Posted on 26th Sep 2024 09:29:13 PM Medicine
1.1 INTRODUCTION
Disinfectant: A product expected to kill most bacterial spores; used to decontaminate devices that ordinarily do not penetrate tissues or that touch only intact skin (Sagripanti and Bonifacino, 1999). Disinfection is an important strategy in prevention and control of cross contamination between surfaces and patients by direct or indirect contact. Healthcare settings are stages for a fight against healthcare- associated with infections HAIs (Dancer, 2005). The increasing importance of infection prevention and control is due to the increasing strains of multi-drug resistant organisms (MDROs) that can result in serious illness and even death in workers and patients (Klein et al., 2007). characteristics (aerosols vs. liquids for example), (iii) the In order to address HAIs as well as other infection prevention and control concerns, many hospitals have expanded the use of cleaning and disinfecting products Conventional cleaning products are complex ingredients have not been tested and their effects are still unknown, many of these ingredients are known or believed to be correlated with asthma and other respiratory disorders. Some others are associated with dermatitis, endocrine and neurologic effects and cancer.
Possibly, harmful exposures from cleaning are a function of multiple factors, including: (i) the chemical characteristics of the cleaning product, (ii) the physical , characteristics (aerosols vs. liquids for example), (iii) the characteristics of cleaning tasks (spraying vs. mopping) and (iv) the characteristics of the built environment to assess and compare knowledge and awareness of disinfection and sterilization among qualified nurses and undergraduate (ventilation, room size) (Bello, 2008). There is evidence that some cleaning product ingredients harm the environment by bioaccumulation in plants and animals, damaging aquatic ecosystems and polluting indoor air, outdoor air and drinking water supplies (OFEE, 2009). A wide diversity of chemical agents (biocides) is found in cleaning products and has been utilized for hundreds of years. Although, little is known about the mode of action of the active broad-spectrum antimicrobial mode of action of the active broad-spectrum antimicrobial agents in comparison to antibiotics, most of these agents reveal broad-spectrum antimicrobial activity. Disinfection is one of the essential strategies to prevent diseases. It can eliminate the majority of pathogenic microorganisms, except bacterial and fungal spore (Rutala, 1996; Rutala and Weber, 1997; Brady et al., 2003).
Disinfectant activity can be influenced by many factors, the significant difference between mean scores of the such as formulation effects, presence of an organic load, synergy, temperature, dilution and test method (Denyer et al.,1985; Russell and Russell, 1995).
Methicillin-resistant Staphylococcus aureus (MRSA) will kill more than 18,000 people this year (Klevens et al., 2007). Many of MRSA's victims will be long-term hospital patients, but some will be healthy individuals within the community (Chambers, 2001). MRS a has killed several young athletes in the past year, including four children in fall 2007 and two high school football players in fall 2008 (Oestreich, 2008; Rao and Langmaid, 2007; Tomaselli, 2007). Athletes are reporting MRSA infections across the United State .In addition to mortality from MRSA, many more athletes will sit out games and miss sports seasons (Delsohn and Franey, 2007).
What was once an exclusively hospital-acquired germ is now a community health-care issue (Chambers, 2001; Drews et al., 2006; Wyllie et al., 2006). The athletic community is especially affected by MRSA (Withers, 2006). Athletes are more likely to develop MRSA infections than non-athletic members of their community due to constant person-to-person contact, dirty equipment, and compromised skin. The cleanliness of the athletic training room where athletes receive health-care from certified athletic trainers may affect an athlete's risk of developing a MRSA infection. Contaminated equipment, such as whirlpools, treatment tables, taping tables and workout machines, may harbor MRSA. Several studies have implicated improper cleaning and disinfection of the athletic training room as contributing to MRSA infections (Begier, et al., 2004; Cohen, 2005; Kazakova, et al., 2005; Romano, and Holtom, 2006; Withers, 2006). Proper use of disinfectants is an essential component of preventing MRSA infections (Larson, 1996; Rutala, 1996).
