Hand Hygiene Practices and Microbial Contamination on Feeding Tubes and Other Components of Feeding Systems
Condition: Enteral Nutrition; Microbial Colonization; Adherence
MeSH terms: Communicable Diseases; Infections
Study type: Interventional

Summary: 
      Enteral feeding tube (EFT) and component of feeding systems can serve as a reservoir of
      microorganisms, and the main reason is inappropriate hand hygiene practices. The aim of the
      project is to determine colonization of microorganisms on the EFT and other components and
      assess the relation between colonization and adherence to hand hygiene practices by
      healthcare workers in the intensive care unit.

      This prospective, observational and semi-experimental study will be conducted in one year.
      The project will be completed with healthcare workers and 51 patients who are feeding enteral
      route via nasogastric tube at least for three days. The researchers will provide training to
      healthcare workers in accordance with the World Health Organization (WHO) Hand Hygiene
      Guidelines. Hand hygiene behaviors of the participants will be observed and the question
      forms will be filled before and after training by researchers. The samples for microbial
      analysis will be collected from the EFT by sterile swaps.
    

Detailed description: 
      Enteral Feeding Tube (EFT) such as Nasogastric Tube (NGT), Duodenal/Jejunal Tube and
      Gastrostomy Tube are frequently used in Intensive Care Unit (ICU). However, EFT is generally
      an omitted/neglected source of contamination. EFT can serve as a reservoir of Methicillin
      Resistant Staphylococcus Aureus (MRSA), which multiplies the risk of mortality by 2-2.5
      times, for microorganism transmission. As a consequence of contamination of EFT,
      microorganisms, that may be manifest with the symptoms such as abdominal pain, distention,
      nausea, vomiting, diarrhea, may reproduce and progress to bacteremia, septicemia and even to
      death. In some studies, it is observed that there is a relation between the contamination on
      the external surface of EFT and contamination on the entry of EFT (hub), and it is also
      reported that the rate of contamination on the hub of the EFT and the environment of the
      patient is quite high. ICU nurses are responsible for sustaining safe and secure feeding,
      medication and fluid replacement of patients. Also, they provide enteral feeding products to
      patients as they are prescribed. Personnel training, proper processing procedures and
      developed enteral feeding protocols are shown to decrease the incidence of bacterial
      contamination on the enteral feeding tube
    

Intervention name(s): Adherence to Hand Hygiene
Intervention type(s): Other
Intervention description(s): determine the colonization of microorganisms due to microbial reproduction on the external surface of the distal end of the enteral feeding tube (EFT), hub of the EFT and other feeding system components and assess the relation between the colonization and adherence to hand hygiene practices by nurses and other healthcare workers
Intervention model: Single Group Assignment
Intervention model description: Prospective, observational and semi-experimental (mix method)
Masking: None (Open Label)
Primary purpose: Prevention