DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20214245

Knowledge and practice of standard precautions among healthcare workers in primary and tertiary health facilities in Enugu state, Nigeria; a qualitative study

Hope O. Nwoga, Miriam O. Ajuba, Babatunde Omotowo

Abstract


Background: Standard precautions (SP) is a broad concept involving measures that should be applied in hospital setting to reduce infection transmission. Most hospital acquired infections occur due to breach in SP practices. The objective was to determine the knowledge and practice of SP among HCWs in primary and tertiary health facilities in Enugu State Nigeria.

Methods: The study used a qualitative design with case study in primary and tertiary health care workers (HCWs) in Enugu Metropolis, Enugu State Nigeria. A total of 74 HCWs; 24 from the primary and 50 from the tertiary health facilities were observed while 37; 12 from primary and 25 from the tertiary health facility were interviewed. The qualitative study used in-depth interview and triangulation with observational checklist.

Results: The HCWs had good knowledge but poor practice of SP. Higher proportion of the tertiary HCWs had better practice of hand hygiene than those in the primary health facilities (OR=17.637, p<0.001). Also, the tertiary HCWs used personal protective equipment (PPE) more adequately (OR=11.417, p=0.001) and practiced injection safety better than the primary HCWs (OR=22.369, p<0.001) except in detaching of needles from syringes where higher proportion of the tertiary HCWs were involved in such practice (tertiary =40.0%, primary =29.2%).

Conclusions: There was good knowledge of SP among the HCWs but their practice was poor.


Keywords


Healthcare workers, Nigeria, Primary health facilities, Standard precautions, Tertiary health facility

Full Text:

PDF

References


Centers for Disease Control and Prevention. Universal precautions for prevention of transmission of HIV and other bloodborne infections. Fact Sheet. MMWR. 1988;37(24):377-88.

CDC 2007. Standard precautions. Excerpt from the guideline for isolations: preventing transmission of infectious agents in the health care settings 2007. Available from https://www.cdc.gov/infection control/pdf/guidelines/isolation-guidelines-H.pdf. Accessed on 25 June 2020

Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35(10):S65-164.

Sharma R, Rasnia S, Verma A, Singh S. Study of prevalence and response to needle stick injuries among health care workers in a tertiary care hospital in Delhi, India. Indian J Community Med. 2010;35(1):74-7.

Mbaisi EM, Ng’ang’a Z, Wanzala P, Omolo J. Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya. Pan Afr Med J. 2013;14:1-8.

Coppola N, De Pascalis S, Onorato L, Calo F, Sagnelli C, Sagnelli E. Hepatitis B virus and hepatitis C virus infection in healthcare workers. World J Hepatol. 2016;8(5):273-81.

Elseviers MM, Arias-Guillen M, Gorke A, Arens HJ. Sharps injuries amongst healthcare workers: review of incidence, transmissions and costs. J Renal Care. 2014;40(3):150-6.

Arinze-Onyia SU, Ndu AC, Aguwa EN, Modebe I, Nwamoh UN. Knowledge and practice of standard precautions by healthcare workers in a tertiary health institution in Enugu, Nigeria. Niger J Clin Pract. 2018;21:149-55.

Tariku GH, Eshetu HE, Abdella AA. Compliance with standard precautions and associated factors among healthcare workers in Gondar University comprehensive specialized hospital, North-West Ethiopia. J Environ Pub Health. 2017;2017.

Mehtar S. Understanding infection prevention and control. Int J Infect Control. 2011;7(1):225-7.

Sydnor ERM, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clin Microbiol Rev. 2011;24(1):141-73.

Hlabano W. Hand hygiene practices among health care workers at Nyangabgwe Hospital, Francistown, Botswana. MPH thesis, University of Limpopo. 2015.

Pittet D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol. 2000;21(6):381-6.

Nwoga HO, Ajuba MO, Ogugua I. Assessment of the knowledge, attitude and practice of standard precautions among healthcare workers in primary government health facilities in Enugu, South-East Nigeria. Niger Res J Clin Sci. 2019;9(1,2):16-30.

Gebresilassie A, Kumei A, Yemane D. standard precaution practice among healthcare workers in public health facilities of Mekelle Special Zone, Northern Ethiopia. J Community Med Health Educ. 2014;4:286.

Tobin EA, Asogun DA, Odia I, Ehidiamen G. Knowledge and practice of infection control among health care workers in a tertiary hospital in Edo State, Nigeria. Direct Res J Health Pharmacol. 2013;1(2):20-7.

Gordon M, Afayo R. Adherence to universal precautions in infection prevention among health workers in Kabarole District. J Health Med Nurs. 2016;26:144-55.

Nwoga HO, Ajuba M, Onwasigwe CN. Availability of infection control supplies in primary and tertiary government health facilities in Enugu Metropolis, Nigeria. Niger Res J Clin Sci. 2019;9(1,2):43-52.

Johnson OE, Asuzu MC, Adebiyi AO. Knowledge and practice of universal precautions among professionals in public and private health facilities in Uyo, Southern Nigeria- a comparative study. Ibom Med J. 2012;5(1):9-19.

Reda AA, Fisseha S, Mengistie B, Vandeweerd JM. Standard precaution: occupational exposure and behaviour of healthcare workers in Ethiopia. PloS One. 2010;5(12):e14420.

Ogoina D, Pondei K, Adetunji B, Chima G, Isichei C, Gidado S. Knowledge, attitude and practice of standard precaution of infection control by hospital workers in two tertiary hospitals in Nigeria. J Infect Prevent. 2015;16(1):16-22.

Agu PU, Ogboi SJ, Ezugwu EC, Okeke TC, Aniebue PN. The knowledge, attitude, and practice of universal precaution among rural primary health care workers in Enugu South East Nigeria. World J Pharm Pharm Sci. 2015;4(9)109-25.

Karadag M. Occupational exposure to blood and body fluids among a group of Turkish nursing and midwifery students during clinical practice training: frequency of needle stick and sharp injuries. Japan J Nurs. 2010;7(2):129-35.

Enwere OO, Diwe KC. Knowledge, perception and practice of injection safety and healthcare waste management among teaching hospital staff in South Eastern Nigeria; an intervention study. The Pan Afr Med J. 2014;19(17):218.

Okechukwu FE, Motshedisi C. Knowledge and practice of standard precautions in public health facilities in Abuja, Nigeria. Int J Infect Control. 2012;8(3).

Vaz K, McGrowder D, Alexander-Lindo R, Gordon L, Brown P, Irving R. Knowledge, awareness and compliance with universal precautions among healthcare workers at the University hospital of West Indies. Intl J Occup Med Environ Health. 2010;1(14):171-81.

Eman R, Mervat K, Entisar MY, Safwat AA. Effect of a developed educational booklet about standard infection control precautions on nurses’ knowledge and practices at women’s health center- Assiut University Hospital, Egypt. Med J Cairo Univ. 2012;80(1):435-45.