Reducing Hospital Infections

CHAPTER I
INTRODUCTION
No stronger condemnation of any hospital or ward could be pronounced than
the single fact that infectious diseases has originated in it”.
-Florence Nightingale
A Nosocomial infection is a hospital infection or toxin that exists in a certain location,
such as a hospital. Now-a-days Nosocomial infections changed with the terms of health-care
associated infections and hospital-acquired infections (HAIs). Graham Rogers (2019)
Infection can be defined as invasion and multiplication of micro-organisms such as
bacteria, viruses and parasites that are present within the body. An infection may occur in
local area is called localized infection and it spread through the blood or body is called
systemic infection.
WPWP campaign (2019) Nosocomial infections can caused by bloodstream
infections, ventilator-associated pneumonia, urinary tract infections, meningitis, secondary
skin infections and abscesses after skin breakdown or an invasive procedure and eye, ear,
nose or throat infections. The most common type of Nosocomial infections are surgical
wound infections, respiratory infections, genitourinary Infection as well as gastrointestinal
infections.
WHO (2018) In the United States, estimated roughly 1.7 million hospital-associated
infections, from all types of microorganisms, including bacteria and fungi combined, cause or
contribute to 99,000 deaths each year. In Europe, where hospital surveys have been
conducted, the category of gram-negative infections is estimated to account for two-thirds of
the 25,000 deaths each year.
Centers for Disease Control and Prevention (2018) The common sources of
infection in their hospital were urinary catheters, central venous (in the vein) catheters,
1
endotracheal tubes and the Ryles tube. The organisms can be transferred from one client to
another (cross-infection). This group includes Staphylococcus aureus, Streptococci,
Enterococci and Enterobacteria etc.
The University of Michigan Health System (2017). Factors that increase a clients
susceptibility to Nosocomial infections include young or old age, decreased immune
resistance, underlying disease and therapeutic and diagnostic interventions Clostridium
difficile is now recognized as the chief cause of Nosocomial diarrhea (Methicillin – resistant
Staphylococcus aureus) MRSA is a type of staphylococcus bacteria that is resistant to certain
antibiotics and may be acquired during hospitalization.
Sahar Mudassar et., al (2017) Across sectional study was conducted “to assess the
effectiveness of STP on knowledge regarding awareness and spread of Nosocomial Infections
among staff nurse”. Likert scale questionnaire was used in this study. The result shows that
nurses had adequate awareness about the spread of hospital infections. Out of 120
participants, 39 (32.5%) were agree and 34(28.3%) were strongly agree and 47 (39.2%) are
aware and spread of Nosocomial infection. The study concluded that Nurses had a good
knowledge regarding the spread of Nosocomial infections and use of safety precautions.
UMHS (2017). The most of HAIs are urinary tract infections (UTIs), surgical site
infections, gastroenteritis, meningitis, pneumonia. The symptoms for these infections may
include discharge from a wound, fever, and cough, shortness of breathing, burning with
urination or difficulty urinating, headache, nausea, vomiting and diarrhoea.
Satish Prabhakar Masavkar et.,al (2016) A Quasi experimental study was
conducted to assess the effectiveness of STP on knowledge, attitude and practice regarding
Nosocomial infection among 48 general medical practioners and 108 medical college
students. Knowledge was assessed by using WHO hand hygiene questionnaire attitude and
practice were evaluated by using self-structured questionnaire. When compared the
2
knowledge, attitude and practice scores of the general medical practitioners and medical
college students, the finding shows that both these groups having similar knowledge, attitude
and practice scores and difference were not found to be statistically significant at Student’s t
test, p>0.05.The result concluded that structured teaching Programme was effective among
General medical practioners.
UNITED NATIONS (2016) Caregivers involved in providing care and assistance to
the elderly and all those clients who are not able to care for themselves. They work with
clients either at a healthcare facility or assistance in their daily life.
NEED FOR THE STUDY
World Health Organization (2019) conducted survey in 55 hospitals of 14 countries
representing 4 WHO Regions showed an average of 8.7% of hospital clients had Nosocomial
infections. The highest frequencies of hospital acquired infections were reported from
hospitals in the Eastern Mediterranean and South-East Asia regions [11.8 and 10.0%
respectively] with a prevalence of 7.7 and 9.0% respectively in the European and Western
Pacific Regions.
WHO (2018) Carried out a cross sectional study to assess the prevalence of mortality
rate of Nosocomial infection among 40 urban and rural areas in India. The estimation of the
year is 2016 about 25 per 1000 live birth in early neonatal period (0-7 days), with about 28
for rural areas and 12 for urban areas neonatal mortality rate for the whole country is about
37 per 1000 live birth with approximately 41 for rural areas and 22 for urban areas.
Celik S et.al (2018) Conducted a cross sectional study in New Blacksmith State
Hospital at Turkey among 430 nursing students to determine the applications status of hand
washing procedure done in practices areas. Random sampling technique was used. The study
concluded that the students practice what they have learned given adequate attention to the
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practice areas.
Indian journal of environmental medicine (2018), In Tamilnadu a longitudinal study
was carried out to assess the prevalence of Nosocomial infection among 226 clients admitted
in NICU Government hospital at Thoothukudi District. The most frequent associated
pathology will be respiratory distress(23.06%) a total of 316 Nosocomial infections were
diagnosed in 226 neonates, 76.7% affecting premature neonates(<1500g). The most frequent
bacteremia is 56.3% and predominance of coagulate negative staphylococci is 46.05%, gram
negative micro-organisms were isolated in 32.1% of the cases (e-coli, pseudomonas,
aeruginosa were the most frequent pathogens). Over all incidence of Nosocomial infection
will be 25.6%. Overall mortality will be 6.6% with higher mortality in the group with
Nosocomial infections (8.7%).
Nursing Journals (2017) Conducted a cross sectional study to assess the Nosocomial
infection among 1765 clients in Government Hospital at Dharmapuri district. The prevalence
of Nosocomial infection in men and women is 53.7 %. The proportion of clients with catheter
associated urinary tract infection is 23.2%, blood stream infection is 56.2 % and surgical site
infection is 23.8% and ventilator associated infection is 18% among clients in Government
hospital.
Aklime and Arzu (2017) Conducted cross sectional study to assess the prevalence of
Nosocomial infection in USA, Italy and India among 10,835 clients in intensive care unit. It
showed an overall rate of 4.4%, and 9.06% health care associated infections, per 1000 ICU-
days. The central venous catheter-related bloodstream infection rate was 7.92 per 1000
catheter-days the ventilator-associated pneumonia rate was 10.46 per 1000 ventilator-days
and the catheter-associated urinary tract infection rate was 1.41 per 1000 catheter-days. In
Italy 53.3% hospital acquired infection was detected and in India it was 9.06% health care
associated infections per 1000 ICU days. This shows that prevalence of hospital acquired
4
infections is high in both developed and developing countries.
Rasmus Leistneret.al (2017) Conducted a cross sectional study to assess the
prevalence of Nosocomial infection in Intensive care units of seven Indian cities. It showed
that 10, 835 clients hospitalized for 52, 518 days for infection in which 476 Health care
associated infections, and it showed an overall rate 4.4% was health care associated
infections, per 1000 ICU-days. The central venous catheter-related bloodstream infection rate
was 7.92 per 1000, the ventilator- associated pneumonia rate was 10.46 per 1000 ventilator-
days; and the catheter- associated urinary tract infection rate was 1.41 per 1000 catheter-days.
Christianes G, Barbier et al (2016) conducted a quantitative study to assess the
effectiveness of hand hygiene procedure for control of Nosocomial infection among 1104
clients at the university hospital of Liege. The hand hygiene programme was given to
promote hand hygiene and most particularly alcohol based hand disinfection. They measured
MRSA transmission rates and consumption of alcohol based hand rub solution and soap in
parallel. The study concluded that, consumption of alcohol based
Hand rubs solution and soap increased by 56% respectively MRSA transmission rates
decreased from 1,104 to 707 cases per 1000 admissions.
Based on above statistical analysis the researcher came to know the incidence and
prevalence of Nosocomial infection and its impact on clients and know the effectiveness of
structured teaching programme. The investigator decided to improve the knowledge about
Nosocomial infection and its prevention among client’s attenders by administering structured
teaching programme and prevent the complications of Nosocomial infection.
STATEMENT OF THE PROBLEM
A study to assess the effectiveness of Structured teaching programme on
knowledge regarding prevention of nosocomial infection Coimbatore among client attenders
in selected hospital .
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OBJECTIVES
 To assess the pre and post-test level of knowledge regarding Nosocomial infection
and its prevention among Client’s attenders in experimental and control groups.
 To determine the effectiveness of structured teaching programme on knowledge
regarding Nosocomial infection and its prevention among Client’s attenders in
experimental group.
 To compare the pre and post-test level of knowledge regarding Nosocomial infection
and its prevention among client’s attenders in experimental and control groups.
 To find out the association between the post-test level of knowledge on Nosocomial
infection and its prevention among Client’s attenders with their selected demographic
variables such as Age,sex,marital status, religion, educational status, Family income,
occupation, number of time visited to hospital, name of the ward and sources of
knowledge in experimental and control groups.
HYPOTHESES
H1: The mean pre-test level of knowledge regarding Nosocomial infection and its
Prevention among Client’s attenders in Experimental group is significantly higher than the
mean post-test level of knowledge in control group.
H2: The mean post-test level of knowledge regarding Nosocomial infection and its
Prevention among Client’s attenders in Experimental group is significantly higher than their
mean pre-test level of knowledge.
H3: The mean post-test level of knowledge regarding Nosocomial infection and its
Prevention among Client’s attenders in control group is significantly lower than their mean
pre-test level of knowledge
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H4: There will be a significant association between the post-test level of knowledge
regarding Nosocomial infection and its Prevention among Client’s attenders with their selected
demographic variables in experimental and control groups.
OPERATIONAL DEFINITION
Assess
In this study, it refers to a process of systematically and continuously collecting,
validating and communicating the data regarding level of knowledge on Nosocomial
infection and its prevention among Client’s attenders and it was measured by semi structured
knowledge questionnaire.
Effectiveness
In this study, it refers to find the degree to which extends the desired outcome of
structured teaching programme regarding Nosocomial infection and its prevention is
improving the level of knowledge among Client’s attenders.
Knowledge
In this study, it refers to the Client’s attenders are answer the questions related
Nosocomial infection and its Prevention such as causes, symptoms, treatment and prevention
as elicited by the semi structured Knowledge questionnaire by the investigator.
Structured Teaching Programme
In this study, it refers to the systematically, organized information prepared by
the investigator in the form of booklet, which consists of causes, risk factors, mode of
transmission, importance and prevention of Nosocomial infection.
Nosocomial infection
In this study, it refers to an infection occurs in Client’s attenders within 48 hours of
hospital admission or 3 days after a surgery due to poor hand washing, cleaning of clients
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urine, vomiting, saliva, faeces and blood with bare hands and using clothing from their own
cloth.
Prevention
In this study, it refers to measures taken to reduce the risk of Nosocomial infection
and its Prevention among Client’s attenders such as by proper Hand washing, avoiding
sharing of food and sleep in the same hospital bed and to avoid clean the clients\ saliva,
vomiting with their own clothes.
Client’s attenders
In this study, it refers persons of both sexes between 35- 55 years age old and who are
taking care of their hospitalized family members from admission to till discharge from the
selected Hospitals.
ASSUMPTION
 The Client’s attenders may have inadequate knowledge regarding Nosocomial
infection and its prevention.
 Structure teaching programme will increase the knowledge on Nosocomial infection
and its prevention among Client’s attenders and will help to prevent infectious
disease.
DELIMITATION
 The Study is limited to 60 samples.
 The Study period is limited to 1 week period.
PROJECTED OUTCOME
Structure Teaching Programme will help the Client’s attenders to aware of
Nosocomial infection and its prevention.
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CONCEPTUAL FRAMEWORK
A conceptual framework is a group of concepts and a set of propositions that spells
out the relationship between them. Their overall purpose is to make scientific findings
meaningful and generalizable.
The investigator selected the conceptual frame work for the study was based on
Ernestine wiedenbach “The Helping Art of Clinical Nursing” (1964). Wiedenbach’s
prescriptive theory may be described as a system of concepturatic invented for a purpose.
Prescriptive theory may be described as one that conceptualizes both the desired situations
and the perception by which it is to be brought about as an outcome.
The conceptual model of nursing practice according to this theory consists of 3 steps
as follows:
Step 1: Identifying the need for help,
Step 2: Administering to the need and
Step 3: Validating to meet need
Step 1: Identifying the need for help
The first step is to identify the need to plan further actions to meet them.
The need identified among the sample is to empower them on Nosocomial infection and its
prevention. The process began with sample selection on the basis of the inclusion criteria
followed by the pre-testing level of the knowledge regarding Nosocomial infection and its
prevention among Client attenders.
Step 2: Administering to the need
The second step refers to the provision of required help to fulfill the identified need. It has
two components
 Prescription: It means fulfillment of central purpose.
 Realities: It includes agent, recipient, goal, means and framework.
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In this study prescription refers to the development, validation and administration of
structured teaching programme on Nosocomial infection. The second component refers to
realities which include factors that influence the process of gaining knowledge in the
present situation. The various aspects which constitute realities are as follows:
Agent: The investigator is the agent who prepared the structured teaching
programme on Nosocomial infection and its prevention.
Recipient: Client’s attenders from Balaji Multi speciality hospital at Coimbatore
were the recipients.
Goal: In this study it refers to the improvement in knowledge score of Client’s
attenders on Nosocomial infection and its prevention and which was evaluated by using a
semi-structured knowledge questionnaire.
Means and activities: A pretest was carried out to assess the level of knowledge
regarding Nosocomial infection and its prevention among Client’s attenders. There are two
groups like experimental and control groups. For control group, no intervention was given
and for experimental group structured teaching programme on Nosocomial infection and its
prevention was administered among Client’s attenders.
Step 3: Validating to met need
The last step is to validate the met need. In this study the validation of the need
was done by conducting a post test (7 th day) by semi structured knowledge questionnaire
was used to assess the level of knowledge regarding STP on Nosocomial infection and its
prevention. Findings revealed that the mean post test score was significantly higher than
their mean pretest score, showing the effectiveness
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REALITIES
CENTRAL PURPOSE Agent : Investigator
Empowerment of STP on knowledge Recipient: Patient’s attenders
regarding Nosocomial infection and its
prevention among Patient’s attenders in Goal: Toassess the
selected hospitals effectiveness of knowledge
PRESCRIPTION regarding STP on Nosocomial
infection and its prevention among
 Preparation of knowledge regarding STP client attenders.
on Noscomial infection and its prevention Mean: Level of knowledge
among client attenders. regarding STP on Nosocomial
 Administration of Structured teaching
programme to client attenders
VALIDATION
Control group No intervention
IDENTIFICATION (N=30)  POST TEST:Assessment of
knowledge regarding STP on
PRE TEST ADMINISTRATION Nosocomial infection and its
prevention among Patient’s
 Assessmentof Experimental Administration of Structured attenders by using semi-
knowledge regarding group (N=30) teaching programme on structured knowledge
questionnaire.
Nosocomial infection Nosocomial infection and its
 Comparison of pre -test and
and its prevention prevention among client post test level of knowledge
among client attenders attenders
by using semi-
structured knowledge Inadequate knowledge
questionnaire.
Feed Back Outcome of the study
Moderately adequate
knowledge
Adequate knowledge
FIGURE 1: CONCEPTUALFRAMEWORK BASED ONWIEDNBACH’S

