CHAPTER-1 Introductions:Good health depends in part on a safe environment clients in all health care setting are setting are

at risk for acquiring infections because of lower resistance to infection microorganisms and invasive procedures Hospital-acquired infection also called Nosocomial infections are defined as defined as infections developing in the patients offer admission to hospital neither present nor in incubation at the time of hospitalization

which were

such infections may manifest during their stay in hospital some timer after the patient is discharged. In 1861 observed the association of puerperal sepsis with the attendants on patients by medical officers and students & he was successful to bring a dramatic chlorinated

reduction in infection rate by the introduction of hand washing with line.

After her experience of hospital acquired infections Florence night gale(1883) wrote in her book notes on hospital infection.. The very first should to the sick no harm. The actual mortality

requirement in a hospital that it

in the hospital, especially in those of large crowed cities, is very much higher than any calculation founded on mortality of the same class of disease among student

treated outside hospital lord leister (1867) introduced his antiseptics surgery with the extensive use of carbolic acid. In ambulatory care facilities client may be exposed to pathogens, some of which may be resistant to antibiotics. In all settings the clients and families must be able to know the sources of infection and be able to institute protective measures clint teaching should include information concerning infections, mode of transmission, methods of etc. The students can protect them form contact with infection material by having knowledge of the infection process & barriers protection. Understanding the chain of infection the (health care students workers) intervenes to prevent infection. 1 prevention

When the client acquires Nosocomial infection the student observer signs symptoms and takes appropriate action to prevent its spread. The course of an infection

influences the `level of using care provided the incident

of Nosocomial infection

can be reduced when to the student practicing aseptic techniques. An analysis of laboratory findings providing information about students defense against infection by know the factors that increasing susceptibility or risk for infection students should be alert other healthcare team to the potential need for therapy and initiates supportive nursing measures. Patient in hospital are likely to get sick due to a new variety of micro organisms responsible for wide spectrum of hospital infection, bacterial isolates of mare resistant to standard antibiotic therapies, and a variety if health care providers

directly involved in patient care. So, hospital has increasing become unsafe place for patient during their stay infection is a health hazard of great expanses and significance affecting the final outcome of treatment. Hence, it is the responsibility of to ensure an adequate arrangement to control the risk of infection since infection control is the quality standard of patient care it is essential well being of patients and safety of both students in a population also infection control measure are to be viewed as a priority and have for be fully

integrated into the continuous process of improvement of quality care.

NEED FOR THE STUDY An infection acquired in the hospital that was not present at the time of hospital admission Hospital acquired infections add over 7.5 million it result in approximately 20,000 death and contribute to 60,000 more deaths yearly in the united states (Wilson et at 1991) Mortality rates may be as high as 25% far infection with some organisms. The estimated cost attributed to catheter related blood stream infection 3,700 to 29,000 per case ( marvel 2000) incidence of Nosocomial infections in children varies by age and hospital unit, ranging from 0.2% to 23.5% in prospective cohort studies. A recent multicenter European study demonstrated on overall hospital Nosocomial infection rate of 2.5%, with the high est. rates in pedantries (23.5%) hematology units (8.2%), and neonatal units (7%) and the lowest rate in general pediatric units (1%). A second prospective cohort study of 4684 pediatric patients found the highest Nosocomial infection rates in children aged 23 months or younger (11.5%). Studies to determine the attribute morbidity, morbidity and cost of Nosocomial infection controlling for length of stay before infection, have not been performed in children. A study of 100 Nosocomial infections at the hospital for sick patients in estimated the attributable cost of Nosocomial infection at 12000 per patient 40% of patients with Nosocomial infection had morbidity attributable to the infection, including increasing length of stay and invasive procedures. Mortality was 11% among infected patients. Students have an important role in assess the Nosocomial infection and decrease incidence educating the students to understand the importance of hand washing and immunization in preventing the spread of disease cant be over emphasized. Hence we felt the need for improvement of student knowledge regarding prevention of Nosocomial infection. Hospital acquired (Nosocomial) infection (HAIS) increase morbidity, mortality and medical costs. In the USA alone, Nosocomial infections cause about 1.7 3

