Knowledge And Safe Injection Practices Among Health Care Workers In Selected Health Centers In Ejigbo, Osun State

Project and Seminar Material for Nursing (Science)

Knowledge And Safe Injection Practices Among Health Care Workers In Selected Health Centers In Ejigbo, Osun State


Abstract


Exposure to blood borne viruses, by health care workers has been on the increase with health workers mostly affected. These exposures constitute serious challenges in the health care setting as they are common causes of illness and mortality among health care workers including hospitalized patients. Practice of standard precautions such as injection safety has been shown to reduce the risk of exposure to blood and body fluids. This study was conducted to assess the knowledge and safe injection practices among health care workers in selected health centers in Ejigbo, Osun state using a descriptive research design. The specific objectives were to assess the level of knowledge of health workers about injection safety, assess injection safety practices and identify the barriers to injection safety practices among health workers in Uniosun Medical Center. Simple random sampling was used to select eighty (80) health workers in Uniosun Medical Center. A questionnaire was used to elicit information. Frequency and percentages were used for descriptive data while the hypothesis was tested using Chi square (X2) analysis at 0.05 level of significance. Result revealed that 59.7% of the respondents had good knowledge of injection safety and 66.0% had good practice of injection safety while 6.8% had poor practice. Barriers to injection safety practices included inadequate supply of injection safety material, none display of injection safety guidelines. Statistical analysis revealed a significant relationship between level of knowledge and practice of injection safety among health workers (P = 112.8 < 0.05). It was recommended that health care administrators and nurse leaders should display injection safety guidelines, supply injection safety materials and ensure that more health workers are recruited into the workforce.


Table of Content


Preliminary Page(s)

  • Title Page
  • Declaration
  • Approval
  • Dedication
  • Acknowledgement
  • Abstract
  • Table Of Content

Chapter One

1.0 Introduction

  • 1.1 Background To The Study
  • 1.2 Statement Of Problem
  • 1.3 Research Objectives
  • 1.4 Research Questions
  • 1.5 Hypothesis
  • 1.6 Significance Of The Study
  • 1.7 Operational Definition Of Terms
  • 1.8 Organization Of Study

Chapter Two

2.0 Literature Review

  • 2.1 Conceptual Review
  • 2.2 Health Workers Level Of Knowledge About Injection Safety
  • 2.3 Barriers To The Practice Of Injection Safety
  • 2.4 Theoretical Framework

Chapter Three

3.0 Methodology

  • 3.1 Research Design
  • 3.2 Study Area
  • 3.3 Target Population
  • 3.4 Instruments For Data Collection
  • 3.5 Method Of Data Analysis

Chapter Four

4.0 Results And Discussion

  • 4.1 Results
  • 4.2 Discussion

Chapter Five

5.0 Conclusion And Recommendation

  • 5.1 Conclusion
  • 5.2 Recommendations
  • References
  • Appendix

Chapter One


1.0 Introduction

1.1 Background to the Study

The safety of injection is an important issue in today’s healthcare where injectable medications and vaccines are commonly used. Coupled with this is the high burden of blood-borne pathogens with potential of transmission through accidental exposure to contaminated needles and syringes (Costa, Rapparini, Schmaltz, Tuyama, Lauria, Saraceni& Barroso, 2017). Globally, the World Health Organization (WHO) estimated that billions of injections are administered every year within healthcare settings (World Health Organization (WHO), 2015). These injections according to the WHO are commonly used for curative purposes, most of which are unnecessary and avoidable. Inappropriate injections can lead to avoidable harm particularly in developing countries where safety resources and practices cannot always be guaranteed (Gyawali, Rathore, Shankar, Kc, Jha & Sharma, 2016). A recent estimate of the burden of blood-borne infections due to unsafe injection practices revealed that up to 46% of hepatitis B, 38% of hepatitis C and 12% of human immunodeficiency virus (HIV) infections are associated with unsafe injections (Reid, 2012). Furthermore, unsafe injection practices can fuel the transmission of other emerging and reemerging infectious diseases such as the Ebola virus disease. Modelling using the fraction of unsafe injection-associated bloodborne viral infections estimated a burden of 9.18 million preventable disability-adjusted life years from 2000 to 2030 (Dziekan, Chisholm, Johns, Rovira&Hutin, 2013).