11 PRESCRIPTIVE THEORY
CHAPTER II
REVIEW OF LITERATURE
Review of literature is defined as broad comprehensive, in depth systematic and
critical review of scholarly publications, unpublished scholarly print materials, audio visual
material and personal communication.
Review of literature of the present study is arranged in the following headings.
SECTION A: Studies related to incidence and prevalence of Nosocomial infections.
SECTION B: Studies related to Prevention of Nosocomial infection.
SECTION C: Studies related to effect of Structured teaching programme regarding
SECTION A: STUDIES RELATED TO INCIDENCE AND PREVALENCE OF
NOSOCOMIAL INFECTIONS.
H.Mythri et.,al (2018) Conducted retrospective study “to assess the prevalence of
Nosocomial infections” among 130 clients in Medical intensive Care Unit of a Tertiary
Health Center in India. Data were collected retrospectively from 130 client's records
presented with symptoms. Descriptive statistics used to calculate the percentage of infection
rate. The result shows that the Nosocomial infection was seen more in the 40-60 year of age
is 58%. The male were more prone to Nosocomial infections than the female.
Madhurima Basu (2016) Conducted a longitudinal study in Udhaya Hospital at
Bhopal “to assess the incidence and prevalence of Nosocomial infection”. It suggested that
the average crude and age adjusted incidence rate of Nosocomial infection ranged from 151
to 232 clients respectively. Furthermore CAUTI and Surgical site infection was the
commonest cause of Nosocomial infection (44%). Assuming the uniform incidence all over
the country approximately, 120 CAUTI clients would require knowledge about Nosocomial
infection.
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Karl (2016) Conducted cross sectional study in Calabria (Italy) among 888 clients “to
assess the prevalence of Hospital Acquired infection (HAI)” for at least 24 hours and not due
for discharge or transfer on the day of the survey. The overall prevalence of hospital acquired
infection was 1·7% and urinary tract and surgical wounds were the most frequent sites (each
four clients, 26·7%). In only eight (53·3%) of the fifteen hospital acquired infection detected,
had a microbiological examination been requested and the only two positive culture results
involved Pseudomonas aeruginosa (surgical site) and Escherichia coli (urinary tract) are
highly affected than others organisms.
Jodhkabhir Khan., (2016) Conducted cross sectional study at tertiary university
hospital in Oslo “to assess the Hospital Acquired infection” among 57360 clients. Over the
whole time period 80.5% in somatic wards and 19.5% in psychiatric wards. The HAI rate was
6.9%, of which 8.1% were somatic and 1.9% psychiatric. About 13.4% of operated clients
had HAI, including 6.2% due to surgical wound infections. In somatic wards, 0.6–1% was re-
admitted with HAI, 15.2–23% had infections and 18–23% used antibiotics. There was a
reduction in HAI until 2014.
Raika Durusoy., (2016) Conducted a prospective study “to determine the prevalence
of Nosocomial urinary tract infections and to investigate risk factors for pathogen type and
extended spectrum beta lantanas positive” among 124 urinary tract infection clients at
Institute National de Nino (INSN) of Lima and Peru. A questionnaire containing 44
Questions and demographic data was send to 51 tentacle hospitals of clients who were risk
for UTI. Univariate and multivariate analyses were conducted. The study result showed that
overall prevalence of UTI was 1.82%.The study concluded that reasons underlying the high
prevalence of Nosocomial UTIs are reduced by better understanding of the risk factors.
Mohamed issa Ahmed (2015) conducted a cross sectional study on prevalence of
Nosocomial wound infection among 140 post-operative wound infection clients at Teaching
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Hospital in Sudan. In this study, 109 wound swabs were collected from clients who had
developed post operative wound infection. Convenient sampling technique was used.
Antibiotics susceptibility was applied for all isolated bacteria. The prevalence rate of HAI
was 25.23%. The study concluded that the highest prevalence rate of Nosocomial post-
operative wound infection was due to poor antibiotic selection for prophylaxis during and
after surgery and increased level of contamination in most part of the hospital.
M.Eshwarappa et al., (2014) conducted a multidisciplinary Prospective
Observational study among 116 clients in Clinical microbiological profile of urinary tract
infection at South India to determine the presentation and risk factors associated with catheter
associated urinary tract infection (CA-UTI). Escherichia coli (66.9%) was the most common
organism causing CA-UTIs with extended spectrum beta lactamase (ESBL) resistance seen in
nearly two-thirds of these cases (42.2%). The organisms recorded least resistance against
carbapenems (3.9%). A high resistance rate was seen for Fluroquinolone (74.1%). The study
concluded that high rate of ESBL-positive organisms and their resistance to commonly used
antibiotics brings a concern for future options in treating these conditions.
Aklime and Arzu (2012) conducted cross sectional study to assess the prevalence
of Nosocomial infection in USA, Italy and India among 10,835 clients in intensive care unit.
It showed an overall rate of 4.4%, and 9.06% health care associated infections, per 1000
ICU-days. The central venous catheter-related bloodstream infection rate was 7.92 per 1000
catheter-days the ventilator-associated pneumonia rate was 10.46 per 1000 ventilator-days
and the catheter-associated urinary tract infection rate was 1.41 per 1000catheter-days.The
above review of literature shows that prevalence of hospital acquired infection in USA was
1.7 million health care associated infections. In Italy 53.3% hospital acquired infection was
detected and in India it was 9.06% health care associated infections per 1000 ICU days.
This shows that prevalence of hospital acquired infections is high in both developed and
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developing countries.
SECTION B: STUDIES RELATED TO PREVENTION OF NOSOCOMIAL
INFECTION.
Christianes G, Barbier et al (2016) conducted a quantitative study to assess the
effectiveness of hand hygiene procedure for control of Nosocomial infection among 1104
clients at the university hospital of Liege. The hand hygiene programme was given to
promote hand hygiene and most particularly alcohol based hand disinfection. They measured
MRSA transmission rates and consumption of alcohol based hand rub solution and soap in
parallel. The study concluded that, consumption of alcohol based hand rub solution and soap
increased by 56% respectively MRSA transmission rates decreased from 1,104 to 707 cases
per 1000 admissions.
Shaukat. F, Naeem. Z., (2015) conducted quantitative study “to evaluate the
effectiveness of planned teaching programme on prevention of Nosocomial infection among
600 Client’s visitors at South Africa among. Pre test and post test data was collected through
structured interview schedule. Structured teaching programme was given The findings
revealed that the mean post-test knowledge score was higher than the mean pre-test
knowledge score which shows that the planned teaching programme was effective in
increasing the knowledge (t = 36 , P<0.05).
Rabin Saba, Dilara Iran et.,al (2015) Conducted a prospective observational
study to assess the hand hygiene compliance in a hematology unit among 576 health care
workers in Sweden. Two observers monitored the hand hygiene compliance of health care
workers in a hematology unit during 30 minutes observation periods distributed randomly
during the day time over 2 months. The non-compliance was higher among nurses. The
lowest compliance rate (4%) was observed before client care and the highest (60%) was after
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insertion of invasive devices. The study concluded that non compliance with hand hygiene
was high in this hematology unit, especially among nurses and before activities.
SECTION C: STUDIES RELATED TO EFFECT OF STRUCTURED TEACHING
PROGRAMME REGARDING NOSOCOMIAL INFECTION AND ITS
PREVENTION.
Mahodro B Shinde et.al (2017) conducted a quantitative study “to assess the
effectiveness of structured teaching programme on knowledge regarding five moments of
hand hygiene in medical college and tertiary care hospital at Karad among 100 nursing staffs
and students”. Non purposive sampling technique was used in this study. Knowledge was
assessed by using WHO hand hygiene questionnaire attitude and practice were evaluated by
using self-structured questionnaire. The results shows that knowledge on hand hygiene was
moderate (144 out of 200, 74%) among the total study population. Student nurses had better
five moments of hand hygiene practices than the staff nurses.
Abdul shamed et.al (2017) Conducted a quantitative study “to assess the
effectiveness of knowledge regarding STP on Prevention of Nosocomial infection” among
160 staff nurses and student nurses in Government college of nursing at Kerala. Among them
40 students were in III year GNM students, IV year B.Sc. nursing students, GNM staff nurses
and B.Sc. staff nurses. Pre- test conducted by questionnaire method. Structured Teaching
Programme was given. Post test was conducted after 1 week. The result showed that majority
of B.Sc. (N) staff nurses (55%) had good knowledge, whereas the knowledge of GNM staff
nurses was 47.5%, Fourth year B.Sc. nursing students had 67.5% knowledge and III year
GNM students had 65% knowledge regarding prevention of Nosocomial infection. So
researcher concluded that STP was effective in B.Sc nursing students has an adequate
knowledge regarding Prevention of Nosocomial infection
16
Olaideedet et.al (2015) conducted a quasi-experimental study“to determine the
impact of HIV/AIDS related structured training Programme on knowledge of standard
precautions in Paul’s college of nursing at Nigeria among 42 undergraduate nursing
students”. A simple random sampling technique was used in this study. A self-developed and
well-validated questionnaire with reliability co-efficient of 0.8 was used for data collection.
The study concluded that planned instruction can improve the knowledge of undergraduate
nursing students on standard precautions; hence they need to expose the students to safety
education before posting them to the clinical setting.
Shaukat. F, Naeem. Z., (2016) conducted quantitative study “to evaluate the
effectiveness of Structured teaching programme on knowledge regarding prevention of
Nosocomial infection among 600 Client’s visitors at South Africa. Pre test was conducted by
semi-structured knowledge questionnaire. After Structured teaching programme post-test was
collected and findings revealed that the mean post-test knowledge score was higher than the
mean pre-test knowledge score which shows that the structured teaching programme was
effective in improving knowledge of Client’s attenders at t = 36 , P<0.05.
Marina. C., (2015) conducted quasi-experimental study “to evaluate the
effectiveness of structured teaching programme on knowledge regarding Infection control
measures among 30 nursing students between 17-22 years age in selected college at Delhi.
The samples were selected by using convenient sampling. The study findings revealed that
post mean percentage was increased to 93.67% after the administration of structured teaching
programme from the mean percentage of 48.25%. Paired‘t’ test showed a very high
significant difference (t=29, P<0.05) between pre-test and post-test knowledge score which
indicate that the structured teaching programme was very effective in improving the
knowledge of nursing students.
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RESEARCH APPROACH
Quantitative Research approach
RESEARCH DESIGN
Quasi experimental pre-test, post-test control group design
TARGET POPULATION
POPULATION SAMPLING
TheBothstudy population
male composed
and females of attenders
aged between of old
35-55 years client
who who are
are taking TECHNIQUE
admitted
care ofin their
Balajihospitalized
multi Speciality
family hospital
membersatadmitted
Coimbatore.
inBalaji Multi Speciality *Convenient
Hospital and who fulfill the inclusion and exclusion criteria. sampling
ACCESSIBLE
--- POPULATION technique was
Demographic It was both male and females between 35-55 years in used to select
ables patient’s attenders in Balaji Multi Speciality Hospital. settings
e *Non
x SAMPLE probability
arital status The study samples are aged between35-55 years who are cared for the purposive
ligion patient admitted in Balaji Multi Speciality hospital. During the data sampling
ucation collection those who met the inclusive and exclusive criterias technique to
come SAMPLE SIZE select samples
cupation Sample size comprises of 60 patient’s attenders, who are
mber of time visited taking care of their PRE-TEST
hospitalized family members in Balaji Multi Data collection
spital Pre-test was conducted by using semi-structured procedure by
me of the ward knowledge questionnaire using semi-
ources of knowledge structured
infection Experimental group (n=30) knowledge
Control group (n=30)
questionnaire
Structured teaching programme regarding No intervention
knowledge on Nosocomial infection and its
prevention
POST –TEST
Semi structured knowledge questionnaire was used to
assess the level of knowledge regarding STP on
ANALYSIS AND INTERPRETATION
Descriptive and inferential statistics
FINDINGS
Structured teaching programme regarding Nosocomial
infection and its prevention was effective to improve the level
of knowledge among patient’s attenders
Report
Figure 2: Schematic Diagram of Research Methodology
18
CHAPTER-III
METHODOLOGY
Research methodology refers to the techniques used to structure a study together
and analysis information in a systematic fashion (POLIT AND HUNGER 2008).
This chapter consist of Research Design, Variables, setting of the study, population,
sample, sample size, sampling technique, criteria for the selection of sample, development
and description of tool, content validity, reliability, intervention, pilot study ,data collection
procedure, plan for data analysis and protection of human rights.
RESEARCHAPPROACH
Quantitative Research approach was used in this study.
RESEARCH DESIGN
Quasi experimental pre-test, post-test control group design was adopted for this
study. It is diagrammatically represented as
GROUP PRE – TEST INTERVENTION POST-TEST
Experimental O1 X O2
group
Control group O3 - O4
Figure: - 3 Schematic representation of research design
KEYS
O1, O3 - Pre-test level of knowledge regarding Nosocomial infection and its prevention in
experimental and control groups.
X - Administration of structured teaching programme on Nosocomial infection and

