The aim of this project is to reduce the incidence of hospital aquired infections and secondary wound sepsis, that develop as a direct result of poor conditions for the patients after surgery. The main areas that require attention to achieve this, are the patient's environment (the ward) and the nursing that they receive (nursing education, appropriate sterile techniques and equipment).
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Reasons for this project: Kumi Hospital has the only orthopaedic surgeon in Eastern Uganda - which has resulted in a large number of patients being referred to Kumi Hospital for reconstructive surgery, orthopaedic management and clinics for visiting surgeons. The problem however, is that there is only one small surgical ward for all of the patients before and after surgery, which is struggling to cope with the increased number of patients being admitted for treatment. An audit carried out in 2007 identified hospital acquired infections and wound sepsis as a major problem (with 80 -90% of large wounds going on to develop a wound infection). The environment on the surgical ward was a major cause of these infections, for a variety of reasons - the bed spaces were dirty, patients were sleeping on bare mattresses (because the hospital did not have its own bed sheets) and overcrowding was one of the largest causes leading to the spread of infections. This was due to there being too many patients on one ward, but also due to the large number of attendants that each patient had with them. In Uganda patients admitted in hospital have to take their own attendants who are there to clean the patient, make their food and assist them in other daily care. Patients will often have 2 or 3 attendants, who then sleep either with them or under their bed. During the day they cook outside, but during the frequent rain storms in the rainy season they all come inside the ward, bringing with them all their cooking equipment and belongings. The projects goals are to create a clean environment for the patients on the surgical ward, through refurbishing the ward, providing bed sheets and blankets for patients, and reducing the overcrowding by initially building a shelter for the attendants of patients, and eventually a second surgical ward. The goals also include providing sufficient sterile nursing equipment, including aprons and gloves, as well as nursing education for the correct nursing techniques and prevention of spread of infections. The total cost of the project currently stands at ¬£33,000. The refurbishment of the surgical ward was completed after the initial audit in 2007. A small amount of bed sheets were also bought, but an industrial washing machine needs to be purchased in order to be able to wash the bed sheets at correct temperatures for infection control. This will cost ¬£5000. The construction of the shelter for the patients' attendants has been started, but a further ¬£4000 is needed to put on the roof and finish the building, to allow its' use by the attendants. The eventual building of a second surgical ward will cost an approximate of ¬£20,000. The nursing education part of the project will cost ¬£4000 to send 4 of the hospital's partially trained nurses to complete their training to fully qualified nurses. These staff will then lead the continuous education of nurses and nursing assitants at the hospital.
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