According to the WHO’s Safe Injection Global Network (SIGN), a safe injection is one that does not harm the recipient, does not expose the provider (HCWs) to any avoidable risks and does not result in waste that is dangerous to the community (WHO, 2012). Hence, safe injection practice involves the administration of rational injection by a qualified and well-trained person using a sterile device, right technique, proper disposal and management of the wastes generated. The SIGN was launched by the WHO as an alliance of global stakeholders to support and ensure the safe, logical and proper use of injections worldwide (WHO, 2012). One of the strategies to achieve the goal of this coalition as highlighted by SIGN is the behaviour change of healthcare workers. The healthcare workers are those individuals who deliver health services such as injection to the sick either directly as health workers and physicians or indirectly as environmental health, laboratory and other supportive staff including waste handlers (Joseph & Joseph, 2016). It is believed that behaviour change among the injection providers will improve the healthcare workers’ and patient safety by preventing the reuse of injection equipment, reducing unnecessary injections, prevention of needlestick injuries and enhancement of community safety via safe sharps and other waste management (Gyawali, Rathore, Shankar & Kumar, 2013).

In Nigeria, a national policy on injection safety and healthcare waste management was formulated in 2007 to address the problem of unsafe injection practices (Ministry of Health (MoH), 2007). The policy supported by the United States Agency for International Development (USAID) under the President’s Emergency Plan For AIDS Relief (PEPFAR) project included training programmes for healthcare workers on injection safety in the context of infection prevention and control and behaviour change (AIDS Support and Technical Assistance Resources, 2012).

Despite the existence of the policy document and training of the healthcare providers, high burden of injections and unsafe practices was reported in parts of Nigeria (Sowande, Jibowu, Amaefule, Pearson &Iyortim, 2014). In addition, an array of studies found that around half of the healthcare workers had poor or low level of injection safety knowledge (Gadzama, Bawa, Ajinoma, Saidu& Umar, 2014). Equally, a wide gap was reported between the injection safety knowledge and practice with many injection providers engaging in unsafe injection practices such as recapping of used needles and syringes (Bolarinwa, Salaudeen, Aderibigbe, Musa & Akande, 2014). Currently, little is known about the knowledge and practice of injection safety among health workers in sub-urban hospitals of Nigeria. Consequently, the aim of this study is to assess the knowledge and practice of injection safety among health workers in Uniosun Medical Center. It is hoped that findings will help inform professionals, patient groups and policymakers.


1.2 Statement of Problem

Exposure to blood borne viruses, by healthcare workers is on the increase with health workers being the most affected as shown in different studies (Yang, Wu, Wang, 2013; Riaz, Kamal, Riaz, Aziz, Rajper and Noorulain 2012). These viruses include hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) etc. These exposures are reported to constitute serious problem in the health care setting as they are common causes of illness and mortality among health care workers in general including hospitalized patients. Practice of standard precautions has been shown to reduce the risk of exposure to blood and body fluids.Despite the numerous researches carried out nationally concerning injection safety practices, reports of needle stick injuries and infection still abound from different units and wards from health workers and doctors with health workers ranking highest notwithstanding the provision of guide lines of universal precautions as provided by the World Health Organization. This fact justifies the need for further investigations into the knowledge and practice of injection safety to allow for more efficient measures for intervention based on knowledge of local reality. This study is aimed at assessing the knowledge and practice of injection safety among health workers in Uniosun Medical Center, Ejigbo, Osun state, Nigeria.