19
its prevention to experimental group
(-) - Structured teaching programme on Nosocomial infection and its prevention. not
given to control group.
O2 - Post-test level of knowledge regarding STP on Nosocomial infection and its
Prevention among experimental group on 7th of study.
O4 - Post-test level of knowledge regarding Nosocomial infection and its Prevention
among control group on 7th of study.
VARIABLES
Dependent variables
Level of knowledge regarding Nosocomial infection and its prevention.
Independent variables
Structured teaching programme on Nosocomial infection and its prevention.
Demographic variables
Demographic variables such as age,sex, marital status, religion, education, income,
occupation, number of times visited to hospital, Name of the ward and sources of knowledge
about infection.
SETTING OF THE STUDY
The setting of the study refers to the hospitals where the study was conducted
in two hospitals like Balaji Multi Speciality Hospital was selected for experimental group and
C.S.I. Balaji Hospital for control group in Coimbatore district.
SETTING-I
Balaji Multi Speciality Hospital is a 150 bedded Hospital situated at Coimbatore
Junction in Coimbatore. It is 60 kms away from CSI. St. Luke’s College of Nursing. The
hospital is facilitated with Post operative ward, Cardio-thoracic ward, Innsive care unit,
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IMCU, General medical ward etc., During data collection, 3.2.2021 to 9.2.2021. Client`s
attenders were stayed along with the in clients. Among them 30 Client’s attenders were
selected from Postoperative ward, Cardio-thoracic ward and General medicine ward for
experimental group.
SETTING-II
Balaji Hospital is a 150 bedded Hospital situated at, Coimbatore. It is 57 kms away
from Texcity college of Nursing. The hospital is facilitated with post operative ward,
Intensive care unit, General medical ward, Cardio-thoracic ward etc., During data collection,
3.2.2021 to 9.2.2021Client`s attenders were stayed along with the Inclients Among them, 30
Client’s attenders were selected from Postoperative ward, Cardio-thoracic ward and General
medicine ward I and II for control group.
STUDY POPULATION
The study population composed of attenders of clients who are admitted in Balaji
multi Speciality hospital at Coimbatore.
Accessible Population
Accessible population was both male and females of Client’s attenders aged
between 35-55 years, who are taking care of their hospitalized family members admitted in
Balaji Multi Speciality Hospital and C.S.I. Jeyaraj Annapackiam Hospital.
Target population
Target population was both male and females aged between 35-55 years old who are
taking care of their hospitalized family members admitted in Balaji Multi Speciality Hospital
and who fulfill the inclusion and exclusion criteria.
SAMPLE
The study samples are aged between 35-55 years who are taking care of their
hospitalized family members admitted in Balaji Multi Speciality hospital and Hospital and
21
those who met the inclusive and exclusive criterias.
SAMPLE SIZE
The sample size of the study was 60 client’s attenders among them 30 client’s attenders
were selected for experimental group in Balaji Multi Speciality hospital and 30 Client’s
attenders were selected for control group in C.S.I. Jeyaraj Annapackiam Hospital at
Coimbatore District.
SAMPLING TECHNIQUE
Samples are selected by using non probability purposive sampling technique.
Step -1: The researcher was selected Balaji Multi Speciality Hospital for
experimental group. During data collection, 40-55 client attenders are stayed along with the
Inclients. Among them, the researcher identified 43 client`s attenders were between the age
of 35-55 years from them 24 were males and 19 were females. Based on exclusive criteria, 8
non cooperative attenders and 5 attenders are health care personnel were excluded and the
remaining 30 client`s attenders were selected for, experimental group as per inclusive
criteria’s.
Step-2: The researcher was selected C.S.I. Jeyaraj Annapackiam Hospital for control
group. During data collection, 40-55 client attenders are stayed along with the Inclients.
Among them, the researcher identified 38 client`s attenders were between the age of 35-55
years from them 22 were males and 16 were females. Based on exclusive criteria, 6 non
cooperative attenders and 2 attenders are health care personnelwere excluded and the
remaining 30 client`s attenders were selected for control group as per inclusive criteria’s.
CRITERIA FOR SAMPLE SELECTION
The samples were selected based on the following inclusive and exclusive criterias.
Inclusive criteria

Client’s attenders who are willing to participate.
22

Client’s attenders who can read and follow the instructions in Tamil or English.

Client’s attenders who were present at the time of data collection.

Client’s attenders aged between 35-55 years of both males and females.

Client’s attenders from Post operative ward, Cardio thoracic ward and General
medicine ward.
Exclusive criteria
 Client’s attenders who are health care personnel.
 Client’s attenders who are already undergone education of Nosocomial infection
and its Prevention
 Client’s attenders who are not available at the time of data collection.
DEVELOPMENT AND DESCRIPTION OF TOOL
The tool comprises two sections
Section A –It deals with demographic variables
Section B-It deals with semi- structured knowledge questionnaires.
Section A: Demographic variables
It consists of demographic variables such as Age, sex, marital status, religion,
education, income, occupation, number of times visited in a hospital, name of the ward and
sources of knowledge about infection.
Section B: Semi-structured knowledge questionnaire
Semi-structured knowledge questionnaire consist of 25 items to assess the Level of
knowledge regarding STP on Nosocomial infection and its prevention among Client’s
attenders.
SCORING PROCEDURE
This section consists of 25 multiple choice items. Each correct response carried score
is one (1) and each incorrect response carried score is zero (0). Inadequate knowledge
23
indicates 0-32 %, the score is 0-08, Moderately adequate Knowledge indicates 33-64 %, the
score is 09-16 and Adequate Knowledge indicates 65-100 %, the score is 17-25. According to
that scoring key was interpreted as follows.
SCORING INTERPRETATION
S.no Score Percentage (%) Level of knowledge
1. 0-08 0-32% Inadequate knowledge
2. 09-16 33-64% Moderately adequate knowledge
3. 17-25 65-100% Adequate knowledge
CONTENT VALIDITY
The content of the tool was validated on the basis of opinion given by experts in the
field of Medical Surgical Nursing.
RELIABILITY
Reliability of tool was tested by test- retest method by using Karl Pearson’s
correlation co-efficient of the reliability method. The reliability score was r=0.9.Hence, tool
was considered as highly reliable for conducting the study.
PILOT STUDY
Pilot study is a rehearsal for main study. In order to test the feasibility of the study
the pilot study was conducted. The researcher got prior permission from the Principal, Head of
the department of Medical surgical Nursing and Ethical Research Committee of CSI. St.
Luke’s college of Nursing. Formal Permission was obtained from the Medical Director of the
Balaji Multi Speciality Hospital. Rapport was established with the Client’s attenders and a
brief introduction and outline of the study was given to all samples. Oral informed consent was
obtained from the Client’s attenders and reassurance was given and the collected data was kept
24
it confidential.
Pilot Study was conducted in Balaji Multi Speciality Hospital. During data collection,
10-15 client attenders are stayed along with the in clients. Among them, the researcher
identified 13 client`s attenders were between the age of 35-55 years. From them 9 were males
and 4 were females. Based on exclusive criteria, 3 non cooperative attenders were excluded
and the remaining 10 client`s attenders were selected by using non- probability purposive
sampling technique for this study, as per inclusive criteria’s. Among them 5 samples were
allotted to control group and 5 samples were allotted to experimental group.
Followed with collection of demographic variables, Pretest was conducted by using
semi-structured knowledge questionnaire. After pre-test, the researcher administered
Structured teaching programme on Nosocomial infection and its prevention for experimental
group and not given for control group. The post- test was conducted on 7 th day of STP
administration by using same questionnaire. After data collection, the collected data was
organized, tabulated, summarized and analyzed according to the objectives of the study by
using both descriptive and inferential statistics.
PLAN FOR DATA COLLECTION
The researcher got prior permission from the Principal, Head of the Department of
Medical surgical nursing and Research Ethical research committee of CSI. St. Like’s College
of Nursing. Before that data collection and formal permission was obtained from the Medical
Director of Balaji Multi Speciality Hospitals at Coimbatore. Rapport was established with
Client’s attenders and a brief introduction and outline of the study was given to all samples.
Oral informed consent was obtained from Client’s attenders and reassurance was provided
that the data collected would be kept in confidentiality.
PHASE - I
25
The researcher was selected Balaji Multi Speciality Hospital for experimental group.
During data collection, 40-55 client attenders are stayed along with the Inclients. Among
them, the researcher identified 43 client`s attenders were between the age of 35-55 years.
From them 24 were males and 19 were females. Based on exclusive criteria, 8 non
cooperative attenders and 5 attenders are health care personnel were excluded and the
remaining 30 client`s attenders were selected using non-probability purposive sampling
technique for experimental group as per inclusive criteria’s.
Step-2: The researcher was selected C.S.I. Jeyaraj Annapackiam Hospital for control
group. During data collection, 40-55 client attenders are stayed along with the Inclients.
Among them, the researcher identified 38 client`s attenders were between the age of 35-55
years from them 22 were males and 16 were females. Based on exclusive criteria, 6 non co-
operative attenders and 2 attenders are health care personnel were excluded and the
remaining 30 client`s attenders were selected by using non-probability purposive sampling
technique for control group as per inclusive criteria’s.
PHASE II
Following with collection demographic variables, Pre-test was conducted by using
semi-structured knowledge questionnaire. After pre-test, Structured teaching programme on
Nosocomial infection and prevention was administered to experimental group for 30 minutes
and not given to control group. Followed with Structured teaching programme, post-test was
done on 7th day by using same questionnaire. After data collection, the collected data was
organized, tabulated, summarized and analyzed according to the objectives of the study by
using both descriptive and inferential statistics.
PLAN FOR THE DATA ANALYSIS
After data collection, the collected data was organized, tabulated, summarized
and analyzed according to the objectives of the study by using both descriptive and inferential
statistics.
26
DESCRIPTIVE STATISTICS
 The frequency and percentage distribution was used to analyze the demographic
variables among client’s attenders in experimental and control groups.
 The frequency and percentage distribution was used to assess the pre-test and post-
test level of knowledge on STP regarding Nosocomial infection and its prevention
among Client’s attenders in experimental and control groups.
 Mean and standard deviation were used to assess the pre-test and post-test level of
knowledge on STP regarding Nosocomial infection and its prevention among
Client’s attenders in experimental and control groups.
INFERENTIAL STATISTICS
 Unpaired “t” test was used to compare the level of knowledge on STP regarding
Nosocomial infection and its prevention between experimental and control groups.
 Paired ‘t’ test will be used to compare the level of knowledge on STP regarding
Nosocomial infection and its prevention among experimental group
 Chi-Square test was used to associate the post-test level of knowledge on STP
regarding Nosocomial infection and its prevention with selected demographic variables
in experimental and control groups.
PROTECTION OF HUMAN RIGHTS
Researcher got prior permission from the Principal, Head of the department of
Medical surgical nursing and Ethical Research committee of CSI. St. Luke’s College of
Nursing. Formal permission was obtained from Medical Director of Balaji Multi Speciality
Hospital and C.S.I. Balaji Hospital at Coimbatore. An oral informed consent was obtained
before starting the data collection and assurance was given to each client’s attenders that the
confidentiality would be maintained.
27
CHAPTER IV
DATA ANALYSIS AND INTERPRETATION
This chapter deals with analysis and interpretation of data collected a descriptive
study to assess the knowledge and practice of Nosocomial infection and its prevention among
Client’s attenders in selected hospital. Descriptive and inferential statistics were used for
analyzing the data of objectives of the study. The data has been tabulated and organized as
follows.
ORGANIZATION OF DATA
The organization of the data is presented under the following sections.
Section A: Description of demographic variables of client’s attenders.
Frequency and percentage distribution of demographic variables of Client’s attenders
with respect of age, sex, marital status, religion, educational status, family income,
occupation, number of time visited to hospital, name of the ward and source of knowledge
about infection.
Section B: Assessment of level of knowledge regarding STP on Nosocomial infection and
its prevention among client’s attenders in experimental and control groups.
 Assessment of frequency and percentage distribution of pre – test and post test
level of knowledge regarding STP on Nosocomial infection and its prevention
among client’s attenders in experimental and control groups.
Section C: Comparisons of level of knowledge regarding Structured teaching
programme on Nosocomial infection and its prevention among client’s attenders in
 Comparison of Mean pre-test level of knowledge regarding STP on Nosocomial
infection and its prevention among Client’s attenders in experimental and control
groups.
28
 Comparison of Mean pre-test and post-test level of knowledge regarding STP on
Nosocomial infection and its prevention among Client’s attenders in experimental
and control groups.
 Comparison of Mean post-test level of knowledge regarding STP on Nosocomial
infection and its prevention among Client’s attenders in experimental and control
groups
Section D: Association of post- test level of knowledge regarding STP on Nosocomial
infection and its prevention among client’s attenders in experimental and control
groups with their selected demographic variables.
 Association of post-test level of knowledge regarding STP on Nosocomial infection
and its prevention among client’s attenders in experimental group with their selected
demographic variables.
 Association of post-test level of knowledge regarding STP on Nosocomial infection
and its prevention among client’s attenders in control group with their selected
PRESENTATION OF DATA
Section A: Description of demographic variables of the samples
Table 1: Frequency and Percentage distribution of demographic variables of Client’s
attenders with respect of age, sex, marital status, religion, educational status, family income,
occupation, Number of times visited to hospital, name of the ward and source of knowledge
about infection.
29
(N=60)
Experimental group(n=30) Control group

