Knowledge, Attitude And Practice On Hospital Acquired Infection, Prevention And Associated Factors Among Health Workers At Specialist Hospital Jalingo
Knowledge, Attitude And Practice On Hospital Acquired Infection, Prevention And Associated Factors Among Health Workers At Specialist Hospital Jalingo
Abstract
The aim of the study was to assess the knowledge, attitude and practice on hospital acquired infection, prevention and associated factors among health workers at Specialist Hospital Jalingo, Taraba state. A quantitative descriptive study was conducted and a random sampling was performed. A total of 130 health workers were recruited in the study. The tool for data collection was a self-designed questionnaire. Data were analyzed using inferential and descriptive statistics of mean, frequency and simple percentages. The Statistical Package for the Social Sciences (SPSS) was used for analysis. Most of the participants were female; 84.7% while 15.3 % were male. The majority of participants had good knowledge in infection prevention and control with the mean score of 83.21. The practice in infection prevention and control was poor with the mean score of 48.88. The major barriers towards infection prevention and control measures were inadequate knowledge of the control measures (78.5%), followed by the lack of access to information (70.1%), then poor nurses’ attitude (68.7%), and finally, language and culture (45.8%). Based on the findings of the current study, it can be concluded that, despite performing well in knowledge and showing a positive attitude towards infection prevention and control, health workers had unsatisfactory practice levels regarding infection prevention and control measure, exposing themselves and the nurses to infection-related diseases. It was recommended that there is need to strengthen the infection prevention and control practice through regular information flow; ensure that that resources, e.g. personal protective equipment is available all the time; observing nurses’ practices. There is therefore the need for nurses to play an important role in the translation of knowledge and practices to the clinical environment including to the health workers for optimum health outcomes. Furthermore, research about the barriers in infection prevention and control practices.
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 Objectives of the Study
- 1.4 Research Questions
- 1.5 Significance of the Study
- 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 Theoretical Review
- 2.3 Empirical Review
Chapter Three
3.0 Methodology
- 3.1 Research Design
- 3.2 Research Setting
- 3.3 Target Population
- 3.4 Sample Size
- 3.5 Instruments For Data Collection
- 3.6 Method of Data Collection
- 3.7 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
Infection-related diseases are still the main cause of death in Nigeria, according to the 2013 health profile acquired by the World Health Organization (WHO, 2013) statistics. The burden of disease in Nigeria includes HIV, TB, Malaria, other infectious diseases and respiratory infections. Expansion of the infection prevention and control movements occur due to the increase in infection occurrences in the country. This increase in infection-related disease’s impact the increase health financing in Nigeria with a government contribution to health care of 57.5% above the figures budgeted for (WHO, 2014).
Infectious health workers are admitted into hospitals and therefore hospitals have become common settings for transmission of diseases. In hospitals, infected health workers are a source of infection transmission to other health workers, health care workers and visitors (Sydnor & Perl, 2011). Nosocomial infection, also known as hospital-acquired infections is one of the leading causes of death and has much economic cost due to increased hospitalization and prognosis (WHO, 2015). According to WHO (2010), Hospital acquired infection is defined as an infection occurring in a patient during the process of care within a health care facility which was not present or incubating at the time of admission. These infections are those occurring more than 48 to 72 hours after admission and within ten days after hospital discharge (Collins, 2012). Due to the admission of health workers with different organisms, the hospital environment has become saturated with highly virulent organisms, namely: Staphylococcus aureus, Streptococcus pyogenic, Escherichia coli, Pseudomonas aureginosa and Hepatitis viruses that survive in a hospital. These organisms cause diseases ranging from minor skin infections to life-threatening conditions such as sepsis (Sydnor, & Perl, 2011).
