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Assessment of Nurse's Knowledge about Nosocomial Infection at
Hospitals in Baghdad City
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Abstract:
Objective: To assess nurse’s knowledge about nosocomial infection at hospital in Baghdad city.
Methodology: A descriptive study was carried out at hospitals in the city of Baghdad and included (Baghdad
teaching hospital, Gazi al-hariri hospital, Al-karama hospital, Al-yarmok hospital, and al-kadhmia hospital).
Starting from 5 of August 2012 to 20 of February 2013. A non-probability (purposive) sample of 100 nurses who
worked in hospitals in the city of Baghdad.
The questionnaires was designed and constructed by the researcher according to review of literature and related
study. The content validity of the instrument was established through penal of 14 experts.
Reliability of the Instrument was determined by test-retest method which was estimated as average (r=0.802).
Data was gathered by interview technique using the questionnaire format and data was analyzed by application
of descriptive and inferential statistical methods.
Results: The majority of nurses was male, with age group 30-39 years old, nursing institute graduated, the
majority of nurses have less than 5 years of employment in the hospital and low number of training course about
nosocomial infection. The result indicated that most of the nurses (69%) have poor knowledge toward NI. There
is significance relationship at P <0.05 between nurse's educational level and their knowledge toward NI. There is
no significance relationship at P >0.05 between nurse's (age, gender, years of employment in the hospital, and
training course of nosocomial infection) and nurse's knowledge toward NI.
Conclusion:
The study concluded that the nurses not have appropriate knowledge toward nosocomail infection
Recommendations: The training course is necessary to increase nurses’ knowledge toward nosocomial
infection. This training course should be regularly done and updated in view of changing knowledge and
practices
Key words: assessment, nurse's knowledge, nosocomial infection
1
INTRODUCTION:
Nosocomial infections (NI) increase patients’ morbidity, mortality, length of hospital
stay and treatment cost (1).
Therefore, knowledge about the frequency and distribution of NI is important to
improve infection control measures as well as to develop effective preventive and curative
strategies which, in turn, will help us in decreasing incidence, morbidity and mortality(2).
Nosocomial infection (NI) referrers to as a hospital acquired infections (HAI) or simply
hospital infections are infections occurring during staying 48 hours or longer, which resulted
in the use of the 48 hour criterion in several epidemiological surveillance system (3).
NI an important health problem throughout the world and affects both developed and
developing countries, it results in high morbidity and mortality, greater use of antibiotics,
prolonged stays in the hospital and consequently increases hospital costs. An effective
knowledge about infection prevention can reduce the rate of NI and its consequence (4).
Nosocomial infection continues to be burden to the world health care system through
increased risk to patient and employees. These infections have tremendous health and
financial costs with an estimate incidence of 2,000,000 infection per year, 20.000 death per
year and added costs of billion dollars per year. Effective infection control program are
essential to controlling and preventing Nosocomial infection (5).
Objective: To assess nurse’s knowledge about nosocomial infection at hospital in Baghdad
city.
METHODOLOGY:
Quantitative design a descriptive study was conducted on female and male nurses who
work in at hospitals in the city of Baghdad and included (Baghdad teaching hospital, Gazi al-
hariri hospital, Al-karama hospital, Al-yarmok hospital, and al-kadhmia hospital). Starting
from 5 of August 2012 to 20 of February 2013.
A non-probability (purposive) sample of 100 nurses were selected from (28 nurses from
Baghdad teaching hospital, 19 nurses from Gazi al-hariri hospital, 10 nurses from Al-karama
hospital, 28 nurses from Al-yarmok hospital, and 15 nurses from al-kadhmia hospital) who
were accepted to be involved in the study.
The content validity of the instrument was established through penal of (14) experts.
Reliability of the problems scale was determined by test-retest method which was estimated
as average (r=0.802).
Data was gathered by interview technique using the questionnaire format and data was
analyzed by application of descriptive and inferential statistical methods.
Results:
Table 1: Observed Frequencies, Percents and Cumulative Percents of Nurse's Demographical
Characteristics.
Dem. characteristics Groups Freq. Percent Cum.
