IMPROVING HEALTH SERVICE DELIVERY THROUGH NURSING PRACTICE: 18th SP NURSING FORUM SI: PRESENTERS : GEORGE LUI-RN,DN,BPHN. : ROLLY VIGA-RN,BN (Acute Care). TOPIC Audit of foreign objects (sharps) and infection control problems inside laundry service at NRH during 2015-2016. Department : Infection Control/OHS, National Referral Hospital,SI IMPROVING HEALTH SERVICE DELIVERY THROUGH NURSING PRACTICE:

PRESENTATION OUTLINE: Background. Introduction. Survey Methodology. Result. Audit Findings. Possible barriers to correct infection Control. Possible Solution. Recommendation. Outcome Future direction. Reference.

BACK GROUND Infection control practices within the departments of the NRH should ensure that laundry staff are not exposed to infection risks when carrying out their roles in cleaning linen services This survey was done at laundry department since June 2015 to January 2016, the study was propose due to complaints raised by the department. This study is looking at why increasing blood stain ,instrument, needles and other human waste mix with linen brought to laundry. This study aims to identify the possible barriers to correct infection control and help improve from current practices within departments. Other research indicates that there are a number of possible reasons why sharps, foreign objects and human fluids are found in linen from individual departments, there is an increase on bed linen and associated materials as sources of infection. Fijan and Turk (2012).

INTRODUCTION All departments contributed to stained linen being collected by laundry services 2 departments (labour and theatre) had sharps etc. inside linen Clinicians felt that improving….. Would help infection control Needle stick injuries are a hazard for people who work with hypodermic syringes and other needle equipment. These injuries can occur at any time when people use, disassemble, or dispose of needles. When not disposed of properly, needles can become concealed in linen or garbage and injure other workers who encounter them unexpectedly.

AUDIT METHODOLOGY: Observation: Log book data collection – identify incidents of sharps and stains within linen. Interview laundry staff and clinical staff on possible reasons for poor infection control. The total of 110 soil linen bags was collected from each ward and check by laundry staff and enter into log book daily during the period of June 2015 to January 2016. Questionnaires .

RESULTS Linen from all departments had some human fluids and wastes (stains) on linen collected by the laundry department 2 Wards had sharps and foreign objects inside linen collected by the laundry services

STAIN LINEN - BLOOD

STAIN LINEN – BLOOD AND FAECES

INSTRUMENT/SYRING WITH NEEDLE

INSTRUMENT/SYRING WITH NEEDLE

RESULT-STAIN LINEN surgical ward 100 medical ward 110 ortho ward theatre ward 90 labour ward 80 children's ward TB ward Antinatal ward 10 Nursery ward 5

RESULT-INSTRUMENT/SYRING WITH NEEDLE: Surgical Medical Ortho Theatre 30 Labour ward 15 Children's ward TB Antenatal Nursery

AUDIT FINDINGS 62% of the ward clinical Nurse consultant said that there is no washing detergent provide in the ward. 13% of the ward clinical Nurse Consultant said that there is no proper sluice for rinse linen. 13% of the ward Clinical Nurse Consultant said negligence. 12% of the ward Clinical Nurse Consultant said that lack of reminder through staff meeting.

POSSIBLE BARRIERS TO CORRECT INFECTION CONTROL No detergent in ward (light blue 62%). Negligence (Red 12%). No proper Sluice (orange 13%). Lack of reminder through staff meeting (Purple 13%).

POSSIBLE SOLUTIONS 50% of the ward Clinical Nurse Consultant said regular Providing washing Resources to ward and Department. 37% of the ward Clinical Nurse Consultant said that regular staff education and patient orientation should be done. 13% of the ward Clinical Nurse Consultant said continue doing research /audit on clinical practices.

INFECTION CONTROL SOLUTIONS: Regular Providing of Washing Resources.(Blue 50%) Regular Staff Education and Patients Orientation.(Red 37%). Continue Doing Research and Audit on Clinical Practices.(Orange 13%)

Recommendations IMPROVE RESOURCE PROCUMENT OR WARD SUPPLY FOR APPROPRIATE DETERGENT. IMPROVE ON REGULAR EDUCATION AND STAFF PERFORMANCE SUPERVISON. IMPROVEMENT FROM NEGLIGENCE PRACTICES. IMPROVEMENT ON REGULAR AUDIT/RESEARCH ON NURSING PRACTICES.

OUTCOME For instrument 6/10/2016 -0nly one cord scissor from Labour ward reported and log into the log book by the laundry staff and 10/10/2016-only one needle from O.T reported and log into log book by the laundry staff . For human body fluid stain there is no major improvement because it beyond our boundary –it needs improvement on facility and money to purchase all the washing resource for ward, it has long term action.

Future Directions We plan to do a small follow up study to observe whether the improvements have resulted in less sharps and stains being collected in linen by the laundry department As of May 2016 How many departments have detergent? How many departments have education on this issues How many departments have sluices Any data on collected linens

REFERENCE. © Copyright 1997-2016 Canadian Centre for Occupational Health & Safety. Fijan S and Turk ss.(2012).Hospital Textiles, Vehicle for healthcare associated infections. International Journal of Environmental Research and Public Health;9(9):3330-3343.

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