The Nigerian Public Health Act, Cap 295, stipulates that the health care institution should provide a safe environment for the health workers in their care. Hospital nurses form the backbone of infection prevention and control, therefore possibly, will either contribute to infection transmission or prevent and control infection. According to Damani (2012), the environment in which a patient is nursed must be planned to reduce the risk of transmission of infection. Infection prevention and control measures aim to protect the vulnerable people from acquiring an infection while receiving health care (Damani, 2012). Lack of knowledge, bad attitudes and poor practices amongst nurses in the prevention and control of infections can lead to hospital-acquired infections.
Hand hygiene is the single most important intervention to prevent transmission of infection and should be a quality standard in all health institutions. An attitude of not washing hands among individuals involved in the provision of health care can increase the rate of hospital-acquired infections. In a study that was conducted in India, where Nair, Hanumantappa, Hinemath, Siraj and Raghunath (2013) assessed knowledge, attitude and practices of hand hygiene among medical and nursing students at a tertiary health care centre, the majority of students had poor knowledge with regard to hand hygiene. Lack of knowledge among nurses can increase the rate of hospital-acquired infections. This is supported by a study that was conducted in Zimbabwe by Tirivanhu, Ancia and Petronella (2014) who determined the barriers of infection prevention and control practices among nurses at the Bindura provincial hospital. The study revealed that the majority of nurses’ lack knowledge on infection control principles as only n= 14 (28%) of n= 50 (100%) nurses had excellent knowledge on infection control principles, n= 21 (42%) of n= 50 nurses did not utilize the infection control manuals. Infection control workshops were poorly organized as 68% of the nurses did not attend any workshop on infection prevention and control practices (Tirivanhu et al., 2014). Hayeh and Esena (2013) assessed the infection prevention and control (IPC) practices among health workers at Ridge Regional Hospital in Accra (Ghana). The study showed that knowledge in IPC practices among health care workers was moderate 51% (n= 204), as availability and access to material for IPC practices at the facility was 58% (n= 118) and overall compliance with IPC guidelines was 54% (n= 110).
The World Health Organization (2016) has indicated that surgical site infections at this particular tertiary hospital in Nigeria are a research priority as there was an increase in wound infections of those people who had surgery at this hospital and this coincides with the researcher’s experiences and proposal.
1.2 Statement of Problem
In most hospitals, it is observed that there was poor utilization of the standard precaution. There was poor handling of body secretions among the health workers, poor hand washing practices carried out among the health workers, health workers’ relatives and the nurses, and a lot of communicable diseases in the hospital which in turn made some previously discharged health workers readmitted. Infection-related diseases are still the main cause of morbidity and mortality in Nigeria (WHO, 2015). Deaths related to nosocomial infection in the hospital continue to be a health care priority. Nurses with inadequate knowledge, bad practices in infection control and prevention, jeopardize the safety of the patient. The WHO has indicated that infection at this particular tertiary hospital in Nigeria is a research priority and this coincides with the proposal. According to the European Centre for Disease Prevention and control (2014), the Nigerian Ministry of Health has indicated that the Ebola virus epidemic in the Democratic Republic of Congo is a public health risk as a neighboring country and therefore preparedness in infection prevention and control measures should be strengthened. Efficient knowledge, good attitude and best practices by the nurse in infection prevention and control may contribute to decreasing in infection rate in the hospital.
Nosocomial infection also called “hospital acquired infection” can be defined as: An infection acquired in hospital by a patient who was admitted for a reason other than that infection. Furthermore, it is an infection occurring in a patient in a hospital, or another health care facility, in whom the infection was not present or incubating as at the time of admission. This includes infections acquired in the hospital but appearing after discharge and also occupational infections among staff of the facility Patient care is provided in facilities which range from highly equipped clinics and technologically advanced university hospitals to front-line units with only basic facilities.
Despite progress in public health and hospital care, infections continue to develop in hospitalized health workers, and may also affect hospital staff. Many factors promote infection among hospitalized health workers: decreased immunity among health workers; the increasing variety of medical procedures and invasive techniques creating potential routes of infection; and the transmission of drug-resistant bacteria among crowded hospital populations, where poor infection control practices may facilitate transmission. Hence, the need to carry out this study on the knowledge, attitude and practice on hospital acquired infection, prevention and associated factors among health workers at Specialist Hospital Jalingo, Taraba state.