S. No Demographic (n=30)
variables F % F %
1. Age
a) 35-40 Years 8 26.67% 4 13.33%
7 23.33% 6 20%
b) 41-45 Years
10 33.33% 8 26.67%
c) 46-50Years
12 40%
d) 51 -55 Years 5 16.67%
2.
Sex
16 53.33%
18 60%
a) Male
14 46.67%
12 40%
3. b) Female
Marital status 26 86.67%

24 80%
a) Married 4 13.33%
4. 6 20%
b) Unmarried
16 53.33%
Religion
14 46.67%
4 13.34%
a) Hindu
6 20% 10 33.33%
5. b) Christian
10 33.33%
c) Muslim
12 40%
Education 5 16.67%
a) Primary 7 23.33%
education 8 26.67% 5 16.67%
b) High education 4 13.33% 6 20%

6.
c) Higher education 13 43.33%
3 10%
d) Graduates
5 16.67%
30
Family income : 2 6.67%
12 40%
a) Rs.4000 -6000 3 10%
10 33.33%
7.
b) Rs .6001-8000 10 33.33%
c) Rs.8001-9000 15 50% 5 16.67%
d) Rs.9001 above 7 23.33%

6
Occupation 20% 8 26.67%
9
8. a) Government 30% 10 33.33%
8
b) Private 26.67%
7
c) House wife 23.33%
6 20%
d) Coolie
5 16.67%
No of times visited to 3
8 26.67%
10%
hospitals 6
11 36.66%
20%
9. 11
a) 1 time
10 36.67%
b) 2 times
33.33%
c) 3 times 11 36.67%
d) 4 times and
13
6 20%
above 43.33%
10. Name of the ward 8
13 43.33%
a) General medicine 26.67%
ward 9
4 13.33%
b) Cardio thoracic 30% 6 20%

3
ward 8 26.67%
5
10% 12 40%
c) Post operative ward
7
16.67%
Sources of knowledge
15
23.33%
a) Newspaper
31
b) Television 50%
c) Family
d) Peer groups
Table 1: Describe the frequency and percentage distribution of demographic variables of
Nosocomial infection and its prevention among Client’s attenders in experimental and control
groups.
With regard to age in experimental group out of 30 samples, 10 (33.33%) of samples
belongs to the age between 46-50 years, whereas in control group out of 30 samples, 12(40
%) of samples belongs to the age between 51-55Years.
With respect to sex in experimental group out of 30 samples, 18 (60%) of them were
males. Whereas in control group out of 30 samples, 16 (53.33%) of them were males.
With respect to marital status in experimental group out of 30 samples, 24 (80%) of
them were married. Whereas in control group out of 26 (86.67%) of them were married.
With regard to religion in experimental group out of 30 samples, 14 (46.67%) of them
were Hindu. Whereas in control group out of 30 samples, 16 (53.33%) of them were Hindu.
Based on educational status in experimental group out of 30 samples, 13(43.33%) of
them were Graduates. Whereas in control group out of 30 samples, 12(40%) of them were
primary education.
With regard to family income in experimental group out of 30 samples, 15(50%) of
them were having the income of Rs. 9001 above. Whereas in control group, 12 (40%) of
them were having the income of Rs. 8001-9000.
With respect to occupation in experimental group out of 30 samples, 9 (30 %) of them
were Private. Whereas in control group, 10 (33.33%) of them were coolie.
32
With regard to number of times visited to a hospital in experimental group out of 30
samples, 11 (36.67%) of them visit 3 times. Whereas in control group, 11 (36.33%) of them
visit 4 times and above.
With respect to Name of ward in experimental group out of 30 samples, 13 (43.33%)
of them were General medicine ward. Whereas in control group 11 (36.67%) of them were
General medicine ward.
With regard to source of knowledge in experimental group, out of 30 samples, 15
(50%) of them got knowledge through Peer group. Whereas in control group 12 (40%) of
them got knowledge through Peer groups.
AGE EXPERIMENTAL GROUP

CONTROL GROUP
45%
40%
40%
35% 33%
26.67%
30%
26.70%
25% 23.30%
16.7%
20%
20%
13.33%
15%
10%
5%
0%
35-40 YEARS 41-45 YEARS 46-50 YEARS 51-55 YEARS
FIGURE 4: Percentage distribution of samples according to the age in years.
33
70% SEX EXPERIMENTAL GROUP
60% CONTROL GROUP
60%
53%
50% 47%
40%
40%
30%
20%
10%
0%
MALE FEMALE
FIGURE 5: Percentage distribution of samples according to the sex.
MARITAL STATUS
EXPERIMENTAL GROUP
100% CONTROL GROUP
90% 87%
80%
80%
70%
60%
50%
40%
30%
20%
20% 13%
10%
0%
MARRIED UNMARRIED
FIGURE 6: Percentage distribution of samples according to marital status.
34
RELIGION
60% EXPERIMENTAL GROUP
53.33% CONTROL GROUP
50% 47%
40%
33% 33.33%
30%
20%
20%
13.34%
10%
0%
Hindu Christian Muslim
FIGURE 7: Percentage distribution of samples according to Religion
EDUCATIONAL STATUS CONTROL GROUP

EXPERIMENTAL GROUP
50%
45% 43.30%
40%
40%
35%
30% 26.70%
25% 23%
20% 16.70% 17%
15% 13.30% 14%
10%
5%
0%
PRIMARY EDUCATION HIGH EDUCATION HIGHER SECONDARY GRADUATES
FIGURE 8: Percentage distribution of samples according to Educational status
35
FAMILY INCOME EXPERIMENTAL GROUP
60% CONTROL GROUP
50%
50%
40%
40%
33% 33%
30%
20% 17%
10% 10%
10% 7%
0%
RS.4000-6000 RS.6001-8000 RS.8001-9000 RS.9000 above
FIGURE 9: Percentage distribution of samples according to Family income
OCCUPATION EXPERIMENTAL GROUP

CONTROL GROUP
33%
23% 27%
17%
30% 23%
27%
20%
Government Private House wife Coolie
FIGURE 10: Percentage distribution of samples according to occupation
36
NUMBER OF TIMES VISITED IN A EXPERIMENTAL GROUP
HOSPITAL CONTROL GROUP
40%
37% 36.66%
35% 33%
30%
26.67%
25%
20.00% 20%
20%
16.67%
15%
10%
10%
5%
0%
1 time 2 times 3 times 4 times & above
FIGURE 11: Percentage distribution of samples according to Number of times visited to

hospital.
NAME OF THE WARD Experimental group

Control group
50%
45% 43.33% 43%
40% 37%
35%
30.00%
30% 26.67%
25%
20%
20%
15%
10%
5%
0%
General medicine ward Cardio thoracic ward Post-operative ward
FIGURE 12: Percentage distribution of samples according to Name of the ward.
37
SOURCE OFKNOWLEDGE CONTROL GROUP
60%
ABOUT INFECTION EXPERIMENTAL GROUP
50.00%
50%
40%
40%
30% 27%
23.33%
20%
20% 16.67%
13%
10.00%
10%
0%
News paper Television Family Peer groups
FIGURE 13: Percentage distribution of samples according to Source of knowledge

about infection.
Section B: Assessment of the level of knowledge regarding STP on Nosocomial infection
and its prevention in experimental and control group
Table 2: Frequency and percentage distribution of pre-test and post-test level of knowledge
regarding STP on Nosocomial infection and its prevention among client’s attenders in
38
(N=60)
S.NO Level of Experimental group Control group

Knowledge Pre-test Post-test Pre-test Post-test
f % f % f % F %
1. Inadequate knowledge 21 70 0 0 23 76.67 25 83.33
2. Moderately 9 30 3 10 7 23.33 5 16.67

adequate Knowledge
3. Adequate Knowledge 0 0 27 90 0 0 0 0
Table 2: Reveals the frequency and percentage distribution of pre test and post test level of
knowledge score regarding STP on Nosocomial infection and its prevention in experimental
and control groups.
It is revealed that in pre- test level of knowledge in experimental group out of 30
samples, 21 (70%) of them had Inadequate knowledge. Whereas in control group out of 30
samples 23 (76.67%) of them had Inadequate knowledge.
It shows that in post- test level of knowledge in experimental group out of 30 samples,
27 (90%) of them had adequate knowledge. Whereas in control group out of 30 samples, 25
(83.33%) of them had Inadequate knowledge.
39
90% Experimental group
Control group
80% 76.67%
70%
70%
60%
50%
40%
30%
30%
23.33%
20%
10% 0% 0%
0%
Inadequate Knowledge Moderately adequate Adequate Knowledge
knowledge
Figure 14: Percentage distribution of Pre-test level of knowledge regarding STP on
Nosocomial infection and its prevention in experimental and control groups.
Experimental Group
Control Group
100%
90.00%
90%
83.33%
80%
70%
60%
50%
40%
30%
20% 16.67%
10%
10% 0% 0.00%
0%
Inadequate Knowledge Moderately adequate Adequate Knowledge
knowledge
Figure 15: Percentage distribution of Post-test level of knowledge regarding STP on
Nosocomial infection and its prevention in experimental and control groups.
40
Section C: Comparisons of level of knowledge regarding Structured teaching
Table 3: Comparisons of mean pre-test level of knowledge regarding Structured teaching
(N=60)
Pre-test Mean ‘t’ test