million infections and 99000 deaths per year. Approximately 15% of Nosocomial infections on the results of patient to patient transmissions of the causative organisms. During 100,781 patient days, 100,829 microbiological specimens from 24,362 patients were sampled average investigation density: 1.0 sample per patient and day. The incidence density of 12.1 per 1000 patient days; range (6.2-16.6) were discerned. Approximately 15% of Nosocomial infection are the result of the cross transmission of causative organisms between patients. The present study attempts to correlate a measure of adherence to standard infection control i.e., the rate of bacterial cross transmission. An estimated 2 million patients develop Nosocomial infections in the united states annually. The increasing number of antimicrobial agent. Resistant pathogens and high risk patients in hospitals are challenges to progress in preventing and controlling these infection we identified 631 infections in 498 patients on average only57% of the infections were properly recorded and cooled in the discharge abstract. Over 1.4 million people worldwide are suffering from HAIS or Nosocomial infections as they are called. In India Nosocomial infection rate is at over 25% and it is responsible for more mortality than any other form of accidental death. 36.2% infection was found per 1000 patient day in the hospital acquired infections were reported in58 patients out of 100, the extent of ventilator associated was found to be 30.7% per1000 ventilators days. Incidences of infection control groups range of from 5% to 85% moreover, the incidence of ventilators associated in the control groups varied from 5% to 85% the incidence of disease is 50% lower on average. The calculated rate is studies from 0.43 to 1 The mortality in the control groups in these studies varied from 10% to 58% in all studies. It was only the mortality of patients which they remained in the hospital that was assessed. Mortality demonstrate by orderly 20% and in the varied from 0.52(95% to 0.12-0.92). the reduction in mortality in these analysis was 20% and 40% when only studies with patients were analyzed. 4

The reports that between 1990 and 1996 and coil, staphylococcus aureus and Enterococci were the most common infecting organisms of Nosocomial infection every year while hospitalized. Approximately 240,000 additional residents of long terms care facilities become infected each year, with anticipated growth of population this may increase to 750,000 by 2005. We identified 631 infections in 498 patients on average only 57% of the infections were properly recorded the 217 patients enrolled, 201 were included in the final analysis, seventy seven (38.5%) patients developed one or the other infection.

CHAPTER-II 1. Problem statement:A study to assess the knowledge regarding prevention of Nosocomial infection among GNM students in Sri Krishna Chaithanya School of Nursing of Madanapalli. 2. Objective: To assess the knowledge of GNM students regarding prevention of Nosocomial infection. To prepare & provide health education module of Nosocomial infection 3. Operational definitions:Assess Knowledge : - The ability to evaluate knowledge of students. : - Refers to awareness of students in selected areas at Madanapalli. Nosocomial infection: - It is also called hospital acquired infections; it is defined as infection occurring in admitted hospital. Prevention : - In this study it refers of an action which taken Before the occurrence of Nosocomial infection. Self instruction module : - It refers to personally to provide informed for the life style Assumptions : Students may be willing to express their knowledge regarding prevention of nosocomial infection. Students may have some knowledge regarding prevention of nosocomial infection. Health education module will improve the knowledge.

Limitations :The study is limited to Who are willing to participate in the study? Who are available during the study?

CHAPTER-III 1. Review of Epub 2011, Jan 25:Hospital acquired infections are spread by numerous router including surfaces especially hands air, water, intravenous routes, aril router and through surgery multiple infection control techniques and strategies simultaneously may offer the best opportunity to reduce the hospital acquired infection most of these infection control strategies will mark then pay for themselves by saving the medical costs associated with Nosocomial infection. 2. Review of Difillippo 2009:over the last 5years clinical traits in vesting action product procedures and treatments aimed at preventing infection in the hospital have been described the findings of these studies appear to confirm the effectiveness of certain preventive procedures with regard to ventilate associated pneumonia the efficacies of decontamination of the all parts all these procedures can be incorporated into departmental protocols for the prevention Nosocomial infections in the hospital level A systematic review of the hand washing:Hand washing is improved by incising the ration of the number of sinks as hand cleaner Dispenser to beds provided automated water appears not to increase hand washing rates compared to traditional non automated sinks a combination of bed side antiseptic hand rub dispensers and posters to remind staff to an improvement in health care workers hand washing compliance glove use was shown to diminish compliance with pre care hand washing by a much as to prevent infection.