1.3 Objectives of the Study
The general objective of this study is to assess the knowledge, attitude and practice on hospital acquired infection, prevention and associated factors among health workers at Specialist Hospital Jalingo, Taraba state. Specifically, the study seeks to;
- Assess the level of knowledge of health workers in infection prevention and control measures in Specialist Hospital Jalingo.
- Ascertain the level of utilization in infection prevention and control measures carried out among health workers in Specialist Hospital Jalingo.
- Assess the barrier among health workers towards infection prevention and control measures in Specialist Hospital Jalingo
1.4 Research Questions
- What is the level of knowledge of infection prevention and control measures among health workers in Specialist Hospital Jalingo?
- To what extent do the health workers utilize the disease control measures in Specialist Hospital Jalingo?
- What are the possible barriers among health workers towards infection prevention and control measures in Specialist Hospital Jalingo?
1.5 Significance of the Study
HO1: There is no relationship between knowledge, attitude and practice of hospital acquired infection and prevention among health workers at Specialist Hospital Jalingo, Taraba state
1.6 Significance of the Study
The findings of this study will enhance efficient knowledge, good attitude and best practices among nurses in infection prevention and control with the aim of contributing to a decrease in the infection rate among health workers in the hospital. This study would also serve as a point of reference and information based on the results that would be derived from the analysis and interpretation for policy implication by health authorities. It is desirable to have information on hospital acquired infection among health workers to help bridge any identified gaps and enable them better understand the benefits of strict adherence to standard precautions and safety measures. Also, this study will contribute to the existing body of literature and serve as a reference for future research in related fields.
1.7 Operational Definition of Terms
Knowledge:
It refers to having a general understanding of a subject, situation etc.
Hospital:
A building designed to diagnose and treat the sick, inured or dying. Usually, it has a staff of doctors, nurses and other healthcare practitioners so as to aid in the treatment of health workers
Infection:
Pathologically, it’s the act or process of infecting. Its an uncontrolled growth of harmful micro-organisms in a host.
Hospital-Acquired Infections:
Otherwise nosocomial infections are simply defined as infections acquired in the hospital within 48 to 72 hours of hospitalization that were neither present nor incubating upon admission of a patient. Infections that present within 10 days after hospital discharge are considered as hospital-acquired infections.
Control Measure:
It includes actions that can be taken to reduce the potential of exposure to hazards
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
Despite the health workers being knowledgeable (mean score 83%) towards infection prevention and control measures, the practices were very poor (mean score 48.8%). However, if nurses are knowledgeable and have a positive attitude towards infection prevention and control, and they are able to influence their practices, which are expected to be good. Furthermore, according to Florence Nightingale’s Environmental theory, the nurse plays an important role in the translation of knowledge and practices to the clinical environment including to the health workers for optimum health outcomes, it is concluded that the health workers are exposed to infection related diseases due to poor infection prevention and control practices. As a result of these findings the researcher has concluded that the barriers to good practice in infection prevention and control measures require further research.
5.2 Recommendations
The following recommendations are made based in the findings if the study;
- Tertiary institutions and nursing schools should emphasize the importance of infection prevention and control (Hospital acquired infections) in the syllabus. This is to prepare the nursing students for their actual clinical practice to be effective once in practice.
- The infection control committee and regulatory bodies should be more proactive so that they can effectively monitor the rate of Hospital Acquired infections as well as give feedback to nurses and relevant authorities.
- There is need for improvement in the nurse-patient relationship. This involves positive attitudes towards the health workers, as well as information flow to the health workers in the infection prevention and control measures specific to their cases. This will serve as a motivation on the part of the health workers to adhere to the standard precautions and improve health outcomes.
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