Institutional factors associated with surgical site infections among post caesarean section in Thika Level 5 hospital

Abstract

Objective: The study aimed at determining the institutional factors that contribute to surgical site infections among post caesarean  section in Thika Level 5 Hospital.

Materials and Methods: The study employed a mixed unmatched case-control study design which targeted all mothers who had undergone caesarean section in maternity unit at Thika Level 5 Hospital and who had or did not have Surgical Site Infection from delivery up to thirty days post-delivery and nurse in-charges of maternity unit.

Result: The sample size of the study was made up of 128 women comprising 32 cases and 96 controls. Qualitative results revealed that poor aseptic technique in theatre during C/S operations led to an increase in Surgical Site Infections (SSIs). Respondents highlighted the significance of maintaining a sterile and clean environment in the theatre to prevent contamination of surgical sites by microorganisms. The study found that mothers who stayed in hospital for more than 24 hours before Caesarian Section (CS) were more likely to get Surgical Site Infection (SSI) as compared those that had stayed in the  hospital for less 24 hours before CS (OR=13.05 [95%CI=4.10-41.53]; p<0.001). Mothers who shared beds with other patients were more  likely to get SSI as compared to those that did not share beds (OR=3.01 [95%CI=1.28-4.19]; p<0.001). Moreover, mothers who spent more than a week in the hospital were more likely to get SSI than those who stayed in the hospital for less than that period (OR=3.41  [95%CI=1.06-11.38]; p<0.001).

Conclusion: The study concludes that there is a potential relationship between the duration of hospital stay  prior to CS and the risk of SSI. Also, the institutional factors associated with SSIs are the response of healthcare workers to the needs  of the patients, the level of care given at the hospital and facility accessibility.