3. Review of reducing hospital acquired infection by design Wilson (2006) A study of the planning and building of new hospital to reduce infection by design they tried to make hand basics were placed as the window all in front at approaching staff and one the peninsula units alcohol hand get was also planned for every bedside hoverer, they did not evaluate the impact of their design on infection control. 4.Review of Vietri-2004:-The effect of moving to a new hospital facility on the prevalence on methicillin resistant Staphilococcus aureus the design of the new facility is much more conductions to the performance of good infection control for 8

example ward beds are segregated into 1-4bed rooms with a sink at each room entrance each with at least 2 dedicated sinks Radical facility design changes, which would be permissive of optimal infection control practices, were not sufficient, by themselves to reduce the Nosocomial spread of infection. 5. Review of MC Gaskin (2006): The effect of random voice hand hygiene massages delivered by medical, nursing and infection control staff in hand hygiene compliance in care. Intensive They found that using random voice message increased hand washing compliance. Twelve voice messages on hand washing compliance facts such as hand hygiene should occur before and after patient contact, and soon well installed to deliver prompts to 2 amplified external speakers.

6. Review of Lesson Etal,(2005):- Effect of antiseptic hand washing, alcohol sanitizer on healthcare associated infectious in neonatal intensive care units. - Tow hand hygiene products were a traditional antiseptic hand wash and an alcohol hand sanitizer. - Each product was used for 11 consecutive months in each neonatal intensive care unit in random order. - These were no significant difference in neonatal infections b/n the two products. -The skin condition of participating nurses was significantly improved during the alcohol phase (p=.02 and p=.049 for observes and self elements, respectively), but these were no significant deference in mean microbial counts on nurses hands. - How raining the impact on infection rats of a single intervention is challenging became of multiple contributory factors such as patient risk unit design, and staff behavior other practices such as quality of hand hygiene are likely to be as important as product in reducing vise of cross transmission. 7. Review of surveillance data of nasocomial in reducing risk of cross transmission. Siena Barwolff, MD.2010:-

Roles of

increasingly used for public reporting and inter hospital

comparisons. These exogenous infection could be prevented by adherence to basic infection control misers measurements and main results primary isolator of six

indicator organism (acinetobacter Baumann, enterococcus facility and fascism, klebsiella pneumonia, pseudo staphyio coccus cures) cultured from clinical samples or methicillin resistant soured surveillance testing of all in patients were

genotyped.indistiuguishable isolates in >2 patients defined potential episodes of transmissions surveillance of Nosocomial infection rates was performed according to the Nosocomial infection rates was performed according to the germen hosocomial infection surveillance system, kvankenhaus infections surveillance system,

kvankenhaus infection rates was performed. According to the germen hosocomial infection surveillance system differences in nasocomial infection rate by cross transmission 8. Review of efficiency of Nosocomial infection control Robestw. Helcy 1993 October:With the emergence of Nosoconial infection as a serious problem among us hospitals, the centers for disease control under took in 1974 a nationwide study to evaluate approaches to infection control. The three phased project now known as the study on the efficacy of Nosocomial infection control or senic project was designed with three primary objectives. To determine whether land id so to what degree the implementation of infection surveilance and control programs (ISCPS)has lower the rate of infection. To describe the current status of ISCPS and infection states To demonstrate the relationship among characteristics of hospital and patients components of ISCPS and changes in the infection rate with data collection completed in a nationality representative sample of hospitals and to point out additional specific questions to be answered by future research. 9. An overview of Nosocomial infection including the role of the micro bilgy laboratory TGEMORI move and gayner 1987 may. An estimated 2 million patients develop Nosoconial infections in the united stats annually the inarching number of anti microsobial agent resistant pathogens and 10 Nosocomial