S.NO Group
Mean SD difference value
Experimental 8.56 3.549 0.013

1
2.41
Group S*
2 Control group 10.97 4.438 1.434

NS
S*=Significant NS=Not significant P<0.05
Table 3 reveals that mean pre-test level of knowledge regarding Structured
teaching programme on Nosocomial infection and its prevention among client’s attenders in
In the experiment group, mean pre-test was 8.56 and SD was 3.549 and in control
group, the mean pre-test value was 10.97 and SD was 4.438. Their mean difference was
2.41.
41
12 Mean
10.97
Standard deviation
10
8.56
8
MEAN VALUE
6
4.38
4 3.549
0
Experimental group Control group
Figure 16: Comparisons of mean pre-test level of knowledge among client’s
attenders in experimental and control groups.
42
Table 4:Comparisons of mean pretest and post-test level of knowledge regarding Structured
teaching programme on Nosocomial infection and its prevention among client’s attenders in
(N=60)
Pre-test Post-test Mean ‘t’ test

S.NO
Group Mean SD Mean SD difference value
Experimental 8.56 3.549 13.83 4.16 5.27 0.013

1
Group S*
2 Control group 10.97 4.38 9.45 3.12 1.52 1.434
NS
The above table depicts the comparison of mean and standard deviation of pre- test
and post-test level of knowledge in experimental group and control group.
In the experimental group, mean pre-test value was 8.56 and SD was 3.549 and the mean
post-test was 13.83 and SD was 4.16.Their mean difference was 5.27. The calculated “t’
value was 0.013. which shows that,there was a significance difference in the pre-test and
post-test level of knowledge among experimental group at p<0.05 level.
So the research hypothesis RH2: The mean post-test level of knowledge regarding
Nosocomial infection and its Prevention among Client’s attenders in Experimental group is
significantly higher than their mean pre-test level of knowledge.was accepted.
In control group mean pre-test value was 10.97 and SD was 4.38 and the Mean
post-test value was 9.45 and SD was 3.12.Their mean difference was 1.5. The calculated
“t’ value was 1.434 which shows that there was significance difference in the pre-test and
post-test level of knowledge among control group at p<0.05 level.
43
So the research hypothesis RH3: The mean post-test level of knowledge
regarding Nosocomial infection and its Prevention among Client’s attenders in control group
is significantly lower than their mean pre-test level of knowledge was accepted.
EXPERIMENTAL GROUP
16 CONTROL GROUP
13.83
14
12
10.97
10 9.45
8.56
8
VALUE
MEAN
0
PRE-TEST POST-TEST
FIGURE 17: Comparison of mean pre- test and post- test level of knowledge of Nosocomial
infection and its Prevention in experimental and control groups.
Table 5: Comparisons of mean post- test level of knowledge regarding STP on
Nosocomial infection and its Prevention among Client’s attenders in experimental and
control groups.
(N=60)
44
Post-test Mean ‘t’ test
S.NO Group
Mea SD difference value
n
Experimental 13.83 4.16 0.013

1
4.38
Group S*
2 Control group 9.45 3.12 1.434

NS
The above table depicts the comparison of mean and standard deviation of pre- test
and post-test level of knowledge in experimental group and control group.
In the experimental group, mean post-test value was 13.83 and SD was 4.16 and in
control group, the Mean post-test value was 9.45 and SD was 3.12. Their mean difference
was 4.38. Which shows that there was significance difference in the Mean post-test level
of knowledge among experimental and control groups at p<0.05 level.
Hence, stated that research hypothesis,H1: The mean pre-test level of knowledge
regarding Nosocomial infection and its Prevention among Client’s attenders in Experimental
group is significantly higher than the mean post-test level of knowledge in control group.
Therefore, the research hypothesis RH1 was accepted.
45
16
Mean
13.83
14 Standard deviation
12
10 9.45
6
4.16
4
3.12
0
Experimental group Control group
FIGURE 18: Comparison ofmean and standard deviation of post-test level of knowledge
46
Section D: Association of post – test level of knowledge regarding STP on Nosocomial
infection and its prevention with their selected demographic variables.
Table 6: Association of post- test level of knowledge regarding STP on Nosocomial infection
and its prevention among Client’s attenders in experimental group with their selected
N=30
Level of knowledge
S.no Demographic Inadequate Moderately Adequate
variables knowledge adequate knowledge χ2
knowledge
f % f % f %
1. Age
a.35-40 Years 0 0 0 0 5 16.67 8.35
0 0 2 6.67 6 df=3
b.41-45 Years 20
0 0 1 3.33 9
c.46-50Years 30 S*
0 0 7
d.51-55Years 0 0 23.33
2. Sex 2.43
a. Male 0 0 1 3.33 11 36.67 df=2

0 0 2 6.67 16 53.33
b. Female 0.51
NS
3. Marital status 2.43
a. Married 0 0 3 10 18 60 df=2
0 0 0 0 9 30
b. Unmarried 0.51
NS
4. Religion
a. Hindu 0 0 1 3.33 12 40 9.02
0 0 1 3.33 5 16.67 DF=3

b. Christian
47
c. Muslim 0 0 1 3.33 10 33.33 0.048
S*
5. Education:
a. Primary 0 0 0 0 1 3.33 9.1
education df=3
0 0 0 0 4 13.33
b. High education 0.04
0 0 1 3.33 8 26.67
c. Higher S*
education
0 0 2 6.67 14
46.67
d. Graduates
6. Family income :
a. Rs.4000 -6000 0 0 0 0 4 13.34 2.43
0 0 1 3.33 3 10 df=3
b. Rs .6001-8000
0 0 1 3.33 8 26.67 0.04
c. Rs.8001-9000
0 0 1 3.33 12
d. Rs.9001 above 40 NS
7. Occupation
a. Government 0 0 1 3.33 7 23.33 0.80
0 0 1 3.33 10 33.33 df=3

b. Private
0 0 1 3.33 4 13.34 0.04
c. House wife
0 0 0 0 6
d. Coolie 20 S*
8. Number of time
visited to hospital
0 0 2 6.67 13 43.33 9.02
a. 1 time
0 0 1 3.33 7 23.34 df=3
b. 2 times
0 0 0 0 6 20 0.048
48
c. 3 times 0 0 0 0 1 3.33 S*
d. 4 times and
above
9. Name of the ward
a. General 0 0 5 16.67 7 23.33 2.53
medicine ward Df=3

0 0 3 10 8 26.67
b. Cardio thoracic 0.511
ward NS
0 0 1 3.33 6 20
c. Post operative
10. ward
Sources of
9.02
0 0 1 3.33 4
knowledge 13.33
df=3
0 0 - - 6
a. Newspaper 20
0.048
0 0 1 3.33 5
b. Television 16.67
0 0 1 3.33 12 S*
c. Family 40
d. Peer groups
#NS- Non significant *S- Significant p<0.05
Table-6: Reveals that the association between the post-test level of knowledge regarding
structured teaching programme on Nosocomial infection and its prevention with their
selected demographic variables in experimental group. While analyzing the statistical
significant at (p<0.05) level it shows that there was significant association of the post-test
49
level of knowledge related with the selected demographic variables like age, religion,
education, occupation, number of times visited to hospital and source of knowledge about
infection. But there was no association found in sex, Family income and name of the ward at
p<0.05 level.
Table 7: Association of post test level of knowledge regarding Structured teaching programme
on Nosocomial infection among client’s Attenders in control group with their selected
50
(N=30)
LEVEL OF KNOWLEDGE
S.no DEMOGRAPHIC Inadequate Moderately Adequate
knowledge adequate knowledg χ2
VARIABLES
knowledge e
F % F % f %
1. Age
a.35-40 Years 7 23.33 0 0 0 0

8.35
3 10 1 3.33 0 0
b.41-45 Years
0 df=3
5 16.67 2 6.67 0
c.46-50Years
6.67 0 S*
d.51-55Years 10 33.33 2 0
2. Sex 0.31
13 43.33 3 10 0 0 df=3
a. Male
0.916
12 40 2 6.67 0 0
b. Female
NS
3. Marital status
a. Married 17 56.67 4 13.34 0 0 2.24

df=3
8 26.67 1 3.33 0 0
b. Unmarried 0.53
NS
4. Religion
a. Hindu 11 36.67 2 6.67 0 0 2.43

df=3
6 20 2 6.67 0 0
b. Christian 0.51
8 26.67 1 3.33 0 NS
c. Muslim 0
5. Education:
a. Primary 3 10 0 0 0 0 9.02
education df=3
5 16.67 0 0 0 0
b. High education 0.04
8 26.67 2 6.67 0 0
c. Higher education S*
9 30 3 10 0
0
51
d. Graduates
6. Family income :
a. Rs.4000 -6000 2 6.67 0 0 0 0 0.80

6 20 0 0 0 0
b. Rs .6001-8000 df=3
9 30 3 10 0 0
c. Rs.8001-9000 0.048
8 26.67 2 6.67 0 0
d. Rs.9001 above NS
7. Occupation
A. Government 12 40 3 10 0 0 2.27
6 20 1 3.33 0 0
B. Private df=3
2 6.67 1 3.33 0 0
C. House wife 0.53
5 16.67 1 3.33 0 0
D. Coolie NS
8. Number of times
visited to hospital
A. 1 time 9 30 3 6.67 0 0
9.02
B. 2 times 7 23.33 1 3.33 0 0
df=2
C. 3 times 4 13.33 1 3.33 0 0 0.741
D. 4 times and 6 20 0 0 0 0 S*
above
9. Name of the ward
A. General medicine 9 30 4 13.33 0 0