1.3 Research Objectives

The main purpose of this study is to investigate the knowledge and safe injection practices among health care workers in selected health centers in Ejigbo, Osun state. Specifically, the following objectives will guide the study;

  1. To assess injection safety practices among health workers in Uniosun Medical Center
  2. To assess health workers’ level of knowledge about injection safety in Uniosun Medical Center
  3. To identify the barriers to injection safety practices among health workers in Uniosun Medical Center

1.4 Research Questions

The following questions were formulated to guide the study based on the research objectives;

  1. What are the injection safety practices among health workers in Uniosun Medical Center?
  2. What is the health workers’ level of knowledge about injection safety in Uniosun Medical Center?
  3. What are the barriers to injection safety practices among health workers in Uniosun Medical Center?

1.5 Hypothesis

The study attempted to test the following hypothesis:

  • HO: There is no significant relationship between knowledge and practice of injection safety among health workers in Uniosun Medical Center, Ejigbo, Osun state

1.6 Significance of the Study

This study will be of great significance to the health workers, the health system and the policy makers/stakeholders. Recommendations from the study if implemented will improve the level of knowledge, practices of injection safety and adherence by health workers to precautionary measures. Educationally, findings will aid health workers and midwives to create awareness on the dangers of poor practices such as needle stick injuries, transmission of HIV, hepatitis Band C and other blood borne infections. Policy makers and hospital administrators through the findings will promote and reinforce injection safety guidelines, create enabling environment and provide adequate resources for health workers and other health care workers to carry out injection safety practices. The study will also provide a baseline for future researchers in relevant topic and will also contribute to the existing literature to bridge the knowledge gap of the subject matter in the sub-region.


1.7 Operational Definition of Terms

Knowledge:

Refers to the facts, information, and skills acquired through experience or education; the theoretical or practical understanding of a subject. In this study, the knowledge of injection safety among health workers in MUTH.

Practice:

Refers to the actual application or use of an idea, belief, or method, as opposed to theories relating to it. In this case, the practice of injection safety among health workers in MUTH.

Injection Safety:

Refers to the practices that do not harm the recipient, do not expose the healthcare worker to any avoidable risk, and do not result into any waste that is dangerous to the community.


1.8 Organization of Study

The study comprises of 5 chapters. In chapter one, the concepts are introduced and the problem of the study is established with the research objectives and questions. Chapter two presents the literature review while chapter three presents the research methodology. The fourth chapter presents the results and discussion, and the last chapter presents the conclusion and recommendation.


Chapter Five


5.0 Conclusion and Recommendation

5.1 Conclusion

The findings of the study revealed that knowledge and practice of injection safety among health workers in Ejigbo, Osun state was good. Implying that the health workers are willing to adhere to safety practices despite the lack of enabling environment, this is highly commendable. However, the percentage of those with fair and poor knowledge calls for concern. This implies that some health workers are still unaware that practicing injection safety helps to prevent occupational hazard and the spread of infectious diseases such as HIV/AIDS, Hepatitis B, C and other blood born infections, which can be transmitted through unsafe injection. The good practice of injection safety was as a result of good knowledge and perhaps positive work attitude of some health workers which is also highly commendable.


5.2 Recommendations

The following recommendations were made based on the findings of the study;

  1. Clinical instructors should collaborate with nurse and hospital administrators to encourage and ensure display of guidelines of universal precaution and supply injection safety material/resources. To this end, available logistics and support supervision should be put in place to ensure that health workers adhere to standard guidelines and practices. This should also include support and counseling services be provided for staff that reported sharp injuries,
  2. Nursing Services, Continuing Education and Infection Control Unit in the hospital should organize more seminars, stressing on the importance of injection safety. This should encourage health workers to continue practicing injection safety in order to prevent occupational hazard and the spread of infectious diseases that could be transmitted through unsafe injection practices.
  3. Regular workshops and seminars should be organized for health workers by Continuous education unit in collaboration with the hospital administration to continue to educate them, especially newly recruited health workers on the need to always adhere to and comply with injection safety guidelines.

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