high-risk patients in hospitals are challenges to progress in preventing and controlling these infections. While Escherichia coli and Staphylococcus aureus remain the most common pathogens is lasted overall from Nosocomial infection coagulase negative staphylococci organisms previously considered contaminats in most culture are now the predominate pathogens in blood stream infection the growing number of antimicrobial agent resistant organism is trouble some particularly vancomycin resistant Enteroccous and pseudomonas auruginosa resistant to imipinem. The active involvement and cooperation of the microbiology laboratory are important to the infection control program particularly in surveillance and the use of services for epidemiologic purpose. 10. Review of Reliability of Kwilkesson October 27,2004 Proper reporting of discharge diagnoses, including complications of medical care is essential for maximum recovery of revenues under the prospective reimbursement system. To evaluate the effectiveness of abstracting techniques in identifying Nosocomial infection at discharge, discharge abstracts of patients with Nosocomial infections were reviewed during September through November of 1984. Patients with Nosocomial infections were identified using modified centers for disease control (CDC) definitions and trained surveillance techniques. Although these lost revenues are substantial, they constitute but a small proportion of the potential costs to the institution where patients acquire Nosocomial infections. 11. Review of an Indian experience Dheeraj Gupta, MD, Ritesh Aggarwal. There is a paucity of data on Nosocomail infection in India . we determined prevalence pattern risk factor and outcome of infections acquired inpatients admitted to our respiratory intensive care unit. Data on RICU acquired infection were collected prospective over a15 month period the presence of risk factor such as endotracheal intubation, surgical drains, renal failure, diabetes mellitus, malignancy immunosuppressive therapy were evaluated in patients who developed infections used univarite logistic. and multivariate Report Nosocomial infections RM Manssanasi, laboratory

11

Infections acquired during hospitalization prolonged ICU stay but had no effect on ICU survival. 12. Review of PGI plans to control hospital acquired infection Aditipaddon tribune news service. Chandigarh July 29 Rising to the challenge posed by hospital acquired infection (HAIS) which are emerging can global health concern, the PGIMER today reiterated its commitment reducing that risk at the tertiary care institute. Like other hospitals of the world, the PGI is not out of bounds for HAIS which have been found to be prevalent an in infection care committee of the PGI through active surveillance has accumulated the following. Data pertaining to HAIS at the institute . Dr. A.K. Gupta aggress, it is tenacious to eradicate HAIS. It is more expensive more prolonged and results in the wastage of hospital resources. Excessive use of antibiotics must also be avoided. There in appropriate and over use leads to growth of drug resistant organisms. 13. Reviews related to Foreign Literature Katrena Wells (2009) in her article. Best ways to prevent Nosocomial infection suggests five ways to help prevent the spread of infections in hospital these are hand hygiene, avoiding infecting others if you are sick using a tissue when you cough or sneeze ensuing should be sanitized before they touch your skin. Others methods of preventing Nosoconial infection include observance of antiseptic technique frequent hand washing especially between patients careful handling cleaning and disinfection of fomites air filtration with in the hospital, and of single use disposable items. 14. Reviews related to hospitals may bring diseases and infections Smith, Tohn 2009. Hospitals may bring diseases and infection to students while attending to all the patients needs because they are the primary attending to all the patients need because they are the primary care gives of patients and are more in contact with the patients. Preventive measures are being implemented for the pts and to the students as 12

well as in order to prevent Nosocomial infection some precautionary measures must be implemented in the event of any social conflict with in the area like using gloves as a protective gear to prevent transmission of diseases from patients on to the student and proper hand washing . 15. Reviews related to hand washing by health care worker john Bosso (2004) Hand washing by health care workers in crucial in preventing and controlling the spread of Nosocomial infection only through staff education and awareness ongoing surveillance and appropriate in tervention can this can problem be alleviated. 16. Reviews related to preventing the spread of disease Maggie Edgar(1996) Tips for provide stated that care providers can stay healthier by following these guidelines wash hands properly and frequently maintain current immunizations especially tetanus like scheduled breaks and vacations observe good nutrition exercise regularly rest sufficiently each day and engage in hobbies or other activities that do not involve caring for someone else care providers who are ill should take care and they can spread germs to others. A health care provider is the key to a healthy. Happy client care experience for clients and their families. 17. Reviews related to conducted a study entailed a study of students Bridger(1997) Conducted a study entitled a study of students views about the Nosocomial middle university royal free hospital at London, UK. this study sought to discover the contribution of students practice to the prevention of hospital acquired an

Nosocomial urinary tract infection (NUTIS) the most commonly Nosocomial infection this qualitative study utilized unstructured interviews to explore the views of 12 registered students about three key issues first what care do study give with the aim of preventing catheter associatiated NUTIS secondly. 18. Reviews related to entitled Nosocomial infection Handwashing compliance. Comparing hand hygiene protocols sensor operater faucetsavets evidence for knowledge this study was conducted in the mediam sized the hospitals and educational institutions the examine the e effect of appropriate quality management activities on Nosocomial infection rates during a 26 month period the study focus on 13

medical department and were included to capture data for students requiring this type of treatment after any surgery the result was mainly aware of opportunities to use quality improved and survival activities as strategies to reduce the risk of infection. 19. Hand washing program for the prevention of Nosocomial infection Saupin won etal (2004): hand washing program for the prevention of nosocomial infection in the ward that was held at a level III in teaching hospital. The participate are statement in the word and the objective of this study is to evaluate effecte of a hand gygiene program on compliance with hand hygiene and the rate was asocddiated with a significance decrease in rated of nosocomial infection in particular and that washing rate of nosocomial infection in particular and that washing hand is a simple economical effective method. 20.Extensive epidemiological surrey of the microbilogical monitoring of the student Torregrossa M.V retention cocchiarap (2000) prevention of hospital.

