Exploring challenges regarding the surgical hand scrubbing, gowning and gloving in the operating theatre of a hospital in Swaziland

Abstract

Background of the study The operating theatre is a controlled environment where surgical teams have to adhere strictly to the infection control principles. If infection control principles are not applied correctly or adhered to in the operating theatre, it can lead to contamination and infection of the surgical site. Surgical site infections are the third most common source of nosocomial infections in developing countries. In Swaziland, the incidence of surgical site infections was exceptionally high and a major cause of post-surgical complications as it accounts for about 12-18% of hospital acquired infections in all the regional hospitals. Surgical hand scrubbing is the process of removing as many microorganisms as possible from the hands of the sterile surgical team members before wearing a sterile surgical attire that consist of a sterile gown and sterile gloves. The antiseptics should conform to the agreed standards of infection control and principles of sterile technique to prevent contamination. Multiple factors influence the availability of the needed resources and the implementation of policies in an operating theatre such as the setting where the research was conducted. Aim of the Study The aim of this study was to explore and describe challenges faced by the surgical teams and the hospital management regarding the surgical hand scrubbing, gowning and gloving procedure in the operating theatre of a hospital in Swaziland. Research Objectives The objectives of the study were the following: · to explore and describe the challenges experienced by surgical teams regarding surgical hand scrubbing, gowning and gloving procedures in the operating theatre; · to explore and describe the challenges experienced by the hospital management regarding surgical hand scrubbing, gowning and gloving procedures in the operating theatre; and · to make recommendations to address the challenges regarding surgical hand scrubbing, gowning and gloving in the operating theatre of a hospital in Swaziland. Methodology A qualitative design was used. The population for this study was the surgical teams from all the surgical disciplines of the operating theatre and the hospital management which includes the operating theatre nurse managers and the administrative management of the hospital. Data were collected by means of focus group interviews, which were conducted separately for the hospital management and the surgical teams. Data analysis was through qualitative content analysis. Themes and subthemes that merged from the focus groups interviews with relevant literature were used to make recommendations to address the challenges experienced. Results of the Study Seven main themes were identified, which were related to the following: Management; Supplies; Physical Facilities; Equipment; Personnel knowledge, skills and attitude; Maintenance of infection control practices; and Process of surgical hand scrubbing, gowning and gloving. Recommendations Recommendations were made for clinical practice, education and research in order to improve surgical hand scrubbing, gowning and gloving procedure in the operating theatre.