Standards for disinfection have been established by the Centers for Disease Control and Prevention (CDC) and the Association for Professionals in Infection Control and Epidemiology, Inc. (AP1C) (Rutala, 1996; Sehulster, et al., 2004; Siegel, et al., 2007). However, it is unknown if athletic trainers adhere to these standards. (Goding et al., 2007) evaluated hand hygiene and MRSA knowledge. As of late 2008, studies on disinfectant use or knowledge about disinfectants by certified athletic trainers were lacking. Research regarding certified athletic trainers' disinfection practices and their knowledge about common disinfectants in use was also deficient. This study was created to assess athletic trainers' disinfectant practices and to assess knowledge about common disinfectants and MRSA.
ALCOHOLS
Alcohols are the base ingredient for many other disinfectants--for example, Lysol contains79%ethyl alcohol and only 0.1% orthophenylphenol. When used as a surface spray or solution on inanimate objects, alcohol is an excellent pathogen destroyer. But it must be left in contact with the item to be disinfected for long periods to do its job--20 minutes contact time is considered proper for disinfection with ethyl alcohol. The higher the "proof" of an alcohol product, the better disinfectant it is, but the more volatile and evaporative it will be. Isopropyl alcohol is not considered to be a disinfectant--it's main use is as a skin wipe to remove loose organic debris from the site of a wound or injection.
ADVANTAGES
Low cost effective against many pathogens with correct contact time.
DISADVANTAGES
Long contact time required for disinfecting action; only certain types of alcohol contain true disinfectant properties; may dissolve synthetic surfaces; fumes may be irritating and contain a fire hazard risk; not effective against some viruses; evaporates quickly, so items being disinfected must be physically soaked in alcohol to obtain disinfection.
CHLORHEXIDINE GLUCONATES
BRAND NAMES: Nolvasan, Virosan, Hibitane, Hibistat Chlorhexidine products are often used as disinfectants for inanimate objects or antiseptics for cleaning skin wounds. Some chlorhexidine compounds contain alcohol, and these have been found to have superior antimicrobial properties to those containing only chlorhexidine. Chlorhexidine is effective against many bacteria, and yeast (especially Candida). It is not effective against most viruses, mycobacteria spores and Pseudomonas. Hexachlorophene has been suggested to be a potent carcinogenic. Some aviculturists use chlorhexidine as a water additive for control of pathogens--this is not recommended by the manufacturers, as these products were never meant for ingestion, and long-term effects have not been studied.
ADVANTAGES
Recommended as a water pan additive in incubators and brooders for control of aspergillus fungus; effective against Newcastle virus; not corrosive to equipment; readily Available, medium cost.
DISADVANTAGES
Poor efficiency against most viruses and many gram-negative bacteria including Pseudomonas (Virosan is the exception--it is effective against Pseudomonas); must be discarded and re-mixed daily; not effective in the presence of organic debris; not effective against bacterial spores or mycobacterium.
CHLORINE
BRAND NAMES: Clorox, Purex
The best known member of this class is sodium hypochlorite (bleach). Bleaches are very harsh but effective. They attack pathogens, organic debris and living tissues equally well. Bleach can create toxic fumes which can lead to chemical pneumonia, skin and eye irritation or burns. It is recommended to wear protective clothing and eye gear when using bleach.
ADVANTAGES
Bleach is inexpensive; easily available without a license; depending on the concentration at which it is mixed it can kill most bacteria, viruses, and mycoplasmas; it is a potent deodorizer, and works best in the presence of sunlight which releases more free radicals (which destroy cells, including pathogens).
DISADVANTAGES
It is very caustic to tissues and equipment; very rapidly inactivated by organic debris (any dirt left on the object being disinfected will interfere with the action of the free radicals, up to the point where no chlorine is left to act on the actual pathogens); it loses its effectiveness quickly while still on the shelf in the bottle; not all brands of bleach, and not all production lots are the same concentration, so the standard dilution of 1/2 cup to a gallon of water (5:25% concentrate) may not always turn out to be the same strength; prolonged contact may be required for heavy sterilization, and the solution may require freshening every few hours. Bleach produces carcinogenic by-products, and must be used in a well-ventilated area; all objects treated with bleach must be well rinsed and allowed to dry before birds are allowed to contact them.