Ocquired infection in the patient cente this study reports on an extensive epidemiological survey this study reports on an extensive epidemiological surrey of the microbiological monitoring of the environments students the aim of the survey was to evaluate the presence and distribution of environmental sources of nosocomial infection in immunocompromised hostes strains strains collected from air tap water and medical and were compared with strains isolated from infection to student the potential route of batleria the nesults showed environment strains present ion a profice identification to that the clinical strans suggesting alink between the student and other. 21.Reviews related to treatment in a hospital or a health care unit according to narciso D.Santiago. Nosoconial infection is a result of treatment in a hospital or a health care service unit but secondary to the patients original condition, it is a hospital acquired infection or more generally know as health care associated infection that is responsible for the large number of death in the word hand washing and improving hygiene praction in the hospital is the effective way for teducing the wpread of there infections.

14

22.Reviews related to hospital acquired infection disclouse act of 2009 according to (camero. Jazmin,20009):Hospital acquired infections disclosure act of 2009 requires all hospetals to submit a yearly report of all the collected data regarding hospital acquired infection care to the department of health then the will submitted by the hospitals. The department of health shall also appoint members of the advisor y committee which includes the physicians representation of infection control department of both private and public hospital academic research epidemiologists health maintenance organization and health insures who will help the department formulate and establish standards rules and regulations needed to execute this bill. 23.Reviws related to surveillance is the close and continuing observation individual or group, according to tessa tan tores ,M.D :Its goal, in the hospital is the collection of accurate reliable and timely data on infection and modifiable diseases acquired with in the hospital surveillance data also includes information on risk factors etiologic agents and antimicrobial susceptibility. The specific aims of sur of surveillance are the following. Detect the areas of concern in terms of infection control. Identify potential epidemics. Anis and consider the effectiveness of infection control measures. Remind the personnel about the infection control practices. Give and provide about for comparison with other services. Surveillance of nosocomial infection is not a control measures by it self and the present of ICC personal can possible lead to stricter adherence on infection control practices among the hospital staff. 24.Reviews related to hoscomial infection convince to be of major clinical and epidemiogical importacnce. According to hillippine journal of micro biology and infection disease:It is was stated that nosocomial infection continues to be major clinical and epideniologcal importance and this night be because of the continuous incidence of transmission of hosocomial infection which is great improper delivery of health this kind of infection develops during a clients confinement at the clinical facility. But not 15

also that is can be mainfected even affer cient is also that is can be manifested even after the client is discharge moreoves nosoconical infection are not clinical to patents but also the health care works can also acquire this situation which usually give asigunifiction effect on the health works life style. 25.Reviews related to health care works knowledge skills and attitudes for good infection control practices according to katz ss.MD 2009:Health care works should be equipped with control practices the infection control team should an training needs of the staff and provide required training through awareness programs in service education and on the staff for essential

infection control practices that are appropriate to their job description provided periodic re-training or orientation of staff and reiew the impact of training.

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CHAPTER - IV METHODOLOGY This chapter deals with the research, research design, setting of study, variables, Population, sample size, sample, sampling technique, criteria for sample selection, description of the tools, and procedure for data collection and plan for data analysis. Research approach:An evaluative approach was used for the present study. Setting of study:The study is conducted in Sri Krishna Chaithanya School of nursing at Madanapalli. Variables:Dependent variable is the knowledge on prevention of Nosocomial infection. Attribute variable Sample :- The sample of the present study was students who full fill inclusion criteria. Sample :-the sample size is 25 samples Sampling Technique:- the purposive sample technique is used to select the sample Criteria for sample selection a) Inclusion Criteria : students who are available at the time of study students who are willing to participate in study b) Exclusion Criteria: Students who are not available at the time of study Students who are not interested and willing to participate in the study.

