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The specific objective of this study was to evaluate the standard of cleanliness of intracavitory transducers by Sonographers in Enugu; the exposure to infectious diseases and the specific regulatory guidelines for infection control in ultrasound laboratory. There are many opportunities for the spread of nosocomial infections in ultrasound laboratories. To assess the standard of cleanliness of ultrasound used by sonographers, the specific regulatory guidelines for infection control in ultrasound laboratories and the incidence of nosocomial infections among sonographers. This is a prospective cross sectional study in which forty sonographers participated. The primary sources of data were questionnaire and observation. Fifty five point five per cent of the sonographers do not properly clean intracavitory transducer after every scan. Only 10% of the sonographers wipe the transducer with cleaning solution whereas 90% wipe the ultrasound coupling gel of the transducer after each scan. Most of the sonographers (75%) do not have specific regulatory guidelines for infection control in their ultrasound laboratories. The incidence of nosocomial infection among the sonographers was 30%. The standard of infection control practiced by the sonographers in the locality is poor and this poses a real problem.




1.1      Background of the study

The practice of hygiene is a process which we cannot overlook as far as health is concerned because hygiene is a science of health and it is of paramount importance in our everyday life. Hygiene is defined as a set of practices perceived by a community to be associated with the preservation of health and healthy living, while in modern medical sciences there is a set of standards of hygiene recommended for different situations. Hygiene refers as the science of health or the act of keeping yourself and the surrounding clean in attempt to prevent infection and diseases. Hygiene practices are employed as a preventative measures to reduce the incidence and spreading of diseases and it determines the extent one can live comfortably without infection or sickness.

Hospital is a place for bread of agents that causes infections and diseases which ultrasound room is not an exception. Therefore maximum medical hygiene practices should be considered as a very important factor for patient’s safety, sonographers and other health assistants. Patients should be protected from cross-infections. The sonographers and other health assistants should also be protected from acquiring infections as a result of poor hygiene.

Good hospital hygiene practice is vital to any strategy for preventing HealthCare Associated Infections(HCAI) in hospitals. They are based on cleaning the general hospital environment, training of staff, Cleaning items of shared equipment.

Association between poor environmental hygiene and the transmission of micro organisms causing HealthCare Associated Infections in hospital should be call to attention. The NHS Code of practice on the prevention and control of HealthCare Associated Infection which came into effect in October 2006 was developed to help Organisations to plan and implement strategies for the prevention and control of HCAIs. It set out criteria by which managers on NHS organizations and other healthcare providers should ensure patients are cared for in a clean environment, where the risk of HCAIs is kept as low as possible.

Transmission of micro organisms from the environment to patients may occur through direct contact with contaminated equipments or indirectly as a result of torching by hands. Nevertheless, the evidence that pathogens responsible for HCAIs can be widely found in the hospital environment and hence readily acquired on hands by touching surfaces does demonstrate the importance of decontaminating hands before every patient contact.

Shared clinical equipment used to deliver care in the clinical environment comes into contact with intact skin and is therefore unlikely to introduce infections. However, it can act as a vehicle by which micro organisms are transferred between patients through the use of non invasive clinical equipments including Stethoscope, lifting equipments and ultrasound probes

Staff education was lacking on optimal cleaning practice in the clinical areas. Knowledge deficits may hinder the application of cleaning practices and monitoring and evaluation was indicated. This is further reinforced by an observation study, which noted that lapses in adhering to cleaning protocol were linked with an increase in environmental contamination.

Medical hygiene practices include: sterilization of instruments used in ultrasound rooms, use of protective clothing and barriers, such as gowns and gloves, safe disposal of medical waste, disinfection of reusables scrubbing up hand-washing especially in ultrasound rooms.

It is obvious that successful prevention, control and elimination of cross-infection of disease in ultrasound centres is greatly dependent on observance of proper and effective hygiene practice.

This research will access and make known the level of hygienic practices in ultrasound centres in Enugu metropolis to prove if the level is adequate or inadequate. In this effect, it will be of good evidence which will help to enhance the level of hygiene practices in ultrasound centres.

1.2      Statement of the problem

Hospital acquired infection is a worldwide problem. The occupational safety and health administration has established guidelines to help prevent the spread of infection in healthcare environment.1 There are many opportunities for the spread of nosocomial infections in ultrasound laboratories. Nosocomial pathogens can be brought into the ultrasound laboratory by patients and these include staphylococcus aureus, salmonella species e.t.c.2 These pathogens can be transferred to the sonographer or other patients by cross infection if proper infection control practices are not adopted.

Group A streptococcus, Escherichia coli and staphylococcus aureus can survive for as long as four days in ultrasound coupling gel and contribute to the spread of nosocomial infections.3 About 12% of hospitalized patients may carry staphylococcus aureus on their skin.3 The use of an improperly cleaned ultrasound transducer was found to be one of the causes of cross infection in ultrasound laboratories.3 Previous report has shown that there is no specific regulatory guidelines available for infection control in ultrasound laboratories. 1 There is also paucity of documented reports of infection control practiced by sonographers in Nigeria to the best of our knowledge. It is the responsibility of the sonographer to provide the highest quality of patient care which includes patient’s safety and infection- controlled environment.

1.3      Objective of the study

The general objective of this study is an assessment of the level of hygiene practice in ultrasound laboratories in Enugu Metropolis. The specific objectives are:

  1. To examine the cleanliness of ultrasound in Enugu metropolis
  2. To evaluate materials used in cleaning ultrasound transducers in Enugu metropolis
  3. To examine the availability of any specific regulatory guidelines for infection control in ultrasound laboratory
  4. To examine the adherence to universal precautionary measures (UPM) for infection control in Enugu metropolis
  5. To examine use of protective barriers for infection control in Enugu metropolis

1.4     Research Questions

  1. What is the level of cleanliness of ultrasound in Enugu Metropolis?
  2. What are materials used in cleaning ultrasound transducers in Enugu metropolis?
  3. Is there availability of any specific regulatory guidelines for infection control in ultrasound laboratory?
  4. Is there any adherence to universal precautionary measures (UPM) for infection control in Enugu Metropolis?
  5. To what extent is the use of protective barriers for infection control in Enugu Metropolis?

1.5     Significance of the Study

It has been recognized in several epidemiological studies that sonographers are caught in the transmission of nosocomial infections. Literature that explored knowledge, perceptions and practices of sonographers is limited. Therefore, this study exposed the level of knowledge, attitude and practice of standard precautions among sonographers and thus could be used as a baseline for intervention. It also identified gaps in standard precautionary practices among these sonographers and the results of the study will be used for planning of the intervention program in health education. The results of this study will add to the existing literature and will as well provide reference materials for the academic society and further research.  Sonographers will find this study to be an important tool to advice patients with nosocomial infections. In addition, health care facilities will get to know the efficacy and the condition necessary for embracing good standard precautions to achieve quality health service. The study will unveil to managements of health care facilities, proactive measures necessary to activates health workers eagerness in performing their expected roles.


1.6     Limitations of the Study

The challenges that posed a threat to this work include the following;

The results is self-reported in nature and some variables based on respondent opinions. The results were limited to the population of sonographers in Enugu. And attitudes turned to be huge obstacles. However efforts were made to address these problems or limitations.

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