STABILIZED CHLORINE DIOXIDE
BRAND NAMES: Oxyfresh Dent-a-gene (full strength stabilized chlorine dioxide), Oxyfresh Cleansing Gele' (detergent with stabilized chlorine dioxide added) Stabilized chlorine dioxide is a chlorine derivative which is a powerful oxidizing agent. It can destroy many pathogens, including bacteria, viruses, fungi and protozoa. Many studies have suggested that stabilized chlorine dioxide is a superior disinfecting agent to sodium hypochlorite (bleach). It is used in Europe to treat drinking water because it does not form carcinogenic by-products like sodium hypochlorite does. Stabilized chlorine dioxide has been shown by Dr. Branson Ritchie DVM, to inactivate avian polyoma virus at a Level of dilution of 1:200. A detergent product containing stabilized chlorine dioxide is a good washing/soaking product for syringes, dishes and other hard surfaces, and can also be safely used on the skin of avian caretakers. Chlorine dioxide is an excellent deodorizer; the oxidizing Properties destroy odor-causing molecules.
ADVANTAGES
Safe for use around birds and humans at recommended working dilutions; deactivates avian polyoma virus in 1 minute contact time; diluted solution creates no harmful fumes and is safe to use on skin or other surfaces; diluted solution at 1:200 is good for 7 days once mixed if kept sealed and out of direct sunlight; when first mixing up solution, the fumes created may be used to fumigate brooders. Medium cost--1 pint makes up to 16 Gallons of diluted solution.
DISADVANTAGES
In undiluted form, fumes of stabilized chlorine dioxide may be toxic to living tissue; rapidly deactivated by organic debris and exposure to sunlight.
GLUTARALDEHYDES
BRAND NAMES : Wavecide, Cidex, Sporcide, Banacide, Sterol,This is a relatively new class of disinfectants which has come out within the past 25 years. The chemical action is to deactivate DNA and RNA proteins. They will deactivate most bacteria (including mycobacteria), viruses, and chlamydia. They are very stable and most work well even in the presence of organic debris. When mixed up in solution, they last a long time, making the cost per use fairly low. But they are very expensive to purchase initially compared to other disinfectants, and have many possible side effects, including tissue toxicity, irritation to the eyes, mucous membranes, respiratory tract and skin. Some glutaraldehyde formulas are corrosive to metals, others are not; read the label of a particular product to find the corrosive properties of that product. Never, ever mix glutaraldehydes with any other cleaning or disinfectant product.
ADVANTAGES
Equally effective in water of any temperature or hardness; effective against essentially any pathogen, even in presence of organic debris; solutions are good for longer periods than any other disinfectant available which lowers cost per use; speed of killing pathogens is very fast compared to many other disinfectants; available in many forms, Including sprays, concentrates and bulk volumes.
DISADVANTAGES
May require a medical license to purchase from some suppliers; EPA testing did not include all animal and bird pathogens--assumptions were made regarding those, based on results of human pathogen testing; may irritate respiratory system if not used in extremely well-ventilated areas; may cause eye, skin or mucous membrane irritation or damage with some brands; must be well-rinsed before allowing birds contact with cleaned surfaces; may cause skin irritation, yellowing or peeling; concentrated forms not available in all states; some forms/brands of product may be corrosive/caustic than others--it is necessary to read all labels carefully before using these products.
IODINES
BRAND NAMES: Vanodine, Betadyne, Povidone, Scrubodyne Iodine, solutions are frequently used as antiseptics for cleaning wounds and skin. Most iodine-containing disinfectants also contain a detergent, and are called “iodophors” Medium cost.
ADVANTAGES
Limited vapor production; not usually affected by hard water; long shelf life; works well in hot or cold water; are effective against many bacteria, some fungi and viruses.
DISADVANTAGES
Most require full-strength use which increases cost per use; may stain surfaces and tissues brown; toxic if ingested (may cause iodine overdose); may dry and crack skin; corrosive to metal surfaces with prolonged exposure; easily deactivated by contact with organic debris; is Not effective against hydrophylic viruses such as polyoma and PFBD (Psittacine Beak and Feather Disease); not effective against all strains of Pseudomonas bacteria.
PHENOLS
BRAND NAMES: Lysol, One Stroke Environ, O-Syl Phenols are produced by coal distillation. Sodium orthophenol is the active ingredient in most phenol disinfectants. Phenols are effective against many bacteria, including Pseudomonas and mycobacteria, fungi and some viruses. They may not work well in the presence of organic material. Some phenols are inexpensive, and are easily available at the grocery store.