17

Population: in the present study the target population comprised of students the accessible population in this study were students those who fulfill the inclusion criteria during time of data collection. NOSOCOMIAL INFECTION Introduction of Nosocomial infection:There is no hospital however small, air or well ventilated, where the epidemic under is not to be found of times, and thus no operation dared to be performed. Every cure stands still, every wound becomes acre and every sore is gggg to run into gangrene. But in great hospitals specially, it prevails at all times and is a real gangrene. The term nosocomial infection that was neither present gggg was in its incubation period when the patient entered the hospital. Nosocomial infection may also make their appearance after discharge from the hospital, if the patient was in the incubation period at the time of discharge. In the united states centers the centers for disease control and prevention estimate that roughly 1.7 million hospital associated infections, from all types of micro organisms, the mortality and morbidity rate is increased, the nosocomial infection is among the most difficult problems confronting clinicians who deal with severally in patients. Definition:A hospital acquired infection also called a Nosocomial is an infection that first appears between 48hours and four days after a patient is admitted to a hospital or other health care facility. Causes: - All hospitalized patients are at risk of acquiring an infection from their treatment or surgery. Some patients are at greater risk than others, especially young children. Prolonged hospital stay. Severity of underlying illness. Compromised nutritional or immune status.

18

Use of individually characters Failure of health care workers to wash their hands between patients or before procedures.

Bacteria Some common procedures that increase the risk of hospital acquired infections include.

Urinary bladder catheterigation. Respitatory procedures such as incubation as mechanical ventilation. Surgery and the dressing are drainage of surgical wounds. Intravenous (IV) procedure for delivery of medication transfuction or nutrition.

Symptoms: Fever is often the first sign of infection. Other symptoms and signs of infection are rapid breathing, mental confusion, low blood pressure, pain reduced urine output, and a high white blood cell count. Patients with a UTI may have pain when urinating and blood in the urine. Symptoms of pneumonia may include difficulty breathing and inability to cough. A Canalized infection begins with swelling, redness and tenderness on the skin

Diagnosis:Infection is suspected any time a hospitalized patient develops a fever that cant be explained by the underlying illness. Some patients, especially the elderly, may not develop a fever, In these patients. The first signs of infection may be rapid breathing or mental confusion and inflammation.

19

Diagnosis is determined by: Evaluation of symptoms and signs of infection. Examination of wounds and catheter entry sites for redness, swelling or the presence of pus or on abscess. A complete physical examination and review of underlying illness. Laboratory tests, including complete blood count (CBC) especially to look for an increase in infection fighting white cells. Urinalysis looking for white cells or evidence of blood in urinary tract, cultures of the infected area, blood, sputum, urine or other body fluids or tissues to find the causative organism. Chest x-ray may be done when pneumonia is suspected to look for the presence of white blood cells and other inflammatory substances in lung tissue. Review of all procedures performed that might have led to infection.

Management:Treatment:Cultures of blood, urine, sputum, other body fluids, or tissue are especially important in order to identify the bacteria, fungi, virus, or other micro organisms causing the infection. Once the organism has been identified it will be fasted again for sensitivity to arrange of antibiotics so that the patient can be treated quickly and effective organism will respond. While waiting for these test results treatment may begin with common broad spectrum antibiotics such as penicillin, cephalosporins, Tetracyclines, or erythromycin when patients with chronic illnesses are frequently given antibiotic therapy for long periods of time. Two strong antibiotics that have been effective against resistant bacteria are vancomycin and imipenem.

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Fungal infections are treated with antifungal medications.

Examples of these are amphotericin B. Viruses do not respond to antibiotics. A number of antiviral drugs have been developed that slow the growth or reproduction of viruses, such as acyelonor, ganciclovir, amantadine. Prevention: Hospitals take a variety of steps to prevent nosocomial infections, including. Adopt an infection control program such as the on sponseaed by the centers for disease control which includes quality control of procedures know to lead to infection. Identify high risk procedures and other possible sources of infection. Strict adherence to hand washing rules rules by health care workers and ration of procedures including use of sterce gowns, gloves masks and barriers. Sterilization of all reusable equipment such as ventilation humidifiers, and any devices that come in contact with the respiratory tract. Frequent changing of dressings for wounds and use of antibacterial ointments under dressing. Prevent contact between respiratory secretions and health care providers by using and masks as needed. Isolation of patients with known infections Sterilization of medical instruments and equipment to prevent contamination Reduction in the general use of antibiotics to encourage better immune response in patients and reduce the cultivation of resistant bacteria.

