［総説］看護師の院内感染に対する意識とラオスの院内耐性菌の動向 : ラオス5市中病院と沖縄県3市中病院の調査
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概要
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We performed a questionnaire survey to evaluate awareness of nosocomial infection on nurses in Lao People's Democratic Republic ( Lao PDR) and Okinawa Prefecture. A comparative study was done between the two different geographical locations. In Lao PDR, the practice status of the standard precautions and changes in Staphylococcus aureus were also surveyed, and the present status with its related problems were evaluated. Most of the nurses in both countries considered that hand washing is an important measure but nurses must play a vital role in the prevention of nosocomial infection. During their work, 92% nurses in Lao PDR and 65% nurses in Okinawa were always aware of nosocomial infection. The use of gloves among nurses when necessary, was observed 88% and 88.7% in Lao PDR and Okinawa respectively. Of the nurses in Lao PDR, 97% used a mask during care for patients with tuberculosis, 3% used a mask when it is available. The practice status of the standard precautions in the nurses in Lao PDR was evaluated by the 1-to-1 observation method. The rates of hand washing practice (when it was necessary) were 0%-60%, showing marked individual differences. Concerning hand washing such an incorrect procedures, short time, use of unclean towels, and contact with unclean surfaces after hand washing were frequently observed. The use of gloves, masks, and gowns was not investigated as because of the articles were required in a few situations. We have performed monitoring surveys of Staphylococcus aureus in Lao PDR since 1993, and observed MRSA isolation since 2001. Some of the isolated MRSA strains showed the same genotypes, suggesting the early MRSA contamination status in the hospitals in Lao PDR. Continuation of careful monitoring of MRSA is necessary. The necessity for improvement of equipments/materials for hand washing and provision of health education regarding the importance of systematic infection is needed for nurses in Lao PDR.
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