ADVANTAGES
Kills many pathogens, including bacteria such as Salmonella and Pseudomonas, mycobacteria, fungi and lipophilic viruses; effective even in hard water; doesn't stain surfaces or leave residual odors, low cost; easy to rinse off objects.
DISADVANTAGES
Toxic to many tissues including skin, eyes, and respiratory tract; VERY toxic to cats and reptiles; may not work well if organic debris is present; not effective against bacterial spores or hydrophilic viruses; must be used with adequate ventilation; must be rinsed off cleaned surface before allowing birds contact with them.
QUATERNARY BAMMONIUM COMPOUNDS
BRAND NAMES: Roccal-D, Quintacide, Parvosol, Hitor, Omega, Barquat, Merquat, Cetylcide "Quats" are a large class of disinfectants which add organic compounds to ammonia. Many quats also function as a detergent, and help remove organic debris from objects. The presence of organic debris, however, may deactivate the disinfectant in the quat compound. They are not recommended for use on objects that will be in direct contact with birds because they are very difficult to rinse off completely, and residue can cause respiratory paralysis and death! May be diluted for lower cost per use, but initial purchase cost may be expensive. Quats are effective against many types of bacteria, some viruses, and chlamydia; they are not effective against spores, mycobacteria or fungi, Pseudomonas, and hydrophylic viruses Such as Polyoma or PFBD.
ADVANTAGES
May be used at very dilute solutions, allowing for lower cost per use; contains detergent for action against organic debris; pleasant scent in most forms; good disinfectant against many bacteria, few viruses, and Chlamydia.
DISADVANTAGES
Not effective against bacterial spores, Pseudomonas, fungi or mycobacteria, hydrophylic viruses; high levels of organic debris may inactivate the product; hard water may inactivate the quat product; may leave slimy residue on objects which won't rinse off; ingestion and inhalation of products or reside may cause respiratory paralysis and even death.
WOOD TAR DISTILLATES
BRAND NAMES: Pine-Sol, Hexol,Wood tar distillates are a by-product of the lumber industry. They include such products as creosotes, turpentine and pine oils. Pine oils are the only member of this group with any disinfectant applications, and only when mixed with soap. They are very safe, but have very low levels of effectiveness against any pathogens. Very inexpensive, and available at many department, hardware and grocery stores.
ADVANTAGES
Easily available; low cost; pleasant fragrance; low toxicity; detergent ingredients make them Good cleaning products for removing organic debris.
DISADVANTAGES
Very poor effectiveness against any pathogens; hard to rinse off surfaces, may leave floors slick.
As stated above, different types of microorganisms vary in their response to antiseptics and disinfectants. This is hardly surprising in view of their different cellular structure, composition, and physiology. Traditionally, microbial susceptibility to antiseptics and disinfectants has been classified based on these differences; with recent work, this classification can be further extended (Fig.1). Because different types of organisms react differently, it is convenient to consider bacteria, fungi, viruses, protozoa, and prions separately.
1.2 Background
In 1994, clearance divers using Canadian Underwater Mine-countermeasures Appara(CUMA)/Canadian Clearance Diving Apparatus (CCDA) at the Experimental Diving Unit – CFEME Toronto experienced recurrent respiratory infections. The working hypothesis to explain this problem was the practice of sharing the rebreather sets, leading to the spread of viruses and bacteria between divers. Savlon solution (Chlorhexidine Gluconate – Cetrimide based) was the product used to clean the diving equipment after each dive. In an attempt to alleviate the respiratory symptoms experienced by the divers, an alternative cleaning agent was sought. The Diving Medicine Consultant at CFEME suggested Virkon S as a suitable replacement for Savlon. Virkon S appeared to solve the immediate problem and has since gained acceptance throughout the CF diving community. The CFSME Army Dive Center recently expressed concerns regarding the use of Virkon S. It was purported to contain Glutaraldhehyde, which is a known health hazard inducing asthma (Palczynskin et al., 2001) and other allergic reactions (Guthua et al., 2001). An initial review of the components of Virkon S revealed that it does not contain Glutaraldhehyde and is Health Canada approved for disinfection on external work surfaces, but has not been approved nor was it intended for human topical disinfection (Canada, 2002). With this knowledge, the Consultant in Diving and Hyperbaric Medicine at CFEME Toronto expressed concerns over the use of Virkon S in the diving community, knowing that divers could potentially inhale the product after the equipment was cleaned.