2.43
ward
6 20 0 0 0 0 Df=3
B. Cardio thoracic
0.511
ward
8 26.67 3 10 0 0 NS
C. Post operative
10. ward
52
Sources of knowledge 2 6.67 2 6.67 0 0
A. Newspaper 4 13.33 0 0 0 0 9.02
B. Television 6 20 0 0 0 0 df=3
13 43.33 3 10 0 0 0.048
C. Family
D. Peer groups S*
Table- 7: Reveals that the association between the post-test level of knowledge regarding
structured teaching programme on Nosocomial infection and its prevention with their
selected demographic variables in control group. While analyzing the statistical significant at
(p<0.05) level it shows that there was significant association of the post-test level of
knowledge related with selected demographic variables like age, education, number of times
visited to hospital and source of knowledge about infection. But there was no association
found in sex, marital status, religion, Family income, occupation and name of the ward at
p<0.05 level. Hence, stated that research hypothesis RH4 was accepted.
CHAPTER –V
DISCUSSION
The research was conducted in a view to assess the effectiveness of structured
teaching programme on knowledge regarding Nosocomial infection and its prevention among
Client’s attenders. The study was done with 60 Client’s attenders in Balaji Multispecialty
hospital at Coimbatore district. The findings of the study were discussed in relation to the
objectives.
53
OBJECTIVES
 To assess the pre- test and post-test level of knowledge regarding Nosocomial infection
and its prevention among client’s attenders in experimental and control groups.
 To determine the effectiveness of structured teaching programme on level of knowledge
regarding Nosocomial infection and its prevention among Client’s attenders in
experimental group.
 To compare the pre-test and post-test level of knowledge regarding Nosocomial infection
variables such as Age, sex, marital status, religion, educational status, Family income,
occupation, number of times visited to hospital, name of the ward and source of
knowledge about infection.
THE MAJOR FINDINGS OF THE STUDY WERE:
belongs to the age between 41-55 years. Whereas in control group out of 30 samples, 12(40
%) of samples belongs to the age between 51-70 Years.
54
them were Graduates, whereas in control group out of 30 samples, 12(40%) of them were
primary education.
With regard to Family income in experimental group out of 30 samples, 15(50%) of
In relation to Number of time visited to a hospitals in experimental group out of 30
samples, 11 (36.67%) of them visit 3 times. Whereas in control group 6 (20%) of them visit 1
time.
of them were General medicine ward. Whereas in control group, 13 (43.33%) of them were
Post operative ward.
With regard to source of knowledge about infection in experimental group out of 30
samples, 15 (50%) of them got knowledge through peer groups, whereas in control group 12
(40%) of them got knowledge through peer groups.
The first objective was to assess the pre and post-test level of knowledge regarding
Nosocomial infection among Client’s attenders in experimental and control groups.
It is revealed that in pre- test level of knowledge in experimental group out of 30
samples, 21 (70%) of them had Inadequate knowledge. Whereas in control group out of 30
samples 23 (76.67%) of them had Inadequate knowledge.
55
It is revealed that in post- test level of knowledge in experimental group out of 30
samples, 27 (90%) of them had adequate knowledge. Whereas in control group out of 30
samples, 25 (83.33%) of them had Inadequate knowledge.
The second objective was to determine the effectiveness of structured teaching
programme on knowledge regarding Nosocomial infection among Client’s attenders in
experimental group.
In the experimental group, mean pre-test value was 8.56 and SD was 3.549 and the
mean post-test was 13.83 and SD was 4.16.Their mean difference was 4.73. The calculated
“t’ value was 0.013. which shows that there was a significance difference in the pre-test
and post-test level of knowledge among experimental group at p<0.05 level.
Hence, stated that research hypothesis, “RH2: The mean post-test level of knowledge
regarding STP on Nosocomial infection and its Prevention among Client’s attenders of
Experimental group is significantly higher than their mean pre-test level of knowledge was
accepted.
The third objective was comparison of pre-test and post – test level of knowledge
regarding structured teaching programme on Nosocomial infection and its prevention
In the experimental group, mean pre-test value was 8.56 and SD was 3.549 and the
mean post-test was 13.83 and SD was 4.16.Their mean difference was 4.73. The calculated
“t’ value was 0.013.
regarding STP on Nosocomial infection and its Prevention among Client’s attenders of
Experimental group is significantly higher than their mean pre-test level of knowledge was
accepted.
In control group mean pre-test value was 10.97 and SD was 4.38 and the Mean
56
post-test value was 9.45 and SD was 3.12.Their mean difference was 1.5. The calculated
“t’ value was 1.434 which shows that there was a significance difference in the pre-test
and post-test level of knowledge among control group at p<0.05 level.
regarding STP on Nosocomial infection and its Prevention among Client’s attenders in
control group is significantly lower than the mean pre-test level of knowledge was accepted.
The fourth objective was find out the association between the post test level of
knowledge regarding structured teaching programme on Nosocomial infection of
Client’s attenders with their selected demographic variables in experimental and
control groups.
 Chi- square test to associate the post- test level of knowledge on Nosocomial
infection and its prevention with the selected demographic variables in the experimental
group While analyzing the statistical significance at (p<0.05) level it shows that there was
significant association of the post- test level of knowledge with the selected demographic
variables like Age, sex, marital status, religion, educational status, Family income,
occupation, number of times visited to hospital and source of knowledge at p<0.05 level.
Hence, the research hypothesis RH4 was accepted.
 Chi- square test to associate the post- test level of knowledge regarding
Structured teaching programme on Nosocomial infection and its prevention with the selected
demographic variables in the control group. While analyzing the statistical significance at
(p<0.05) level it shows that there was significant association of the post- test level of
knowledge with the selected demographic variables like Age, sex, marital status, religion,
educational status, Family income, occupation, number of times visited to hospital and source
of knowledge at p<0.05 level. Hence, stated that research hypothesis RH 4 : the association
57
between the post test level of knowledge regarding structured teaching programme on
Nosocomial infection of Client’s attenders with their selected demographic variables in
experimental and control groups was accepted.
CHAPTER – VI
SUMMARY, CONCLUSION, IMPLICATION AND RECOMMENDATIONS
This chapter deals the summary of the study and conclusion drawn. It clarified the
limitation of the study and implications. The recommendations are given for different area
like nursing education, nursing administration, nursing practice and nursing research.
SUMMARY OF THE STUDY
58
This study was undertaken to assess the knowledge of structured teaching programme
on Nosocomial infection and its Prevention among Client’s attenders.
OBJECTIVES
 To assess the pre- test and post-test level of structured teaching programme on
knowledge regarding Nosocomial infection and its prevention among client’s
attenders in experimental and control groups.
 To determine the effectiveness of structured teaching programme on level of
knowledge regarding Nosocomial infection and its prevention among Client’s
attenders in experimental group.
 To compare the pre-test and post-test level of knowledge regarding Nosocomial
infection among Client’s attenders in experimental and control groups.
variables such as Age, sex, marital status, religion, educational status, Family income,
occupation, number of times visited to hospital, name of the ward and source of
knowledge about infection.
HYPOTHESES
RH1: The mean post-test level of knowledge regarding Nosocomial infection and its
Prevention among Client’s attenders in Experimental group is significantly higher than the
mean post-test level of knowledge in control group.
59
RH2: The mean post-test level of knowledge regarding Nosocomial infection and its
Prevention among Client’s attenders in Experimental group is significantly higher than their
mean pre-test level of knowledge.
RH3: The mean post-test level of knowledge regarding Nosocomial infection and
its Prevention among Client’s attenders in control group is significantly lower than their
mean pre-test level of knowledge
RH4: There will be a significant association between the post-test level of knowledge
regarding Nosocomial infection and its Prevention among Client’s attenders with their
selected demographic variables in experimental and control groups.
ASSUMPTION
1. The Client’s attenders may have inadequate knowledge regarding Nosocomial
2. Structured teaching programme will increase the knowledge on Nosocomial
infection and its prevention among Client’s attenders.
SECTION A: Studies related to incidence and prevalence of Nosocomial infections.
SECTION B: Studies related to Prevention of Nosocomial infection.
SECTION C: Studies related to effect of Structured teaching programme regarding
The conceptual framework for the study was based on Weiedenbachs’s Prescriptive
Theory.
During Pilot study, data pertaining to demographic variables was collected.
Investigator assessed the pre-test level of knowledge by semi-structured knowledge
questionnaire on Nosocomial infection and its prevention. The investigator was administered
Structured teaching programme on Nosocomial infection and its prevention for experimental
60
group and not given for control group. The post- test was conducted by using same
questionnaire. The post-test mean value was 10.2 and standard deviation was 3.156 at p<0.05
level. It shows that pilot study was feasible and practicable to conduct main study. There was
no modification made in the tool
During the data collection procedure the investigator introduced herself and
established rapport with the Client’s attenders. They are assured that no physical and
emotional harm would be done in the course of the study.
Data regarding demographic variables were collected. Investigator assessed the pre
test level of knowledge by using semi structured knowledge questionnaire. Followed with
pre-test, the investigator was given structured teaching programme on Nosocomial infection
and its prevention. Post test level of knowledge assessment was done on 7 th day by using
semi-structured knowledge questionnaire. The post test level of score is p<0.05. After the
scoring the investigator was done during data analysis and interpretation.
THE MAJOR FINDINGS OF THE STUDY WERE AS FOLLOWS:
belongs to the age between 46-50 years, whereas in control group out of 30 samples, 12(40
%) of samples belongs to the age between 51-55Years.
61
them were Graduates. Whereas in control group out of 30 samples, 12(40%) of them were
primary education.
With regard to family income in experimental group out of 30 samples, 15(50%) of
With regard to Number of times visited to a hospital in experimental group out of 30
samples, 11 (36.67%) of them were visit 3 times. Whereas in control group, 11 (36.33%) of
them were visit 4 times and above.
of them were from General medicine ward. Whereas in control group 11 (36.67%) of them
were from General medicine ward.
With regard to source of knowledge in experimental group, out of 30 samples, 15
(50%) of them got knowledge through Peer group. Whereas in control group 12 (40%) of
them got knowledge through Peer groups.
CONCLUSION
The following conclusions were drawn from the finding of the present study. From
the study results, underline the importance of Nosocomial infection and its prevention among
Client’s attenders. So the structured teaching programme was very effective to improve the
awareness among the Client’s attenders regarding Nosocomial infection and its prevention.
IMPLICATIONS
The Researcher has derived the following implications from the study which are vital
importance in the field of Nursing practice, Nursing administration, Nursing education and
Nursing research.
62
NURSING PRACTICE
Nurses can conduct screening programmes to assess level of knowledge regarding
STP on Nosocomial infection and its prevention.
Nurses can implement structured teaching programme on Nosocomial infection for
Client’s attenders.
NURSING EDUCATION
 The curriculum should give more emphasis on Nosocomial infection.
 Nurse educators should give more importance to prevent the Nosocomial
infection.
