Effect of Self-Regulation Enhancement on Aseptic Technique Practices of Wound Management Among Registered Nurses in Accident and Emergency Department

Abstract

Wound infection is a problem in hospital, accident and emergency departments, with high incidence attributed to improper aseptic technique during the wound management process. This quasi-experimental pre-post with control group design was used to test the effectiveness of self-regulation on aseptic technique practices of wound management among registered nurses in the accident and emergency departments of two hospitals from November 2015 to January 2016. Aseptic techniques were environmental controls, hand hygiene, appropriate use of protective personal equipment, aseptic field management, and non-touch aseptic technique. A random sampling method was used to select participants into the experimental or control group. At least eighteen events of wound management and stitching activities were observed. The experimental group attended a self-regulation training on the practice of aseptic technique in wound management. The educational training on the self-regulation was provided together with guidelines (Bandura, 1991) Data were collected using general information questionnaires and an observation checklist related to aseptic technique in wound management activities. All instruments were tested for content validity by five experts. The content validity Index was 0.94. Data analysis was performed using the frequency distribution, percentage, average, standard deviation and Chi-squared test.

          The results of the study revealed that, after the intervention, proper aseptic techniques in the experimental group increased from 62.53% before the intervention to 89.36% (p<.05) after the intervention. When analyzed by sub-categories, the results revealed that hand hygiene was the technique that was most significantly improved after the intervention; rising from 25.37% before the intervention to 84.50% (p<.05) after the intervention. The appropriate use of protective personal equipment increased from 81.11% to 100% (p<.05). However, the changes in aseptic non-touch technique was non-significant with an increase from 96.67% to 100%. With regards to aseptic field management category, the percentage increased non-significantly from 98.33% to 100% after the intervention. For environmental controls, the results increased from 47.50% to 63.16% after the intervention, though this change was not significant. In all areas, the control group had a low level of practice in each area and this remained unchanged after the intervention. The difference between the rates between the intervention group at the post intervention period were significant.

          In conclusion, self-regulation was effective in improving the aseptic techniques and wound management practices of registered nurses in the accident and emergency department in the sub-categories of hand hygiene and the use of protective personal equipment. However, the intervention was not effective in improving the environmental controls thus other strategies should be implemented.