MECHANISMS OF ACTION
Introduction Considerable progress has been made in understanding the mechanisms of the antibacterial action of antiseptics and disinfectants (Russell and Chopra,1996). By contrast, studies on their modes of action against fungi (Russell and Russell, 1995, Russell and Furr,1996). viruses (Maillard et al., 1998) and protozoa have been rather sparse. Furthermore, little is known about the means whereby these agents inactivate priors.
Whatever the type of microbial cell (or entity), it is probable that there is a common sequence of events. This can be envisaged as interaction of the antiseptic or disinfectant with the cell surface followed by penetration into the cell and action at the target site(s). The nature and composition of the surface vary from one cell type (or entity) to another but can also alter as a result of changes in the environment (Brown and Gilbert, 1993). Interaction at the cell surface can produce a significant effect on viability (e.g. with glutaraldehyde) (Power, 1995 ), but most antimicrobial agents appear to be active intracellularly (Russell and Chopra, 1996). The outermost layers of microbial cells can thus have a significant effect on their susceptibility (or insusceptibility) to antiseptics and disinfectants; it is disappointing how little is known about the passage of these antimicrobial agents into different types of microorganisms. Potentiation of activity of most biocides may be achieved by the use of various additives, as shown in later parts of this review.
In this section, the mechanisms of antimicrobial action of a range of chemical agents that are used as antiseptics or disinfectants or both are discussed. Different types of microorganisms are considered, and similarities or differences in the nature of the effect are emphasized. The mechanisms of action are summarized.
Summary of mechanisms of antibacterial action of antiseptics and disinfectants General Methodology A battery of techniques are available for studying the mechanisms of action of antiseptics and disinfectants on microorganisms, especially bacteria (Russell et al.,1997). These include examination of uptake (Hiom, 1995), lysis and leakage of intracellular constituents (DeNobel et al.,1990), perturbation of cell homeostasis, effects on model membranes (Gilbert et al.,1991) inhibition of enzymes, electron transport, and oxidative phosphorylation (Furr, Oxford, England), interaction with macromolecules (Russell et al., 1997; Trujillo and Laible, 1970), effects on macromolecular biosynthetic processes (Eklund, 1991), and microscopic examination of biocide-exposed cells (Beveridge et al., 1991). Additional and useful information can be obtained by calculating concentration exponents values (Hiom, 1996) and relating these to membrane activity (Hugo, 1987). Many of these procedures are valuable for detecting and evaluating antiseptics or disinfectants used in combination (Fitzgerald et al., 1999). Similar techniques have been used to study the activity of antiseptics and disinfectants against fungi, in particular yeasts. Additionally, studies on cell wall porosity (DeNobel et al., 1989) may provide useful information about intracellular entry of disinfectants and antiseptics (Hiom et al., 1992).
Mechanisms of antiprotozoal action have not been widely investigated. One reason for this is the difficulty in culturing some protozoa (e.g., Cryptosporidium) under laboratory conditions. However, the different life stages (trophozoites and cysts) do provide a fascinating example of the problem of how changes in cytology and physiology can modify responses to antiseptics and disinfectants. (Khunkitti et al., 1997) have explored this aspect by using indices of viability, leakage, uptake, and electron microscopy as experimental tools. Some of these procedures can also be modified for studying effects on viruses and phages (e.g., uptake to whole cells and viral or phage components, effects on nucleic acids and proteins, and electron microscopy) (Rogers et al., 1985). Viral targets are predominantly the viral envelope (if present), derived from the host cell cytoplasmic or nuclear membrane; the capsid, which is responsible for the shape of virus particles and for the protection of viral nucleic acid; and the viral genome. Release of an intact viral nucleic acid into the environment following capsid destruction is of potential concern since some nucleic acids are infective when liberated from the capsid (Maillard and Russell, 1997), an aspect that must be considered in viral disinfection.
