Comparative Number of Germs Based on The Length of Time Washing Hands on Medical Personnel

Presented by Belladona Ayudityawati 20080310039 Medical Faculty and Health Science Muhamadiyah University of Yogyakarta 2011

CHAPTER I

BACKGROUND The sources of microorganisms that can cause infections fall into two categories : the sources of endogenous and exogenous sources (Hudak et al, 1996) Nosocomial infections are infections acquired by patients being treated for or had been hospitalized (Roeshadi, 1993) The core of the prevention and control of nosocomial infections is to control the proliferation and spread of microbial pathogens (Darmadi, 2008)

BACKGROUND
Nosocomial Infections in RSUP dr. Soeradji Tirtonegoro Klaten
0.70% 0.60% 0.50% 0.40% 0.30% 0.20% 0.10% 0.00% Nosocomial Infections in RSUP dr. Soeradji Tirtonegoro

Tahun 2007

Tahun 2008

Tahun 2009

Prevention of microbial pathogens can be done by good hand washing with soap containing antiseptic

FORMULATING THE PROBLEM

1. What is the total number of germs on hands of medical personnel before and after washing hands with soap that contains Chlorhexidine 2% for 30 seconds, 45 seconds and 60 seconds ? 2. Does washing hands with soap that contains Chlorhexidine 2% for 45 seconds is more effective than washing hands for 30 seconds, 60 seconds ?

RESEARCH PURPOSE

1. Knowing the number of germs found on hands of medical personnel after taking medical action against the patient's

2. Knowing the effectiveness of hand washing using soap containing 2% Chlorhexidine.

BENEFIT OF RESEARCH

1. 2. 3. 4.

Hospitals Institutions Educational Institutions For Researchers For Medical Personnel

RESEARCH ORIGINALITY

1. Selvi Puspitasari (2009), about Comparative Number of Germs Before and After Rubbing Hands With Alcohol 70% On Drying 15 Seconds, 30 Seconds and 60 Seconds 2. Endang Sri Lestari dan Helmia Farida (2004), about "Comparative Effects disinfectants Chlorhexidine gluconate 1.5% + Setrimid 15% in the basin and Alcohol Hand as Health Officer for Hand Washing Facilities

CHAPTER II

LITERATUR REVIEW Microorganisms are divided into two groups : Resident Flora Transient Flora Wash Hands : WHO standard (how to wash hands, hand washing materials, and the duration of hand washing) Disinfectant and Antiseptic : Soap Containing Chlorhexidine 2%

CONCEPTUAL FRAMEWORK

HYPOTHESIS

Number of germs after washing hands with soap that contains Chlorhexidine 2% with a time of washing hands for 45 seconds lower than the 30 seconds and 60 seconds

CHAPTER III

RESEARCH METHODS

Research Design
Quasi experiment in one group (one group pre test - post test design)

Research Subject
Population : 389 medical personnel Sampling was done by purposive sampling, with a total sample : 39 medical personnel

INCLUTION AND EXCLUTION CRITERIA Inclution : 1. medical personnel who activity and wash their hands after performing medical acts by using soap containing Chlorhexidine 2% 2. Medical personnel who are willing to participate in research

Exclution : 1. medical personnel who refuse willing to participate in research 2. Medical personnel who did not wash hands in accordance with WHO standards

RESEARCH VARIABLE

Independent variables : Long time hand washing Dependent variable : Total number of germs on hands

OPERATIONAL DEFINITION
Number 1 Variable Long time hand washing Operational Definition - Calculated at the time began to wetting hands with soap containing Chlorhexidine 2% and water, smooth and rubbed his hands, until dry hands with a disposable towel and use towel to turn off the faucet - Hand washing time is 30 seconds, 45 seconds and 60 seconds - The number of germs that are calculated on a particular area (cm2), with unit Colony Forming Units (CFU) / cm2 - The number of germ, calculated by culturing the germ in the blood jelly dish as a general culture medium for growing gram positive germ and gram-negative germ - One colony considered one bacterium

Total number of germs on hands

RESEARCH PROSEDURE

DATA ANALYZING

1. Data analyzed with One Way Anova by software SPSS 16 2. Statistical test using paired

t test

CHAPTER IV

RESULTS

Paired t-test
Group Mean of Germs Number Pre test 68.46 52.440 30 Sec 111.62 56.929 45 sec 35.00 35.637 60 sec 0.62 0.768 0,005 3.08 8.902 0,000 Post test 8.15 9.797 0,001 P value

RESULT ONE WAY ANNOVA

RESULT MEANS PLOT

DISCUSSION Factors that influence the effectiveness of antiseptics (Darmadi, 2008) :

a. Antiseptic factor consisting of concentration, pH and solvent b. Microbial factors consisting of the number of microbes and form endospores c. Environmental factors are from an organic material such as blood, pus, saliva, or feces d. Exposure time factor

DISCUSSION Mechanism of Chlorhexidine to kill germs ( Sebayang, 2010) :

permeability cell-wall penetration into cytoplasm microorganism death

Chlorhexidine binded with the bacterial cell-wall

Thats why Chlorhexidine is more effectively at killing germs than soap and alcohol

CHAPTER V

CONCLUSSION The conclusion from this research is washing hand using soap contain Chlorhexidine 2% for 45 second is the more effectively than washing hand for 30 second and 60 second

RECOMENDATION Need further research by considering more carefully about the possibility of contamination while incubating, and the skin of the hands of respondent characteristics Need to do research with antiseptic ingredients other than those already mentioned in this study Need to correct information, both to the medical officer as well as related community good hand washing, duration of hand washing and antiseptic soap containing a good according to WHO standards

REFERENCE Roeshadi, D., Winarti, A., 1993, Pengendalian Infeksi Nosokomial di RSUD Dr Soetomo Surabaya, Majalah Cermin Dunia Kedokteran, Jakarta Darmadi, 2008, Infeksi Nosokomial Problematika dan Pengendaliannya, Penerbit Salemba Medika, Jakarta Sebayang, Kurniady, 2010, Perbedaan Efektivitas Oral Hygiene antara Povidone Iodine terhadap clinical pulmonary infection score pada penderita dengan ventilator mekanik, Magister Ilmu Biomedik dan Program pendidikan Dokter Spesialis Anestesiologi Universitas Diponegoro, Semarang

THANK YOU. WASSALAMUALAIKUM. BACKDROP