Compliance To Safety Hygiene Practice: Perception Of Radiographers In South East States Of Nigeria.

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This research project was designed to assess perception of radiographers on compliance to safety hygiene practice in the radiology department. It also aim to evaluate the cases of nosocomial infection in the department and assess the standard of hygiene condition obtained from the department. Seven hospital were selected UNTH,NOHE ESUTH,FMC Owerri ,FMC Umuahia, NAUTH ,FMC Abakiliki. The increasing low compliance rate observed by the researcher during his clinical posting in some radiological department necessitated this research. The study was done using 126 questionnaires shared to radiographers as primary source of data. The compliance rate ,hygiene condition and cases of nosocomial infection formed the indices for the research. Tables were used to analyzed the data collected. From the results generalization was made which show that the compliance rate is poor as regards washing of hand and cleaning of couch and chest stand during practice but is high as regards sterilization of equipment used in special exam. The condition of the dressing gown and changing cubicle was poor and of low standard while ventilation and common room is adequate hygienically. Cases of nosocomial infection could not be ascertained.

Title Page - - - - - - - - -i
Approval Page - - - - - - - -ii
Certification Page - - - - - - - -iii
Dedication - - - - - - - - -iv
Acknowledgement - - - - - - - -v
Table of Contents - - - - - - - -vi
List of Tables and Charts - - - - - - -vii
Abstract - - - - - - - - -viii
1.1: Background of Study - - - -13
1.2: Statements of Problem - - - -18
1.3: Objectives of Study - - - 18
1.4: Significance of Study - - - -19
1.5: Scope of Study - - - -19
CHAPTER TWO: LITERATURE REVIEW                                    20
3.1: Research Design - - - - -39
3.2: Target population - - - - -39
3.3: Method of data collection                         40
3.4: Method of Data Analysis - - - -40
5.1: Discussion - - - - - -50
5.2: Summary of Findings - - - -53
5.3: Recommendations - - - - -54
5.4: Limitations of Study - - - -54
5.5: Areas of Further Study - - - -55
5.5: Conclusion                                                              55
REFERENCES                                                                                              57
Appendix                                                                                                    61

Table 1: The distribution of radiographers according to state of work.
Table 2: It represents the sex of the radiographers according to state
Table 3: Represent the Academic Qualification of The Various Radiographers
Table 4: The frequency of hand washing by radiographers during work
Table 5: Frequency of cleaning of couch and chest stand during examination
Table 6: The response of radiographers on sterilization of instrument used in special exam.
Table 7: Knowledge of radiographers to safety precautionary measures of infection control and acquring of nosocomial infection by them.
Table 8: Response of radiographers to hygiene condition of dressing gown and changing cubicle
Table 9: Response on ventilation condition, hygiene condition of call room and rest room 
Hygiene can be described as the science of health and the study of ways of preserving it, particularly by promoting cleanliness.1
Hygiene is as old as medicine itself. The word hygiene is derived from the Greek word hygieia who was the daughter of aesclepius. Hygieia sees to the prevention of illness and promotion of health by promoting cleanliness.2
But the importance of Hygiene has become more important now especially with the high incidence of nosocomial infection reported all over the world. Nosocomial infection is the acquiring of an infection which the patient did not come to the hospital with. 
The U.S centers for disease control and prevention (CDC) estimates that approximately two (2) million nosocomial infections occur every year and approximately 90,000 patients die as a result of its.3 It is estimated that it will be high for developing nation which Nigeria is one of them. 
Considering world health organization (WHO) and the centre for disease control and prevention (CDC) guidelines about infection prevention and hygiene practice. Which states that the premise of standard precautions is that all patients are colonized or infected with micro-organism, whether or not there are signs or symptoms and that a uniform level of caution should be used in the care of all patients. 
Therefore the practice of hygiene can never be overemphasized as it is the science of health and the bedrock of modem medicine.
Since the hospital setting is a likely place for the breed of agents of diseases and infections. It is therefore important that proper and adequate hygiene practice should be strictly observed so as to present the spread of disease and infection which will invariably defeat the purpose of establishment of hospitals. 
The radiology department is an integral part of the hospital where high percentage of the patient who comes to the hospital must pass through. 
It is estimated that about 543 million radiological examinations is performed in the United States in 20034.
Also considering the range of patients that come to the departments  who are mostly elderly, immune-compromised or infected with antibiotic resistant bacteria and children. Radiology department therefore play a very vital role in the prevention and control of nosocomial infections.  The special and unique type of examination which is performed in the radiology department like intravenous urography, hysterosalpinography, micturating urography, colonography etc, is of special concern because this procedure  exposes the patient to high risk of acquiring infection that they did not come with. Therefore the practice of hygiene should be a major concern for the radiographers and radiologist when carrying out this procedure. 
As it is believed that with proper compliance to safety hygiene practice like proper waste disposal, clean surroundings, clean changing gown and other hospital accessories such as bed pans, buckets; sterilization and disinfection of instrument used in special examination like intravenous urography, hysterosaplinography etc, then the incidence of infections and nosocomial infection will be greatly reduced both to the patient and staff as well.
But the compliance of radiographers to safety hygiene practices have been very poor which have contributed to the high mortality rate reported in the radiology department. 
  Dhanda et al5 in their study to evaluate the compliance of hand hygiene practices  in radiology technologist and health care worker and its impact on the mortality rate in  intensive care unit of a secondary level hospital in India. The result of the study showed that nursing staff compliance was around 45% only why radiology technologists were around 25%. Mortality rate were around 26% before the study but after seminar and various programme the compliance rate increase to about 50% and 45% both for the nursing staff and the radiology technologists  respectively and the mortality rate decrease to about 15%.
 This clearly showed that much work still needs to be done on the part of radiographers as regards their compliance to hygiene practice which will be of benefits not only to the patient but staff of radiology department as well. 
        This work therefore tends address this problem by trying to evaluate the compliance of radiographers in the South East State of Nigeria to ascertain their compliance rate. As from the researcher knowledge no work has been done to evaluate the compliance of radiographers in the south east states of Nigeria as integral member of the health care team. It will also try to evaluate the cases of nosocomial infection reported in radiology department in the south east states of Nigeria with the intention of recommending ways which if followed will reduce the incidence of nosocomial infection in the radiology department. In addition to assessing the standard condition of the radiology departments in the selected states. 
Since from researcher experience during his clinical postings, emphasis is mostly made on technique used in patient positioning, adherence to radiation protection rule (AlARA principle), etc. but as regards hygiene practice, there appears to be cases of negligence shown both as regards cleaning of couch, chest stand, scrubbing of  floor, cleaning of x – ray equipment. Also non use of gloves even during procedure involving injured and soiled patient has left him to begin to wonder if this is the standard procedure for the department especially considering the high incidence of nosocomial infection reported all over the world.
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