NURSING ADMINISTRATION
In- service education programme and continuing nursing education program
regarding Nosocomial infection can be organized by nurse administrator, nurse, paramedical
students and Client’s attenders in the hospital.
NURSING RESEARCH
Extensive research must be conducted in this area to identify several causes of
the poor management of bio medical wastes and necessary steps to be taken to prevent
Nosocomial infection.
LIMITATIONS
 Small sample size
 The study was limited to Balaji Multi Speciality Hospital.
RECOMMENDATIONS
 Similar study can be replicated on a large sample.
 A similar study can be conducted among staff nurses working in a hospital
63
 A similar study can be conducted for the nursing students.
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in the neonatal intensive care unit. Arch pediatric Adolescents Med. 2006 Aug;
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APPENDICES
APPENDIX- A
INFORMED CONSENT
Good Morning,
I am Ms. A.Alpons Nisha, M.Sc. Nursing I year (Medical Surgical Nursing)
students of CSI. St. Luke’s College Of Nursing, conducting “A study to assess the
effectiveness of structured teaching programme on knowledge regarding Nosocomial
infection and its Prevention among Client’s Attenders in Balaji Multi Specialty Hospital at
Coimbatore district” as a partial fulfillment of the requirement for the degree of M.Sc.
Nursing under The Tamilnadu Dr. M.G.R. Medical University. The structured teaching
programme on knowledge regarding Nosocomial infection and its Prevention will be given
68
30 minutes per day and post-test level of knowledge will be assessed by using semi-
structured knowledge questionnaire on 7th day of the study.
I assure, you that information obtained will be kept confidential. So I request you to
kindly co-operate with us and participate in this study by giving your frank and voluntary
consent.
Thank you
69
APPENDIX-B
SECTION A
SAMPLE NO:
DEMOGRAPHIC VARIABLES
It consists of structured interview schedule. It has questions related to demographic
data of the client’s attenders
1. Age
a) 35−40 years
b) 41−45 years
c) 46−50 years
d) 51-55 years
2. Sex
a) Male
b) Female
3. Marital status
a) Married
b) Unmarried
4. Religion
a) Hindu
b) Christian
c) Muslim
5. Educational status
a) Primary education
b) High education
c) Higher education
d) Graduates
70
6. Family income
a) Rs 4,000 – Rs 6,000
b) Rs 6001 – Rs 8000
c) Rs 8001 – Rs 9000
d) Above Rs 9001
7. Occupation
a) Government
b) Private
c) House wife
d) Coolie
8. Number of previous visited in a hospital
a) 1 time
b) 2 times
c) 3 times
d) 4 times and above
9. Name of the ward
a) General medicine ward
b) Cardio thoracic ward
c) Post operative ward
10. Sources of knowledge
a) Newspaper
b) Television
c) Family
d) Peer groups
71
SECTION B
SEMI STRUCTURED KNOWLEDGE QUESTIONNAIRE
1. What is Nosocomial infection?
a) Infection occurs due to taking care of the client
b) Infection occur one week to month, when symptom occurs
c) Infection transfer from one person to another
d) Infection transfer from animal to person
2. Nosocomial infection is otherwise known as
a) Cross infection
b) Hospital acquired infection
c) Super infection
d) Zoonosis
3. Which one of the following is frequently occurred in hospital by Nosocomial
infection?
a) Reproductive tract infection
b) Urinary tract infection
c) Respiratory tract infection
d) Infectious diarrhoea
4. The most common cause of Nosocomial infection by
a) Staphylococci and E.coli
b) Staphylococci and P.auroginosa
c) Ecoli and P.auroginosa
d) Pneumococci and E.coli
72
5. Which one of the following is not a portal of entry for Nosocomial infection by
bacteria?
a) Eyes
b) Nose
c) Mouth
d) Intact skin
6. Nosocomial infection occurs __________
a) Within 5 days of hospital admission
b) Within 2 days of hospital admission
c) Within 15 days of hospital admission
d) Within a month of hospital admission
7. Nosocomial infection will be transmitted by
a) Droplet
b) Direct contact
c) Airborne
d) Vector borne
8. The source of Nosocomial infection is
a) Ventilator associated pneumonia
b) Catheter associated pneumonia
c) Surgical site infection
d) All the above
9. Choose the correct risk factor of Nosocomial infection
a) Diabetus mellitus
b) Hypertension
c) Acute renal failure
d) Bronchial asthma
73
10. Which one of the following is not a prevention of Nosocomial infection?
a) Not Eating foods in a client’s room
b) Not Sitting on the client’s bed
c) Restricting the visitors
d) Using room sprays
11. Hand washing is necessary to prevent infection.
a) True
b) False
12. When and all you have to hand wash?
a) Before and after touching the clients
b) While Entering of the client room
c) While Before using client rest room
d) Before and after touching each articles in a client’s room.
13. Which type of hygiene is important to prevent Nosocomial infection?
a) Food hygiene
b) Environmental hygiene
c) Personal hygiene
d) Menstrual hygiene
14. The most common bacterial cause of Nosocomial infection is
a) Leprosy
b) Rabies
c) Malaria
d) Tuberculosis
74
15. Which one of the following activities should not be done at client’s side to prevent
Nosocomial infection?
a) Sneezing or coughing near client’s side
b) Taking foods or snacks in client’s side
c) Drinking water
d) Both a and b
e) Both b and c
16. Whether the children will be permitted to stay along with client in a hospital?
a) Yes
b) No
17. The most commonly affected by Nosocomial infection is
a) Men
b) Women
c) Children
d) All the above
18. How will be prevented the client from Nosocomial infection?
a) Wear clean and neat hospital clothes
b) Leave the slippers outside of the client room
c) Avoid keeping more articles inside the room
d) All the above
19. Which one is correct measure to prevent surgical site infection?
a) Do not allow others to touch the surgical wound
b) Keep the surgical wound neat and clean
c) Always clean the hands before care of the wound
d) All the above
20. What are the symptoms of surgical site infection?
75
a) Purulent discharge, tenderness and fever
b) Numbness, redness and swelling
c) Redness, Ecchymosis and itching
d) All the above
21. Who are the most responsible to prevent Nosocomial infection?
a) Client’s attenders
b) Medical team
c) Client’s attenders and medical team
d) None of the above
22. Frequent hand washing helps to
a) Prevent transmission of infection from one person to another
b) Keep the hands neat and clean
c) Avoid soiling of hands
d) All the above
23. How many attenders should be stayed along with the client’s room?
a) 1 visitor
b) 2 visitors
c) 3 visitors
d) Above
24. Why Nosocomial infection should be prevented?
a) To ensure safety and transmission of client from Nosocomial infection
b) To ensure all measures are taken to reduce infections and prevent transmission
c) It helps to prevent transmission of infection from one person to another
d) All the above
76
25. The most common complications of Nosocomial infection among client is
a) Tuberculosis
b) Pneumonia
c) Swine flue
d) Corona virus
77
ANSWERS KEY
S.NO ANSWERS S.NO ANSWERS
1. A 17. D
2. B 18. D
3. C 19. D
4. A 20. A
5. A 21. D
6. A 22. A
7. B 24. A
8. E 24. B
9. C 25. B
10. D
11. A
12. D
13. C
14. D
15. D
16. B
78
APPENDIX-C
பகுதிஅ
தனிநபர்விபரம்
1.வயது
அ.35 முதல்40 வயதுவரை
ஆ.41 முதல்45 வயதுவரை
இ.46 முதல் 51 வயதுவரை
ஈ.51 முதல் 55 வயதுவரை
2.பாலினம்
அ.ஆண்
ஆ.பெண்
3.திருமணநிலை
அ.திருமணமானவர்
ஆ.திருமணமாகதவர்.
4.மதம்
அ.இந்து
ஆ.கிறிஸ்தவம்
இ.முஸ்லிம்
ஈ.மற்றவர்.
5.கல்வித்தகுதி
அ.முதன்மைகல்வி
ஆ.உயர்நிலைகல்வி
இ.மேல்நிலைக்கல்வி
79
ஈ.பட்டப்படிப்பு.
6. குடும்பவருமானம்
அ. ரூ.4000-ரூ. 6000 வரை
ஆ. ரூ.6001-ரூ. 8000 வரை
இ. ரூ.8001-ரூ. 9000 வரை
ஈ. ரூ. 9001 மேல்.
7.தொழில்
அ.அரசாங்கம்
ஆ.தனியார்நிறுவனம்
இ.குடும்பநிறுவானர்
ஈ.கூலிதொழில்
8.எத்தனைமுறைநோயாளியைமருத்துவமனையில்பார்க்கவந்துள்ளீர்கள்?
அ.ஒருமுறை
ஆ.இரண்டுமுறை
இ.மூன்றுமுறை
ஈ.மூன்றுமுறைக்குமேல்
9.வார்டின்பெயர்என்ன?
அ. பொதுமருத்துவபிரிவு
ஆ. அறுவைசிகிச்சைபிரிவு
இ. இருதயசிகிச்சைபிரிவு
10.நோசோகோமியல்தொற்றுபற்றியமுந்தையஅறிவுஎதன்மூலம்பெற்றீர்கள்?
அ.செய்தித்தாள்
ஆ.தொலைக்காட்சி
80
இ.குடும்பம்
ஈ.நண்பர்கள்
பகுதிஆ
கேள்விகள்
1. நோசோகோமியல்தொற்றுஎன்றால்என்ன?
அ.மருத்துவமனையில்நோயாளிகளைகவனித்துக்கொள்வதால்ஏற்படும்தொற்று.
ஆ. தொற்றின்அறிகுறிகள்ஒருவாரம்முதல்மாதம்வரைபரவும்
இ. இதுபொதுநடவடிக்கையால்ஏற்படும்தொற்று.
ஈ. இதுதொழிற்சாலையில்ஏற்படும்தொற்று.
2. நோசோகோமியல்தொற்றின்வேறுபெயர்என்ன?
அ. குறுக்குதொற்று
ஆ. மருத்துவமனையில்ஏற்பட்டதொற்று
இ. சூப்பர்தொற்று
ஈ. குறுக்குமற்றும்புரவலன்தொற்று
3. நோசோகோமியல்தொற்றைதடுப்பதன்அவசியம்?
அ. நோயாளிகளைநோசோகோமியல்தொற்றிலிருந்துபாதுகாத்தல்
ஆ. சுற்றுபுறத்தைதூய்மையாகவைத்தல்
இ. தூய்மைசுகாதரத்தைமேற்கொள்ளுதல்
ஈ. இவைஅனைத்தும்
4.கீழ்கண்டவற்றுள்எந்ததொற்றுமருத்துவமனையில்ஏற்படும்?
அ. இனப்பெருக்கதொற்று?
ஆ. சிறுநீரகபாதைதொற்று
81
இ. மூச்சுக்குழாய்தொற்று
ஈ. தொற்றுமூலம்ஏற்பட்டதொற்று
5. எதுநோசோகோமியல்தொற்றுபரவுவதற்குமுக்கியகாரணம்?
அ. பாக்டீரியா
ஆ. பூஞ்சை
இ. வைரஸ்
ஈ. புரோட்டோசோவா.
6. கீழ்கண்டவற்றுள், எப்பகுதிபாக்டீரியாநுழைவதற்கானபொதுவழிஅல்ல.
அ. மூக்கு
ஆ. கண்
இ. வாய்
ஈ. சருமத்தோல்
7.நோசோகோமியல்தொற்றுபரவுவதற்கானவழிஎது?
அ. வென்டிலேட்டர்தொடர்புடையநிமோனியா
ஆ. சிறுநீர்க்குழாய்தொடர்புடையநிமோனியா
இ. மத்தியவரிதொடர்புடையநிமோனியா
ஈ .இவைஅனைத்தும்
8.நோசோகோமியல்தொற்றுபரிமாற்றத்தின்முக்கியவழிகள்
யாவை?
அ. தொடர்புபரிமாற்றம்
ஆ. துளிபரிமாற்றம்
82
இ. காற்றுமூலம்பரவுதல்
ஈ.இவைஅனைத்தும்
9.யாரெல்லாம்நோசோகோமியல்தொற்றால்அதிகம் பாதிக்கப்படுவார்கள்?
அ.70 வயதிற்குமேல்
ஆ.குறுகியசிறுநீரகசெயலிழப்பு
இ.நிலைவற்றநிலை
ஈ.அவசரசிகிச்சைபிரிவில்அதிகநாட்கள்இருத்தல் 3 நாட்கள்
உ.இவைஅனைத்தும்
10. குழந்தைகளைமருத்துவமனையில்அனுமதிக்கலாமா?
அ. ஆம்
ஆ. இல்லை
11. யார்அதிகமாகநோய்த்தொற்றால்பாதிக்கப்படுவர் ?
அ. ஆண்கள்
ஆ. பெண்கள்
இ. குழந்தைகள்
12. நோசோகோமியல்தொற்றுஏற்படுதல் ---------------------
அ. மருத்துவமனையில்அனுமதித்த 2 நாட்கள்
ஆ. மருத்துவமனையில்அனுமதித்த 5 நாட்கள்
.இ. மருத்துவமனையில்அனுமதித்த 15 நாட்கள்
. ஈ. மருத்துவமனையில்அனுமதித்த 1 மாதம்.
83
13. நோசாகோமியல்தொற்றைஎவ்வாறுதடுக்கலாம்?
அ. அடிக்கடிகைகழுவுதல்
ஆ. சுற்றுபுறத்தைதூய்மையாகவைத்தல்
இ. நோயாளியின்பார்வையாளர்களைத்தவிர்த்தல்
ஈ. இவைஅனைத்தும்.
14.கைகழுவுதல்நோசாகோமியல்தொற்றுபரவுதலதடுப்பதற்கு அவசியம்.
அ. ஆம்
ஆ. இல்லை.
15.எத்தனைபார்வையாளர்கள்நோயாளிகளிடம்தங்கியிருக்க வேண்டும்?
அ. 1 நபர்
ஆ. 2 நபர்
இ. 3 நபர்
ஈ. அதற்குமேல்.
16.கீழ்கண்டவற்றுள்எந்தசூழல்களில்நீங்கள்கைகழுவுதல்
அவசியம்?
அ. நோயாளிகளைத்தொடுவதற்குமுன்மற்றும்பின்
ஆ. நோயாளிஅறையில்நுழைவதற்குமுன்
இ. கழிப்பறைஉபயோப்பதற்குமுன்
17.எவ்வாறுநோசோகோமியல்தொற்றிலிருந்துநோயாளிகளை
84
தடுக்கலாம்?
அ. சுத்தமானஆடைஅணிதல்
ஆ.காலணிகளைநோயாளியின்அறையில்வெளியில் கழற்றுதல்
இ. அதிகபொருட்களைஅறையில்வைப்பதைதவிர்த்தல்
18.எந்தவகையானசுகாதாரத்தைபயன்படுத்துவதன்மூலம்நோசோகோமியல்தொற்றைதடுக்
கலாம்?
அ. உணவுசுகாதாரம்
ஆ. சுற்றுச்சூழல்சுத்தம்
இ. தனிமனிதசுத்தம்
ஈ. மாதவிடாய்சுத்தம்
19. நோசோகோமியல்தொற்றைஎவ்வாறுதடுக்கலாம்?
அ. நல்லதனிமனிதசுத்தம்பயன்படுத்துதல்
ஆ. அதிகபார்வையாளர்தவிர்த்தல்
இ. அறுவைசிகிச்சைசெய்தஇடத்தில்தொடுவதை
20.கீழ்கண்டவற்றுள்எதைநோயாகளின்பங்கேற்பாளர்கள்மருத்துவமனையில்செய்யக்கூ
டாது?
அ. தும்மல்மற்றும்இருமலைதவிர்த்தல்
ஆ. உணவுமற்றும்சிற்றுண்டிஉண்ணுதல்
இ. குடிநீர்பருகுதல்
ஈ. அமற்றும்ஆ
உ. ஆமற்றும்இ
85
21. அறுவைசிகிச்சைதொற்றின்அறிகுறிகள்யாவை?
அ. வீங்குதல்,சிகப்புநிறம்காணப்படுதல்மற்றும்வலி
ஆ. சீழ்வடிதல்மற்றும்வலி
இ. நீலநிறத்தில்காணப்படுதல்மற்றும்வலிஏற்படுதல்
22.எந்தவழிமுறைகளைவீட்டில்பின்பற்றுவதன்மூலம்அறுவைசிகிச்சைதொற்றைதடுக்கலா
ம்?
அ.மற்றவர்களைஅறுவைசிகிச்சைசெய்தஇடத்தைதொடுவதைதவிர்த்தல்
ஆ. அறுவைசிகிச்சைசெய்தபுண்களைசுத்தமாகவைத்தல்
இ.அறுவைசிகிச்சைசெய்தபுண்தொடுவதற்குமுன்கைகளைசுத்தமாகவைத்தல்
23.நோசோகோமியல்தொற்றுபரவுதலைதடுப்பதற்கானமுக்கியபொறுப்பாளர்யார்?
அ. நோயாளியின்பார்வையாளர்கள்
ஆ. மருத்துவக்குழுமட்டும்
இ. நோயாளியின்பார்வையாளர்கள்மற்றும்மருத்துவக்குழு
ஈ. எவருமில்லை
24. அடிக்கடிகைக்கழுவுதலின்முக்கியஅவசியம்என்ன?
அ.மனிதரிடமிருந்துமனிதருக்குதொற்றுபரவுதலை தவிர்த்தல்
ஆ. கைகளைசுத்தமாகவைத்தல்
இ. கைகளில்அழுக்குப்படுவதைதவிர்த்தல்
25. நோசோகோமியல்தொற்றின்பக்கவிளைவுகள்என்ன?
86
அ. காசநோய்
ஆ. நிமோனியா
இ. பன்றிக்காய்ச்சல்
ஈ. கொரோனாவைரஸ்.
விடைகள்
வரிசைஎண் விடைகள் வரிசைஎண் விடைகள்
87
1. அ 22. அ
2. ஆ 23. அ
3. இ 24. அ
4. அ 25. ஆ
5. அ
6. அ
7. ஈ
8. உ
9. உ
10. ஈ
11. அ
12. ஈ
13. இ
14. ஈ
15. ஈ
16. ஆ
17. ஈ
18. ஈ
19. ஈ
20. அ
21. ஈ
88
LESSON PLAN
ON
NOSOCOMIAL INFECTION AND ITS PREVENTION
GENERAL OBJECTIVE
At the end of the structured teaching programme, the client attenders will be able to acquire adequate knowledge about definition,
characteristics, importance of Nosocomial infection, able to identify the causes, risk factors, mode of transmission and sources and follow the
preventive measures of Nosocomial infection and its complication s in their daily life practices.
SPECIFIC OBJECTIVES
At the end of the structured teaching programme the client attenders will be able to,
1. Recall about Nosocomial infection and its effects
2. Define Nosocomial infection
3. Identify the causes and risk factors of Nosocomial infection
4. Find the mode of transmission
5. Detect the sources of Nosocomial infection
89
6. Specify the importance of Nosocomial infection
7. Follow the preventive
8. measures of Nosocomial infection and its complications.
Teacher’s Learner’s
Specific Av aids Evaluation
90
Time Content Activity Activity
S.no objectives
1. 2 minutes At the end of the INTRODUCTION