Percent
2
Age Groups
20 - 29 36 36 36
30 - 39 42 42 78
40 - 49 13 13 91
50 - 59 7 7 98
60 ≥ 2 2 100
Gender Male 70 70 70
Female 30 30 100
Education levels
Training course in nursing 3 3 3
Secondary nursing school 31 31 34
Nursing institute 45 45 79
Nursing college and more 21 21 100
Years of employment
in the hospital
1 - 5 43 43 43
6 - 10 28 28 71
11 - 15 14 14 85
15 - 20 7 7 92
21 - 25 2 2 94
26 - 30 3 3 97
30 > 3 3 100
Training course
0 38 38 38
1 - 5 55 55 93
6 - 10 6 6 99
10 > 1 1 100
This table indicates that the observed frequencies, percents and cumulative percents of
demographical characteristics variables in the sample which age group (30-39) (42%). More
than half of the subjects are males (70%). (45%) of sample was nursing institute in
educational level. About years of employment in the hospital (1-5) (43%) and about training
course of nosocomial infection (1-5) was larger group (55%) in the sample.
Table 2: Nurses Responses about Nosocomial Infection
Parameters
Good knowledge Poor knowledge Total
Frequency Percent Frequency Percent Frequency Percent
Nurse's
information
about
nosocomial
infection
31 31 69 69 100 100
This table indicates the nurses have poor knowledge about nosocomial infection in which just
(31%) of nurses have adequate knowledge and most of them (69%) have inadequate
knowledge toward nosocomial infection .
Table 3: Association between the Nurse's Demographical Data and their
Knowledge
Nurse's Demographical Data Contingency
Coefficient
Approx.
Sig. C.S.
Age Groups 0.291 0.773 NS
Gender 0.141 0.889 NS
3
Education levels 0.287 0.04 S
Years of employment in the hospital 0.209 0.370 NS
Training course 0.209 0.370 NS
This table shows that there are no significant correlation at P >0.05 between (age
groups, gender, Years of employment in the hospital, and Training course about hospital
acquired infection), and nurse's knowledge about nosocomial infection, which there are
significant correlation at P <0.05 between nurse's educational level and their knowledge
toward nosocomial infection.
DISCUSSION:
Throughout the course of data analysis table number (1) indicates that the majority of
the samples were (30-39) years old who were a counted (42%). This finding comes along with
result obtained from study done by (Motamed, et al., 2006) which indicated that majority of
the nurse's age were (30-40) years old (6).
In relation to gender, most of nurses in this study (70%) were male. This result is
compatible with (Abdollahi, et al., 2003) which indicated that (67.7%) of nurses in their study
was male (7).
Relative to educational level (45%) of nurses was nursing institute. This finding agrees
with results obtain from study done by (Abdollahi, et al., 2003) which indicated that the
majority of the nurses in their study was nursing institute (7).
Regarding years of employment of nurses in the hospital, about half of nurses (43%)
have less than 5 years of employment in the hospital. This result is compatible with (Taheri
and Jokar, 2007) which indicated that most of sample has less than 5 years of employment in
the hospital (8).
In relation to training course about NI, more than half of nurses (55%) take (1 - 5)
training course. This result is incompatible with (Janjua, et al., 2007) which indicated that
most of nurses take more than 5 training course about NI (9).
Throughout the course of data analysis table number (2) indicates that the majority of
the samples (69%) have poor knowledge toward nosocomial infection. This finding comes
along with result obtained from study done by (Ghadamgahi, et al., 2011; and Taneja, et al.,
2009) which indicated that majority of the nurses (67.9% and 68.3% respectively) have poor
knowledge toward nosocomial infection (10, 11).
In this study the results in table (3) reflect that there is no relation between nurse's age
and their knowledge toward NI. This result may be related to inadequate training to the nurses
about NI. This result is incompatible with (Motamed, et al., 2006) which indicated that there
is relation between nurse's age and nurse's knowledge about NI (6).
Regarding gender, there is no relation at p>0.05 between nurse's gender and their
knowledge toward NI. This result agrees with the results obtained from study done by
(Harbarth, et al., 2009) which they found that there are no relationship between nurse's gender
and their knowledge toward NI, and disagrees with the results obtained from study done by
(Motamed, et al., 2006) which they found that females were more knowledgeable than males
toward NI (12, 6).
Relative to educational level there is significant association at P <0.05 between nurse's
educational level and their knowledge toward NI. When the nurses increased their level of
education, their knowledge increased too. This finding agrees with results obtain from other
4
studies done by (Cardo, et al., 2010) which indicated that there are good relation between
nurse's educational level and their knowledge toward NI (13).