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CHAPTER-V RESULTS DATANALYSIS This chapter deals with the analysis and interpretation of data collected from 25 students in Sri Krishna Chaithanya School of nursing at Madanapalli in order to assess the knowledge of selected GNM students regarding prevention of Nosocomial infection. Prevention of Nosocomial infection:The data collected were analysis which includes descriptive statistics. The data finding has been tabulated according to the plan for data analysis and interpreted under the following objectives. To assess the level of knowledge regarding prevention of Nosocomial infection. To find association between the findings with selected demographic variables.

Presentation of data:The analysis of data is organized and presented under the following sections. Section A: - Demographic variables of selected GNM students. Section B: - Assessment of level of knowledge of selected GNM students.

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FREQUENCY AND PERCENTAGE DISTRIBUTION OF DEMOGRAPHIC VARIABLES

S.N 1 DEMOGRAPHIC DATA Age a) 17-20 years b) 20-23 years c) 23-26 years 2 Religion a) Hindu b) Christian c) Muslim 3 Educational Status a) 1st GNM b) II GNM c) III GNM 4 Place of residence a) Rural b) Urban c) Slums 5 Source of information a) Mass Media b) Teachers c) Friends 3 9 13 12 36 52 12 13 0 48 52 0
rd nd

FREQUENCY 21 2 2 17 6 2 13 12 0

PERCENTAGE 84 8 8 68 54 8 52 48 0

The Table-1 Shows that out of 25 sample car people 21(84%) student were in the age group of 1720 years, followed by 2(8%) students were in the age group of 20-23 years, followed by 2(8%) of people were in the age group of 23-26 years. In religion 17(68%) were Hindus and 6(24%) were Christians and 2(8%) were Muslims. Education status shown that majority of student 13(52%) had first GNM students 132(48%) had second GNM student and (0.0%) 3rd GNM student. 23

Place of residence shows that maximum students 13(52%) belonged to urban community and 12(48%) belongs to rural community 0(0.0%) students belongs belongs to slums.

Soured of information showes that 13(52%) student get information throgh teacher 3(12%) had got infarmation through mass media. Table-2

Knowledge level Inadequate Moderate Adequate

Ranging <50% 50-70% 70%

Frequency 12 8 5

Percentage 48% 32% 20%

This table shows 12(48%) students have inadequate knowledge 8(32) students had moderate knowledge & 5(20) students had adequate knowledge. TABLE-3 S.NO Content Total No. of Scare(x) Percentage Mean(x- Standard number questions X) deviation of samples 2 2 3 2 8 8 2 2 3 2 8 8 8% 8% 12% 8% 32% 32% 1.92 1.92 2.88 1.92 7.68 7.68 0.6715 0.4529 0.7681 1.0196 1.7126 1.5915 25 25 25 25 25

1 2 3 4 5 6

Introduction 25 Causes Symptoms Diagnosis Care Prevention

That there is higher knowledge found in preventive measures (18012%) knowledge found in the easement phase of introduction and definition diagnosis (0.96%); prevention of nosocomial infection knowledge.

24

90 80 70 60 50 40 30 20 10 0

84

17-20 years

20-23 years Age

23-26 years

AGE Percentage Distribution Of Students According To Age

25

80 70 60 50 40 30 20 10 0 Hindu Christian Religion Muslim 8 68 54

RELIGION Percentage Distribution Of Students According To Religion

26

100% 80% 60% 40% 20% 0% 1st GNM IInd GNM IIIrd GNM Education 0

52

48

EDUCATION Percentage Distribution Of Students According To Education

27

Palce of Living
0%

48% 52%

Rural Urban Slums

PLACE OF LIVING Percentage Distribution Of Students According To Place Of Living

28

60 50 36 40 30 20 10 0 Mass Media Teachers Source of Information 12

52

Friends

SOURCE OF INFORMATION Percentage Distribution Of Students According To Place Source Of Information

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CHAPTER-VI The Chapter Deals with the discussion of findings of data analysis. The statement of the problem was a study to assess the knowledge regarding prevention of Nosocomial infection among GNM students in Sri Krishna chaithanya school of Nursing at Madanapalli. The highest mean knowledge noticed in the aspect of [retentive measures(18.12),followed by treatment (14.4%)introduction (3.84),Diagnosis(4%), symptoms(6.88), causes(5.76) and least knowledge found on causes(3.84)(highest to lowest). The overall knowledge among people rereals that (48%) of the respondents had in adequate knowledge(32%) of the respondents had moderate knowledge and (20%) of the respondents had adequate knowledge.

