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Journal : PUBLIC HEALTH AND PREVENTIVE MEDICINE ARCHIVE (PHPMA)

HANDWASHING AS A RISK FACTOR FOR INCREASING VENTILATOR ASSOCIATED PNEUMONIA (VAP) INCIDENCE AT SANGLAH HOSPITAL, DENPASAR, 2012 Azis, Abdul; Sawitri, A.A. Sagung; Parwati, Tuti
Public Health and Preventive Medicine Archive Vol 1 No 2 (2013): Public Health and Preventive Medicine Archive
Publisher : Program Magister Ilmu Kesehatan Masyarakat Universitas Udayana

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Abstract

Ventilator associated pneumonia (VAP) is a lower respiratory tract nosocomial infection which frequently resulting from mechanical ventilation support of more than 48 hours in an intensive care unit (ICU). The incidence of VAP at Sanglah Hospital is 15.48 per 1000 days used still higher than the national standard of 10 per 1000 days used. Risk factors for VAP transmission include host condition, medical equipment hygiene and healthcare provider behaviors, including handwashing. This study aimed to analyze contributing risk factors for VAP incidence at Sanglah Hospital, specifically handwashing procedures. Study applied case control with 27 sample cases (those with VAP) and 54 control subjects (non-VAP), from similar gender and age backgrounds. Case control data was obtained from medical records of 2012. Data from healthcare providers (doctors and nurses attending to the study population) was obtained through interviewing using structure questionnaires and cross checking through assessment of medical records. The univariate and bivariate data was analyzed by chi square and multivariate by logistic regression. Findings indicated that the contributing factors are healthcare provider handwashing (OR=6.11; 95%CI: 1.54-24.25), length of hospital stay (OR=4.18; 95%CI: 1.36-12.81) and associated disease (OR=4.22; 95%CI: 0.98-18.25). Nurse behaviors contributed to VAP incidence (OR=4.69; 95%CI: 1.22-18.08). Doctors indicated difficulty in adhering to handwashing protocol (the 5 moment handwashing requirements) particularly before aseptic procedure (45,1% in cases and 66,3% in control). Study indicates that poor handwashing behaviors contribute to VAP incidence. There is a need for health promotion initiatives that encourage adherence to official handwashing protocol.
Co-Authors - Khalidin A.A.Ayu Emi Primayanthi, A.A.Ayu Emi A.R., Syamsuddin Abdullah, Usep Mudani Karim Adhelia Desi Prawestri, Adhelia Desi Adi Wiratno, Adi Agus Fakhrina Agus Susilo Ahmad Lubis Ghozali, Ahmad Lubis Ahmad Rosidi, Ahmad Ahmad Rosyid Albertus Sudirman, Albertus Alhafidz, Mohammad Alhabieb Andari Puji Astuti, Andari Puji Andreasta Meliala, Andreasta Arifa, Laily Nur Bakhtiar Bakhtiar Barati, Dwi Anggani Lingga Basri, Herlina BT, Albertus Novian Budiono Budiono Cahyani, Suci Cahyani, Suci Darsih, Darsih Dias Ayu Budi Utami, Dias Ayu Budi Djalal Rosyidi Doddy M. Soebadi Dwi Krisbiantoro, Dwi Dwi Yulianti Dwija Yasa, I Dewa Gede Elin Herlina, Elin Elvia Ivada Febrianti, Irine Kartika Firman Jaya Ganis Lukmandaru Hajrah Hajrah, Hajrah Handriani, Aan Hanifuni?am, Fanny Fauzi Hanny, Rissa Hendrival Hendrival Heru Pramono Idawati Idawati Iskandar Mirza istiqomah istiqomah Iswanto, Sufandi Iwan Setiawan Iwan Zaenul Fuad Kartono Kartono Langlang Handayani Lestari Wibowo, Lestari Lilik Eka Radiati Luh Mira Puspita, Luh Mira Lukman Hakim Lutfan Lazuardi Mahdi Santoso Maulana, Sofi Meliyana Meliyana, Meliyana Mohammad Nasikin Muhamad Isnaini Muhammad Haikal Muhsinin, Mahmud Mukhtar Mukhtar Munandar, Didih Syakir Munira, Widia Muslim, Nor Mustafa Lutfi Mustakim Mustakim Muyassir Muyassir Ni Siluh Putu Nuryanti Nina Mariana, Nina Nisa, Ulfa Lathifatun NITA NURDIANA, NITA Nova Maulidina Ashuri, Nova Maulidina Nurasiah Nurasiah Nurdin, Alimin Nurmala, Eneng Oktami, Wantia Oktami, Wantia Pasanda, Octovianus S. R. Pebrianti, Irine Kartika Prayitno, Tibertius A Prayitno, Tibertius A. Prihartono, Agustinus Prihartono, Agustinus Pujiastuti, Dwi Yuli Putranto, Banu Dwi Radite Praeko Agus Setiawan Rahmawati Prihastuty, Rahmawati Rahmawati, Aulia Pungki Ramadhani, Nur Rizky Riberu, Hardiyanti Risqiantoro, Arif Riswan Riswan Rita Arbianti Riyanto Rizal, Soni Samsu Rozal, Reri Aresta Sa?adah, Noor Nailis Saeful Anwar, Saeful Saifullah Saifullah Saismana, Uyu Saleh, Sitti Fithriani Sawitri, A.A. Sagung Sa’adah, Enok Hilmatus Selamet Selamet Setiawan, Ito Setiawan, Rio Siti Aminah Siti Rohmah Siti Zainab, Siti Sri Minarti Suarni Suarni Sugandar, Ferry Anka Sukma, Ating Sukma, Ating Sumarti, Sri Susilowati Suriani, Ade Irma Susilaningsih - Sutjipto A Hadikusumo Syam, Nurwati T.A. Prayitno Teduh Dirgahayu, Teduh Testiana Deni Wijayatiningsih Tineke Mandang Toheri Toheri, Toheri Tomy Listyanto Tri Afirianto, Tri Tuti Parwati Utami, Diaz Ayu Budi wahjoe djatisoesanto Wawan Hermawan Wibisono Sukmo Wardhono, Wibisono Sukmo Widastra, I Made Wirawan, Gusti Putu Alik Witarsa, I Made Surata Wiwik Indrawati, Wiwik Wulandari, Fenny Yuhdi Fahrimal, Yuhdi Zurrahmi Wirda