Concerning years of employment of nurse in the hospital there is no relation at P >0.05
between nurse's years of employment and their knowledge toward NI. This result may be
related to educational level of nurses or inadequate training during these years to the nurses
about NI. This result is incompatible with (Taheri and Jokar, 2007) which indicated that there
was positive relation between the knowledge and the years of employment as a nurse in to
increasing their knowledge (8).
In relation to training course, the findings showed that there is no significant association
at P>0.05 between the nurse's training courses about NI and their knowledge toward NI. This
result may be due to the facts that the nurses who have not the educational courses about NI,
or they have training course 5 years ago, or the curriculum in that course has not been
implemented effectively. This finding agrees with results obtain from other studies done by
(Adra`a, 2008) which indicated that there are no significant relation between the nurse's
training courses about NI and their knowledge about NI. This finding disagrees with results
obtain from other studies done by (Ghadamgahi, et al., 2011) which indicated that there was
good relation between nurse's knowledge and training course about NI (14, 10).
Conclusion:
According to the present study findings, the researcher can conclude the following:
1. The majority of nurses have less than 5 years of employment in the hospital.
2. Most of the nurses have less than 5 training course of nosocomial infection.
3. Nurses do not have adequate and appropriate knowledge about nosocomial infection.
4. There is significance relationship at P<0.05 between nurse's educational level and
their knowledge toward NI.
5. There is no significance relationship at P>0.05 between nurse's (age, gender, years of
employment in the hospital, and training course of nosocomial infection) and nurse's
knowledge toward NI.
Recommendations:
According to the results of the study, the researcher recommends to:
1. Training course is necessary to increase nurses’ knowledge toward nosocomial infection.
2. Training course should be regularly done and updated in view of changing knowledge and
practices.
References:
1- Coffin S.; Zaoutis T.: Health care Associated Infections, Principles and Practice of
Pediatric Infectious Diseases, 3rd edition. Churchill Living stone, 2008, P.101.
2- Park K: Park’s Textbook of Preventive and Social Medicine, 20th Edition, 2008, p.
313.
3- Vaquej B.; Rodrigoja D.: Medicine preventive Journal, Vol. 14, 2008, p. 571.
4- Juntaradee, M.; Yimyaem, S.; Soparat, P.; Ariyase, T.; and Danchavaijitr, S.: Nosocomial
Infection In District Hospital In North Thailand, Journal Of Medical Association
Of Thailand, Vol. 88, N.10, 2005, P.102
5- Ducel, G.; Fabry, G.; and Nicolle L.: Prevention of Hospital Acquired Infection, World
Health Organization, Practical Guide, 2nd Edition, 2002.
6- Motamed N.; Baba F.; Khalilian A.; and Nozari N.: Knowledge and practice of health
care worker and medical students towards universal precaution in hospitals in
Mazandaran province, Eastern Mediterranean Health Journal, Vol. 12, N. 5, 2006, Pp.
653-658
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7- Abdollahi A.; Rahmani H.; KHodabakhshi B.; Behnam N.: Determine knowledge,
attitude and practice nurses of Golestan university medical sciences about hospital
infection control, Gorgan Univ Med Sci J, Vol. 5, N. 1, 2003, p. 80.
8- Taheri Z.; Jokar F.: Comparison of knowledge of students and nursing staff in relation to
hospital infections, Journal Infection Disease Trop Med, Vol. 1, N. 37, 2007, p.83.
9- Janjua N.; Razaq R.; Chandir S.; and Rozi S.: Poor knowledge-predictor of no adherence
to universal precautions for blood borne pathogens at first level care facilities in Pakistan.
BMC infection Journal, Vol. 7, N. 1, 2007, p. 81.
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efficacy of nursing staffs in hospital infections control, Iranian Journal of Military
Medicine, Vol. 13, N. 3, 2011, Pp. 167-172.
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knowledge and practice amongst nursing staff toward infection control measures in a
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12- Harbarth S.: Nosocomial infections in Swiss university hospitals, a multi-centre
survey and review of the published experience, Schweiz Med Wochenschr, 2009, p. 97.
13- Cardo D.; Halverson P.; Fishman N.; Kohn M.; and Murphy C.: Moving toward
elimination of healthcare-associated infections, Am J Infect Control, Vol. 38, N. 9,
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infection in neonatal intensive care unit of Baghdad pediatric teaching hospitals, thesis,
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