Important considerations in viral inactivation are dealt with by Klein and Deforest (Klein and Deforest, 1983) and (Prince et al., 1991 ), (Grossgebauer, 1970). Alcohols although several alcohols have been shown to be effective antimicrobials, ethyl alcohol (ethanol, alcohol), isopropyl alcohol (isopropanol, propan-2-ol) and n -propanol (in particular in Europe) are the most widely used (Morton, 1983). Alcohols exhibit rapid broad- spectrum antimicrobial activity against vegetative bacteria (including mycobacteria), viruses, and fungi but are not sporicidal. They are, however, known to inhibit sporulation and spore germination (Yasuda-Yasuki et al., 1978), but this effect is reversible (Trujillo and Laible, 1970). Because of the lack of sporicidal activity, alcohols are not recommended for sterilization but are widely used for both hard-surface disinfection and skin antisepsis. Lower concentrations may also be used as preservatives and to potentiate the activity of other biocides. Many alcohol products include low levels of other biocides (in particular chlorhexidine), which remain on the skin following evaporation of the alcohol, or excipients (including emollients), which decrease the evaporation time of the alcohol and can significantly increase product efficacy (Bush et a., l998). In general, isopropyl alcohol is considered slightly more efficacious against bacteria (Coulthard and Skye, 1936) and ethyl alcohol is more potent against viruses (Klein and Deforest, 1983); however, this is dependent on the concentrations of both the active agent and the test microorganism. For example, isopropyl alcohol has greater lipophilic properties than ethyl alcohol and is less active against hydrophilic viruses (e.g., poliovirus) (Klein and Dforest, 1983). Generally, the antimicrobial activity of alcohols is significantly lower at concentrations below 50% and is optimal in the 60 to 90% range.
Little is known about the specific mode of action of alcohols, but based on the increased efficacy in the presence of water, it is generally believed that they cause membrane damage and rapid denaturation of proteins, with subsequent interference with metabolism and cell lysis (Larson and Morton, 1991). This is supported by specific reports of denaturation of Escherichia coli dehydrogenases (Sykes, 1939) and an increased lag phase in Enterobacter aerogenes, speculated to be due to inhibition of metabolism required for rapid cell division (Dagely et al., 1950).
Glutaraldehyde. Glutaraldehyde is an important dialdehyde that has found usage as a disinfectant and sterilant, in particular for low-temperature disinfection and sterilization of endoscopes and surgical equipment and as a fixative in electron icroscopy. Glutaraldehyde has a broad spectrum of activity against bacteria and their spores, fungi, and viruses, and a considerable amount of information is now available about the ways whereby these different organisms are inactivated . Earlier reviews of its mechanisms of action have been published (Gorman and Scott, 1980 and Power, 1995).
MECHANISMS OF RESISTANCE
As stated above, different types of microorganisms vary in their response to antiseptics and disinfectants. This is hardly surprising in view of their different cellular structure, composition, and physiology. Traditionally, microbial susceptibility to antiseptics and disinfectants has been classified based on these differences; with recent work, this classification can be further extended. Because different types of organisms react differently, it is convenient to consider bacteria, fungi, viruses, protozoa, and prions separately.
1.3 RATIONALE
DISINFECTANT- An agent that will destroy many of the disease-causing microorganisms present on the surface of an inanimate object. Alcohols which are low cost: effective against many pathogens with correct contact time. But long contact time required for disinfecting action; only certain types of alcohol contain true disinfectant properties; may dissolve synthetic surfaces; fumes may be irritating and contain a fire hazard risk; not effective against some viruses; evaporates quickly, so items being disinfected must be physically soaked in alcohol to obtain disinfectant . It toxic to many tissues including skin, eyes, and respiratory tract. The use of many chemicals with toxic characteristics in health care environments necessitates additional protection for health care workers. In addition to worker safety, patient safety needs to be considered when selecting possibly hazardous chemicals to be used in the health care setting. Disinfection is an important strategy in prevention and control of cross contamination between surfaces and patients by direct or indirect contact. But the use of disinfectants and the precautions necessary when using disinfectants. Nurses are working in infection prevention . Nurses act as a managers and matrons. Nurses are the important member of the health care delivery system. Properly use of disinfectant and infection control are very important part in the hospital. Infection control measures can be as simple as knowledge and properly use of disinfectant. So nurses minimum knowledge essential in this aspect. As a result this study is aim to find out the knowledge of disinfectant and their uses.
1 .4 RESEARCH QUESTION
What are the level of nurses knowledge on different disinfectant and their uses ?