structured The term hospital acquired infection or
teaching
Nosocomial infection is applied to infections Explaining Listening Flash
programme
occurring in hospitalized clients who were card
Client’s attenders
will be able to, neither infected nor were in incubation at the
recall about
time of their admission to the hospital
Nosocomial
infection and its According to WHO, 57% of hospitalized
effects client experience a Nosocomial infection
represents an important public health problem in
developing countries and as a major cause of
high morbidity.
2 1 At the end of the
structured DEFINITION Define

minutes
teaching Nosocomial infection can be defined as Flash Nosocomial
Explaining Listening
card infection.
programme infection acquired by the persons in the
91
Client’s attenders hospital, manifestation which may occur during
will be able to, hospitalization or after discharge from the
define the hospital. The persons may be client, members
Nosocomial of hospital staff or client attenders in a hospital.
infection
CAUSES OF NOSOCOMIAL INFECTION
3. 3 minutes At the end of the Name any Answerin Flash List down
1.Nosocomial infection can be caused
five g for the card the causes of
structured by Bacterias,
bacteria’s? questions Nosocomial
teaching  Staphylococcus aureus
infections?
 Methicillin resistant staphylococcus
programme
aureus
Client’s attenders  Pseudomonas aeruginosa
will be able to,
2.It can be caused by Bacterial diseases
identify the
such as,
causes and risk  Tuberculosis
 Urinary tract infection
factors of
 Gastroenteritis
Nosocomial
 Ventilator associated pneumonia
infection
Flash
92
RISK FACTORS card What are
risk factors
 Age more than 70 years Lecturing Asking
of
 Shock and doubts
Nosocomial
Clarifying
 Major trauma
infections?
their doubts
 Acute renal failure
 Coma
 Mechanical ventilation
 Drug affecting immune system (steroid
and chemotherapy)
 Indwelling catheter
4. 4minutes
Prolonged ICU stay (>3 days)
At the end of the

MODES OF TRANSMISSION Flash
structured
teaching Micro-organism are transmitted in hospital by card
How the
programme several routes and same micro-organism be Listening Nosocomial
Client’s attenders Explaining
transmitted by more than one routes .There are 5 infection
will be able to, will be
ﬁnd mode of main routes of transmission
transmitted?
transmission of  Contact transmission
infection
93
1. Direct contact transmission
2. Indirect contact transmission
 Droplet transmission
 Air borne transmission
 Common vehicle transmission
 Vector borne transmission.
1.CONTACT TRANSMISSION
It is the most important and
frequent mode of transmission of Nosocomial
infection is divided into two subgroups
 Direct contact transmission

What are
 Indirect contact transmission
the
a) DIRECT CONTACT TRANSMISSION activities
will be
It involves contact a direct body surface
94
to surface and physical transfer of micro-organism carried out
while
between susceptible hosts.
taking care
Flash
For example, Changing position of the clients, of the
card
clients?
given a bath to the clients or perform other client
Answerin
care activities.
g for the
questions
2.DROPLET TRANSMISSION
Droplet transmission occurs What is

droplet
when bacteria or viruses travel on relatively large
infection?
respiratory droplets when people sneeze, cough,
drip or exhale.
3.AIRBORNE TRANSMISSION
Airborne transmission is the spread of an
infectious agent caused by the dissemination of
5. droplet nuclei (aerosols) that remain infectious

2
when suspended in air over long distances and
95
minutes time.
At the end of the

structured
teaching SOURCES OF NOSOCOMIAL INFECTION
programme
Client’s attenders VENTILATOR ASSOCIATED PNEUMONIA What are all
will be able to, sources of
detect the sources Ventilator associated pneumonia Nosocomial
of Nosocomial infection?
(VAP) is a type of lung infection that occurs in
infection Flash
people breathing artificially through machine in card
hospital.
URINARY TRACT INFECTION Answerin

g for the
An infection in any part of the urinary system, questions
the kidneys, bladder or urethra.
What are
Urinary tract infections are more common in
the
women. It usually occurs in the bladder or urethra,
functions of
but more serious infections involve the kidney.
Urinary
96
A bladder infection may cause pelvic pain, tract?
increased urge to urinate, pain with urination and
blood in the urine.
Flash
PUERPERAL INFECTION card
Puerperal infections also known as child bed
fever are any bacterial infections of the female
reproductive tract following childbirth or Answerin

g for the
miscarriage. It usually occurs after the ﬁrst ten
questions
days following delivery. Explaining
6. 1 minutes Flash
CENTRAL VENOUS CATHETER card
 Avoid tugs or pull on the central line.

At the end of the
 The catheter and dressing is wet.
teaching Client’s
SURGICAL SITE INFECTION (SSI)
attenders will be
Specify the
able specify the P Purulent discharge, abscess or spreading
Listening importance
importance of cellulitis to surgical site upto one month after
surgery. of
Nosocomial
7. 7minutes Explaining Nosocomial
infection IMPORTANCE OF NOSOCOMIAL
Flash
97
INFECTION card infection?
At the end of the  To ensure the safety of the client visitors

structured and staffs.
teaching  To ensure all measures are taken to reduce
programme Explain the
infections and prevent transmission of
Client’s attenders preventive
Nosocomial infection among Client’s
will be able to, measures
attenders. Listening
follow the and list
Lecturing down the
preventive
PREVENTIVE MEASURES OF
measures and its complicatio
NOSOCOMIAL INFECTIONS AND ITS
complications of ns of
COMPLICATIONS
Nosocomial Nosocomial
infection Sanitize hands before and after visiting the infection?
Client’s room. Flash

The soap and hand sanitizer will keep in every cards
client’s rooms. Wash or sanitize the hands when
entering and leaving the room of the persons are
visiting to avoid bringing in and carrying out
germs.
 Clean hands after sneezing, coughing,

touching eyes, nose, or mouth, after using
98
the restroom and before and after eating or Listening
drinking. Lecturing
 Cover cough or sneeze with sleeve and do
not sit on client beds or handle their
equipment. Flash
 Read and follow the instructions posted
card
outside the client’s room.
Stay home if visitors sick.
Do not visit the hospital, if sick or any
ill symptoms within last three days—including
nausea, vomiting, diarrhea, fever (or feeling
feverish), an uncontrolled cough, or a rash.
Avoid wear flowers , bring the food from
outside and children
Listening
Wearing flowers, children and home-made
foods should not be allowed in the hospital. lecturing
Follow special precautions,
If the persons are visiting in an “isolation
precautions,” talk to the nurse before entering the
room to find out what steps have to take, such as
wearing a mask or other protective clothing.
Don’t contribute to the clutter.
Limit the client’s personal items. Less
clutter eases the critical job of cleaning hospital
rooms. Keep client items off the floor and away
99
from waste containers.
COMPLICATIONS
 Pneumonia
Hospital-acquired pneumonia is lung
infection that develops in people who have been
hospitalized, typically after about 2 days or more
of hospitalization. It can be treated by antibiotic
medications
 Urinary tract infection

Nosocomial urinary tract infection
(UTI) is an important cause of increased morbidity
and mortality in hospitalized clients. The
increasing use of broad spectrum antibiotics will
result in changes in the microbiological and
antibiotic sensitivity pattern of pathogens isolated
8. 6 minutes from Nosocomial UTI.
 Meningitis
Summarize the
Meningitis is an inflammation of the
topic
meninges. Meningitis should be removed early
in cases of suspected Nosocomial meningitis,
and carbapenems might be required for the poor
100
treatment response.
 Blood stream infection.
A bloodstream infection (BSI) is one or more
positive blood cultures associated with systemic
9. 3 minutes signs of infection such as fevers, chills, and/or
hypotension. Use of maximal barrier precautions:
strict adherence to hand hygiene; wearing surgical
Concluded the
cap, mask, sterile gown, and sterile gloves; and
topic
use of sterile drapes.
SUMMARY
Nosocomial infections, also known

as hospital-acquired infections, are newly acquired
infections that are contracted within a hospital
environment. The most causes of Nosocomial
infection are Bacterial infection and it transmitted
by direct body surface area. It can be prevented by
wearing mask, maintaining hygiene and
maintaining isolation from clients.
CONCLUSION
The prevention of Nosocomial infection
101
can help to reduce medical costs, hospital stay,
and mortality rate in hospitalized clients.
BIBLIOGRAPHY
 Lakshmi kaur, “A text book of
nursing foundation”, second edition
2010, page no: 638-642.
 Suraj Gupte, "A short textbook of
paediatrics”,9 th edition ,New
Delhi ,Jaypee brothers
publication ,page no 200-203
 Park.K., "Prevention and social
medicine”,22ndedition ,2007,Banars
idasBhanot publication, page
no:164-174
 http://.www.nosocomial
infection .slideshare.net.in.
102

Reducing Hospital Infections

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Reducing Hospital Infections

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CHAPTER I

No stronger condemnation of any hospital or ward could be pronounced than

the single fact that infectious diseases has originated in it”.

A Nosocomial infection is a hospital infection or toxin that exists in a certain location,

associated infections and hospital-acquired infections (HAIs). Graham Rogers (2019)

Infection can be defined as invasion and multiplication of micro-organisms such as

WPWP campaign (2019) Nosocomial infections can caused by bloodstream

infections, ventilator-associated pneumonia, urinary tract infections, meningitis, secondary

wound infections, respiratory infections, genitourinary Infection as well as gastrointestinal

WHO (2018) In the United States, estimated roughly 1.7 million hospital-associated

infections, from all types of microorganisms, including bacteria and fungi combined, cause or

contribute to 99,000 deaths each year. In Europe, where hospital surveys have been

conducted, the category of gram-negative infections is estimated to account for two-thirds of

the 25,000 deaths each year.

another (cross-infection). This group includes Staphylococcus aureus, Streptococci,

Enterococci and Enterobacteria etc.

susceptibility to Nosocomial infections include young or old age, decreased immune

resistance, underlying disease and therapeutic and diagnostic interventions Clostridium

Staphylococcus aureus) MRSA is a type of staphylococcus bacteria that is resistant to certain

antibiotics and may be acquired during hospitalization.

effectiveness of STP on knowledge regarding awareness and spread of Nosocomial Infections

urination or difficulty urinating, headache, nausea, vomiting and diarrhoea.

Satish Prabhakar Masavkar et.,al (2016) A Quasi experimental study was

practice were evaluated by using self-structured questionnaire. When compared the

General medical practioners.

UNITED NATIONS (2016) Caregivers involved in providing care and assistance to

clients either at a healthcare facility or assistance in their daily life.

NEED FOR THE STUDY

World Health Organization (2019) conducted survey in 55 hospitals of 14 countries

Indian journal of environmental medicine (2018), In Tamilnadu a longitudinal study

in NICU Government hospital at Thoothukudi District. The most frequent associated

pathology will be respiratory distress(23.06%) a total of 316 Nosocomial infections were

bacteremia is 56.3% and predominance of coagulate negative staphylococci is 46.05%, gram

negative micro-organisms were isolated in 32.1% of the cases (e-coli, pseudomonas,

Nosocomial infections (8.7%).

Rasmus Leistneret.al (2017) Conducted a cross sectional study to assess the

Christianes G, Barbier et al (2016) conducted a quantitative study to assess the

parallel. The study concluded that, consumption of alcohol based

decreased from 1,104 to 707 cases per 1000 admissions.

teaching programme and prevent the complications of Nosocomial infection.

STATEMENT OF THE PROBLEM

A study to assess the effectiveness of Structured teaching programme on

knowledge regarding prevention of nosocomial infection Coimbatore among client attenders

 To determine the effectiveness of structured teaching programme on knowledge

regarding Nosocomial infection and its prevention among Client’s attenders in

variables such as Age,sex,marital status, religion, educational status, Family income,

knowledge in experimental and control groups.

mean post-test level of knowledge in control group.

mean pre-test level of knowledge.

pre-test level of knowledge

demographic variables in experimental and control groups.

In this study, it refers to a process of systematically and continuously collecting,

validating and communicating the data regarding level of knowledge on Nosocomial

structured teaching programme regarding Nosocomial infection and its prevention is

improving the level of knowledge among Client’s attenders.

as elicited by the semi structured Knowledge questionnaire by the investigator.

Structured Teaching Programme

In this study, it refers to the systematically, organized information prepared by

transmission, importance and prevention of Nosocomial infection.

In this study, it refers to an infection occurs in Client’s attenders within 48 hours of

vomiting with their own clothes.

 The Client’s attenders may have inadequate knowledge regarding Nosocomial

infection and its prevention.