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.