1.5 RESEARCH OBJECTIVES
Objective of the study
General objective: To assess the Nurses knowledge regarding different disinfectant and their uses.
Specific objective
1. To assess the socio –demographic information of the respondents.
2. To find out definition of disinfectant.
3. To find out uses of disinfectant.
4. To assess the know-ledge about advantage and disadvantage of disinfectant.
5. Relationship between knowledge and socio demographic characteristic of the respondent.
1.6 VARIABLES
Variables used in this study are:
Independent Variables:
· Age
· Sex
· Religion
· Marital Status
· Academic qualification.
· Professional qualification.
· Complete B.Sc from.
· MPH from
· Special course
· Long of special course
· Length of service
Dependent variables:
1. Socio demographic information of the respondent.
2. Knowledge about definition of disinfectant.
3. Knowledge about uses of disinfectant.
4. Knowledge about advantage and disadvantage of disinfectant.
1.7 OPERATIONAL DEFINITION
Disinfectant: Disinfectant refers to eliminate most micro organism on the surface or object but not eliminate spore.
Nurse : Nurse is a ideal person who give care of the patient for recovery from disease, due to prevention and control of infection .She is qualified by getting degree diploma in nursing or B.Sc in nursing or other institution.
Knowledge: In this study knowledge refers to the degree of knowing, how much the nurse to know the information about different disinfectant and their uses.
Regarding : Regarding refer to concerning to or with regard.
Contamination: A generic term used to describe both organic soiling and contamination by micro-organisms.
Decontamination: An umbrella term used to processes that render items safe for reuse. The processes always include cleaning and may also involve disinfection and/ or sterilization, depending on the purpose of the item.
Detergent: A water-soluble cleaning agent that can remove water-soluble and oily dirt.
Dirt: A generic term used to describe organic soiling.
Sporicide: A chemical agent capable of killing spores produced by bacteria such as Clostridium difficile (“C.diff”).
Wipe: in health care settings, a pre-moistened fabric material used for wiping in order to clean disinfectant surface.
1.8 LIMITATION OF THE STUDY
This study has some limitations. It was a hospital based study. Hospital based study usually bears some limitations. During this study various type to limitations were faced which may influence the quality of the study. These are as follows:
1. The study place was conducted purposively, the findings are limited the study group and can not be generalized. The population (50) was a fraction of total nurse who was care giver in surgery ward and there are very busy. So response of limited respondents might be different from that of the vast majority.
2. The methodology was done cross-sectional.
3. One of the limitations of the study was that it was conducted on a small sample size. The sample size was not calculated following statistical method, rather this was done purposively.
4. It was not always possible to interview the respondents in complete isolation. So respondents who were present in front of others’ during the interview were to some extent biased by them.
5. There were so many surgery wards in Rajshahi city, but data were collected from one hospital and there are very busy.
6. Economic and time limitation were also major constrains. If there were economic support and wider time the study could be done in wider aspects with large number of respondents.
7. Lack of willingness of the respondents and limited research knowledge.
CONTENTS
Abstract
CHAPTER-1
1.1 Introduction
1.2 Background of the study
1.3 Rationale
1.4 Research question
1.5 Research objectives
1.6 Variables of the study
1.7 Operational definition
1.8 Limitation of the study
CHAPTER-2
2. Literature review
CHAPTER-3
3.1 Study design
3.2 Place of study
3.3 Study population
3.4 Selection criteria
3.5 Study period
3.6 Sample size
3.7 Sampling technique
3.8 Research Instrument
3.9 Data collection procedures
3.10 Data processing and analysis
CHAPTER-4
4.1 Demographic questionnaire
4.2 Nurses knowledge regarding different disinfectant and their uses
CHAPTER-5
5. Discussion
CHAPTER-6
6.1 Conclusion
6.2 Recommendation
CHAPTER-7
References
ANNEXURE
Informed consent
Questionnaire
LIST OF TABLES
Table 1. Demographic information of the Nurse
Table 2. Knowledge related question
LIST OF FIGURES
Figure 1. Show the respondent age percentage.
Figure 2. Show the respondent professional qualification percentage.
Figure 3. To assess nurses knowledge regarding disinfectant.
Thesis, Assessment, Nurses, Knowledge, Regarding, Different, Disinfectant, Rajshahi, Nursing, College, Medical, Hospital
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