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CHAPTER-VII CONCLUSION The chapter present the conclusions drawn, implications, limitations, recommendation and delimitations. The focus of this study was to evaluate the knowledge regarding prevention of Nosocomial infection among GNM students in terms of knowledge regarding selected aspects of prevention of Nosocomial infection in Sri Krishna Chaithanya school of nursing at Madanapalle. The major findings of the study knowledge among people on the selected aspects of prevention of flurosis. There is no significant association between the age and knowledge level of respondents on the aspect of prevention of Nosocomial infection. There is no significant association. There is no significant association between knowledge level and demographic variable viz. Religion of students. Nursing implications:The findings of the study can be used in the following areas of nursing profession. Nsg education:The nursing curriculum should consists of increased depth, content and activities which helps to develop skill of nurses in prevention of Nosocomial

infection among students, As a nurse educators there are an abundant opportunities for nursing professionals to educate the students regarding selected aspects of Nosocomial infection. The nurse should educate about the utilization of local health services and voluntary health agencies assistance, which helps to promotes health of people. Nursing practice:Nurses are the key persons of the health team who play a major role in effective health promotion and maintenance. Nursing care is an art and science in providing quality care. Nursing international program can be used as a teaching strategy in the hospital as well as in the community, i.e. Though radio, television, documentary films, pamphlets, leaf lets etc.

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Nsg Administration:The nursing administration can take part in developing protocols, standing orders related to designing the health education program me to update nursing personal knowledge regarding prevention of Nosocomial infection. The nurse Administrator should take interest in providing information on selected aspect of Nosocomial infection. The nurse administration should plan and organize continuing education program for the faculty of nursing school and colleges to organize the comparing on the knowledge regarding prevention of Nosocomial infection among GNM students. Nurse research:This study helps the nurse researchers to develop a propriety health education tools for educating the people regarding selected aspects of prevention of nosocomial infection according to their demographical characteristics nurse should come forward to take up unsolved aspect in the field of nosocomial infection to carry out studies and public them for the benfit of patients public and nursing fraternity. The public and private agencies should also encourage research in this field through materials and funds. Recommendations:On the basis of the finding of the study following recommendations have been mode A similar study can be replicated on a small sample to generation the findings A student can be conducted by demographic variable. Self instructional modules may be develop in all dimensions and aspects of prevention of noscomial infection.

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Chapter- VIII SUMMARY Nosocomial infection is naturally occurring substance found in other crest it is found in natural water supply in earth crest it is found in natural water supply it causes serious problem among people many going people affected by server nosocomial infections. The main aim of this study was to evaluate the knowledge rearding prevention of nasocomial infection among GNM student. Objectives of the study :To assess the knowledge regarding prevention of

nosocomial infection among GNM students to assess the knowledge level with selected demographic variable. The find findings of the student were related to the knowledge scoures on selected aspects on prevention of nosocomial infection among GNM students. Over all mean knowledge are 56.48 the highest mean found in preventive measures (16.16) and least mean found in curses. The knowledge noticed according to aspect wise adequate knowledge (76%) responders had moderate knowledge and respond ants had in a adequate knowledge about the infection and definition of noscomial infection. The responders had adequate knowledge had moderate knowledge and had adequate knowledge regarding causes of nosomial infection on, the knowledge noticed 9(36%)respond ants had adequate knowledge12 (48%) respondents had moderate knowledge and 4(16%) respondents had inadequate knowledge regarding biagnosis of nosocomial infection. The knowledge noticed 5(20%) respondents had adequate knowledge 13(52%) respondents had moderate knowledge and (28%) respondanty had moderate knowledge regarding of nosocomail infection the knowledge 14(56%) resposdants had ad equate knowledge 14(56%) respondents lad quart knowledge and 6(24%) respondants had inadequate knowledge regarding prevention of noscomail infection. The are all mean knowledge is the aspects of introduction causes symptoms 8.48 dig noses 8.48,treatment 9.44 and preventive measures 16.16.

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