed that the instrument was suitable for the study.
Results
Socio demographic
Frequency %
1- Marital status
Married
148 ( 82.2)
Single
12
( 6.7 )
Divorced
12
( 6.7)
Widowed
( 4.4)
Total
180
( 100)
Primary school
26
( 14.4)
Intermediate
103
( 57.2)
Secondary
51
(28.3)
Total
180
( 100)
16
( 8.9)
164
( 91.1 )
Yes
140
(77.8)
No
40
2- Education level
( 22.2)
Knowledge level of nurse midwives about HIV was more than 80%
80% of nurse/midwives prone to needle stick injury and few of them reported it (23%)
60
50
40
30
20
10
0
Series1
applica
first
secon
third
forth
fifth
six
51.5
48.6
44.4
38.7
45.5
44.9
Figure (4) Comparison 0f means of total application of UPs .Pre & post
intervention
Discussion
Education is a very crucial element for nurse midwives, particularly in
countries where there is lack of formal and well-organized infection
control programs. Despite limited resources, developing countries,
such as Sudan, still have to deal with complex issues related to
enforcement of standard precautions. In this context, exposure to risk
is increased, because of the inadequate supply of personal protective
equipments, improper disposal of medical waste, and lack of effective
sharp instrument disposal systems. In this study, despite these
conditions, Universal precautions application scores increased
knowledge
scores
increased
significantly
after
The high level of knowledge shown in this study did not correspond with
nurse midwives performance and even post intervention .This was similar to
what was mentioned by(Grellier ,2000) in the South Thames Region of the
UK who concluded that : Knowledge obtained within midwifery education
may be difficult to be translated into clinical practice.
The prevalence of needle stick injury, as shown by this study, was very high
among most of midwives who are all have needle stick injury while suturing
because of the fact that they didnt use a needle holder this, is similar to
what was mentioned by(Ismail ,etal,2005) in Egypt, who
found that
exposure to needle stick injuries were common among the HCWs (66.2%).
Also (Nsubuga and Jaakkola, 2006) in a study of needle stick injuries
among nurses in Sub-Saharan Africa showed that, 57% of the nurses and
midwives had experienced at least one needle stick injury a year. Only 18%
had not experienced any such injury in their entire career
Conclusions
This program was effective in increasing nurse midwives application of universal
precautions
The study showed a high rate of needle stick injuries occurred among nurse midwives
Also the study revealed that the nurse/midwives were highly knowledgeable, but their
knowledge did not reflect on their performance
Resources needed for safe practice should always be made available and the environment
should be much more conducive for practice
Recommendations
Creation of a body to supervise application of universal infection control precautions to
grantee the continuity of the program
We call for effective training that should include safe system of work with availability of
resources and reasonable number of staff
Application of universal precautions should be carried by all health care workers
(HCWS) during the process of labor
There is a responsibility on managers to provide appropriate Protective measures to
enable midwives to practice safely and thus, ensure safety of the women they care for
References