Healthcare Personnel Opinion and their Implementation Obstacles

Context: Hemodialysis HD patients, as well as the dialysis staff, are vulnerable to contracting health-care-associated infections (HAIs) due to frequent and prolonged exposure to many possible contaminants in the dialysis environment. Aim: Assess healthcare personnel's HCP opinion and their implementation obstacles regarding standard precautions (SPs) in the hemodialysis unit. Methods: The study was conducted at the hemodialysis unit at Al Mouwasat University Hospital, Alexandria, Egypt. A descriptive research design was used to collect data for this study. All healthcare personnel working in the setting mentioned above were included. Two tools were used. The first tool is a standard precautions practices in hemodialysis observational checklist: The second tool is a structured interview questionnaire to assess the opinion of healthcare personnel regarding the applicability of standard precautions in the hemodialysis unit and their implementation obstacles. Results: The standard precautions practice score showed unsatisfactory practice among HCP. Regarding their opinion, the majority of HCP disagreed to follow the five moments and reported that the WHO technique of hand hygiene is so sophisticated and time-consuming; they disagreed with changing gloves between patients and considering gloves as a substitute to hand hygiene. The majority recap the needle by two hand techniques disagreed with following respiratory hygiene, and color-coding was accepted only by nurses. Also, it was found that there was a positive correlation between years of experience, infection control training programs, and the level of SPs practice score. Conclusion: Unsatisfactory SPs practices showed a high percentage of HCP. Healthcare personnel tends to agree to certain infection control practices over other practices. Availability and accessibility of equipment and supplies that interfere with the application of SPs practices and lack of knowledge concerning infection prevention and control were considered as implementation obstacles of SPs practices. Education and training of HCP on SPs, together with consistent and robust management support, are recommended. In addition to the development of national precautions after conducting researches that confirm its effectiveness

Efeect of Kegel's Exercises on First Degree Pelvic Organ Prolapse Among Women

Background: Kegel's exercises are recommended to increase the strength and elasticity of the pelvic floor muscles and decrease the incidence of prolapse and stress urinary incontince. Aim: was to assess the effect of kegel's exercises on first degree pelvic organ prolapse among women. Design: quasi-experimental, non equivalent pre-post test research design was adopted. Setting: this research was carried out at gynecological clinic at El Galaa Obstetrics and Gynecology Teaching Hospital. Sample: Convenience sample, of 110 women were recruited for this study as one group to be measured before and after according to certain criteria. Tools: three tools were used for data collection: structured interview tool; assessment & follow up tool for clinical picture of prolapse and Prinometry to measure the strength of pelvic floor muscles. Result: revealed that, a statistically significantly differences were founded between before and after following of kegel's exercises in relation to sexual clinical picture P value was ≥ 0.05, urinary clinical picture was (χ2 = 145.4 and p value ≤ 0.001 and types of urinary problems. χ2 = 167.4 and p value≤ 0.001 ) . And bowel clinical picture was (χ2 =128.8 & P.value ≤ 0.001). Regarding to perinometry reading, the results revealed that, highly statistically significant differences was found between the three reading of prinometry (F=68.047, p≤0.001). In Conclusion: practicing kegel's exercises lead to decrease in the clinical picture of prolapse and improve strength of pelvic floor muscles. Recommendation: based on the study findings, its recommended kegel's exercises should be followed during each development phases of women's life span, so it should form an essential part of sex education and the nurse should work as educator and counselor to teach women benefits and technique of kegel's exercises. Keywords:  kegel's exercises, prolapse, prinometry