Vloga medicinske sestre pri preprečevanju prenosa bakterij, ki izločajo karbapenemaze

Čampa, Agata (avtor), Zore, Anamarija (mentor), Suhadolc Milković, Nina (komentor)

Uvod: Karbapenemaze so encimi, ki jih lahko izločajo po Gramu negativne bakterije, najpogosteje iz družine Enterobacteriaceae, Pseudomonas aeruginosa in Acinetobacter baumannii. Okužbe, ki jih povzročajo bakterije, odporne proti karbapenemom, povezujejo z visoko stopnjo umrljivosti, obolevnosti in visokimi stroški zdravljenja. Higiena rok je najpomembnejši preventivni ukrep, tako med zaposlenimi, kot med bolniki in obiskovalci. Medicinske sestre imajo pomembno vlogo v boju s temi bakterijami, saj so v nenehnem kontaktu z bolnikom. Namen diplomskega dela je pregledati obstoječo literaturo s tega področja in z raziskavo ugotoviti ali medicinske sestre poznajo smernice za preprečevanje širjenja bakterij, ki izločajo karbapenemaze. Želeli smo potrditi ali ovreči hipotezo, da medicinske sestre poznajo bakterije, ki izločajo karbapenemaze in poznajo ter uporabljajo ukrepe za preprečevanje njihovega širjenja. Metode dela: v teoretičnem delu je prikazana raziskava, v kateri smo pregledali strokovno literaturo s področja karbapenemaz in preprečevanja okužb, povezanih z zdravstvom. Domačo in tujo literaturo smo zbirali od junija 2016 do decembra 2016. V empiričnem delu diplomskega dela smo osebno razdelili 120 anketnih vprašalnikov v času od 1. 11. 2016 do 30. 11. 2016 med diplomirane medicinske sestre in zdravstvene tehnike, zaposlene na Onkološkem inštitutu Ljubljana. Vrnjenih je bilo 81 anketnih vprašalnikov, ki smo jih obdelali s programom Microsoft Excel. Rezultati: ugotovili smo, da večina anketiranih ve, katere bakterije izločajo karbapenemaze. Večina anketiranih (77,8 %) ne pozna razlike med pogosto uporabljenima kraticama CRE-CPE in CRE. 65,4 % anketiranih ve, kaj so karbapenemaze, nekaj manj kot polovica (44,4 %) pa zmotno pravi, da je bolnika smiselno dekolonizirati. Večina anketiranih pravi, da imajo izobraževanja na temo okužb, povezanih z zdravstvom enkrat letno. Razprava in sklep: medicinske sestre se v povprečju zavedajo, kako pomembna je bolnišnična higiena in kako pomembno je upoštevati izolacijske ukrepe. Še vedno je treba veliko narediti na področju higiene rok. Roke so najpomembnejše pri preprečevanju prenosa patogenih mikroorganizmov. Anketa je pokazala, da sicer v malem deležu nekateri zaposleni v zdravstveni negi še vedno niso prepričani, kdaj si je treba roke umiti in kdaj razkužiti. Zdravstveno osebje ima pomembno vlogo pri preprečevanju širjenja bakterij, ki izločajo karbapenemaze, saj preživijo večino časa ob bolniku. Če bodo imeli dovolj znanja in potrebno osebno varovalno opremo, bodo lahko ustrezno zaščitili sebe ter bolnika.

• Jezik: Slovenski jezik
• Ključne besede: karbapenemaze, enterobakterije, karbapenemi, z zdravstvom povezane okužbe, medicinska sestra
• Vrsta gradiva: Diplomsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2017
• PID: 20.500.12556/RUL-91092
• COBISS.SI-ID: 5241963
• Datum objave v RUL: 20.03.2017

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Role of a nurse with preventing the spread of carbapenemase-producting bacteria

Izvleček

Introduction: carbapenemases are the enzymes which can be produced by Gram-negative bacteria, most often enterobacteria, found in the intestines. Carbapenemase-producing bacteria belong to the Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii bacteria families. Infections caused by carbapenem-resistant Enterobacteriaceae lead to a high mortality and illness rate as well as high healing expenses. Hand hygiene among employers, patients and visitors is the most importantant preventive measure. Nurses play an important role in the fight against these bacteria, because they are in constant connection with patients. Purpose of the thesis is to examine the literature existing in this field and to find out through a research wheather the nurses know the trends in preventing the spread of carbapenemase-producing bacteria. With the help of the research we wanted to confirm or refute if the nurses know the carbapenemase-producing bacteria, if they know the preventive measures against the spread of the carbapenemase-producing bacteria and if they actually use them. Methods: in theoretical part of the thesis we went through the existing technical literature related to carbapenemase and the prevention of hospital-acquired infection with these bacteria. We were gathering the Slovene and English literature from June 2016 to December 2016. For the empirical part 120 questionnaires were distributed among the qualified nurses and health care technicians employed at the Institute of Oncology Ljubljana. The questionnaires were personally distributed at regular meetings taking place between 1st November 2016 and 30th November 2016. 81 questionnaires were returned and analysed in the Microsoft Excel Programme. Results: the survey showed that the majority of respondents knows which bacteria produce carbapenemases. The majority of respondents (77,8%) doesn't know the difference between the frequently used acronyms CRE-CPE and CPE. 64.5% of respondents know what carbapenemasa are, some less than a half (44.4%) however mistakenly say that the patient should be decolonised. The majority of respondents say, that the education on topic Hospital-aquired infections is available once a year, in most cases carried out by qualified nurses. Discussion and conclusion: on average, nurses are aware how important the hygiene in hospitals is and how important it is to take into account isolation measures. A lot can still be done in the field of hand hygiene. Hands are most important in the fight to prevent the transfer of pathological mycroorganisms. The survey has shown that although a small proportion but there still are some employees in health care field who are not sure when they need to wash their hands and when to disinfect them. Health care personnel plays an important role in preventing the spread of carbapenemase-producing bacteria for they spend most of their time with patients. If they have enough knowledge and a required pesonal protective equipment they will be able to suitably protect themselves and patients.

• Ključne besede: carbapenemases, Enterobacteriaceae, carbapenems, nosocomial infections, nurse