Knowledge, Attitude And Practice Of Standard Precautions Among Health Care Workers Acknowledgements

WHO estimates that 501,000 deaths have occurred because of unsafe injection practices.84These deaths could have been prevented by injection safety practices, which is an element of standard precautions, an integral component of infection prevention and control as well as a key element of health care worker safety.

Such deaths involving members of the family especially the bread winners could lead to sorrow and poverty for many families.  Also, the rising prevalence of morbidity and mortality from these blood-borne infections can cause absenteeism from work, use of huge sums of money for treatment, reduced worker effect and decreased productivity, which will affect the economy adversely.

In spite of the risk HCWs are exposed to, studies have extensively reported sub-optimal and non-uniform adherence to standard precautions by HCWs in both developed and developing countries. 12, 55, 65, 66  For instance, in a study done in Benin City, only 34.2% of nurses had heard of universal precautions,85 and in another study done in South East Nigeria, only 15.2% of Doctors had good practice of standard precautions.

Compliance with these universal precautions has been shown to reduce the risk of exposure to blood and body fluids.64  However, it is known that these preventive strategies are mostly not implemented fully and/or compromised in the health care systems of most developing countries.25,33,61,86,87,88  Standard precautions is practiced in high income countries to protect HCWs from occupational exposure to blood and the consequent risk of infection with blood-borne pathogens, but the situation is different in low income countries, where standard precautions are partially practiced.65  

Occupational safety of HCWs is often neglected in low income countries in spite of the greater risk of infection due to higher disease prevalence, low level awareness of the risks associated with occupational exposure to blood, inadequate supply of personal protective equipment (PPE), and limited organizational support for safe practices.33 Efforts to reduce population levels of infections such as hepatitis and HIV are important goals.  

Identified and similar problems exist in Central Hospital, Warri, other health establishments in Delta State as well as other states.  However, the knowledge, attitude and practice of standard precautions among HCWs in Central Hospital, Warri, have not been assessed before.

Justification for the Study

On the whole, available data show that needle stick injuries and blood borne pathogens are serious threats to patients, HCWs and to the host community.  The rising prevalence of morbidity and mortality as a result of nosocomial and blood borne infections such as HIV/AIDS, HBV and HCV among others is as a result of lack of awareness, wrong attitude towards and non-compliance with the definitions and recommendations of standard precautions.  Compliance with standard precautions has been shown to reduce risk of exposure to blood and body fluids.64 Due to this, surveillance of HCWs’ compliance to standard precautions is an important element of occupational and nosocomial infection control as it enables assessment of risks from occupation exposure to infection.89

This study will expose the level of awareness, attitude and practice of standard precautions among the HCWs and hence could be used as a baseline for intervention.  It will also identify gaps which would be recommended for correction through interventions.  This study could be used to monitor trends of events concerning knowledge, attitude and practice of standard precautions among health care workers in Central Hospital, Warri, by reviewing from time to time, the incidence of needle stick injuries and the morbidity and mortality pattern.  It will also identify gaps in the standard precaution practices among these HCWs and the results from the study will be used for the planning of health education intervention programme.  It will also provide reference material for the academic society as well as further research.

1.2 AIMS AND OBJECTIVES

General Aim 

The general objective is to assess the knowledge, perception and practice of standard precautions among health care workers in Central Hospital, Warri, Delta State.

Specific Objectives

1. To assess the level of knowledge of standard precautions among health care workers in Central Hospital, Warri.

2. To ascertain the attitude of health care workers in Central Hospital, Warri towards standard precautions.

3. To determine the level of practice of standard precautions among health care workers in Central Hospital, Warri.

4. To determine the level of immunization of the health care workers against infectious diseases such as HBV.

5. To describe the action taken by the health care workers when they are exposed to occupational hazards and injuries. 

6. To ascertain the attitude of  the health care workers towards patients with HIV-AIDS.

7. To determine the practice of environmental cleanliness and waste disposal of the health care workers in Central Hospital Warri.

8. To determine some of the factors that affect knowledge, attitude and practice of standard precautions among the health care workers.