Practice Of Infection Control Among Health Workers

Project and Seminar Material for Public Health

Practice Of Infection Control Among Health Workers

Abstract

This study was carried out to examine tthe practice of infection control among health workers in General Hospital Lafiagi, Edu Local Government Area Kwara State. The study was carried out toestablish the level of healthcare workers awareness of healthcare associated infections, examine the practices of health care workers regarding infection control measures in General Hospital Lafiagi, and ascertain the attitude of health care workers towards infection control practices in General Hospital Lafiagi. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of healthcare workers in General Hospital Lafiagi, Edu Local Government Area Kwara State. In determining the sample size, the researcher conveniently selected 57 respondents and 50 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses were tested using Chi-square statistical tool. The result of the findings reveals that the level of healthcare workers awareness of healthcare associated infections is high. The study also revealed that the practices of health care workers regarding infection control in General Hospital Lafiagi includes: Washing of hands before and after direct contact with the patients, Putting on a mask and glasses when performing invasive and body fluid procedures, Recapping needles after use and before disposal, Following aseptic techniques strictly, and Screening patients to detect colonization even if no evidence of infection. Therefore, it is recommended that the Minister of Health to lobby for sufficient funds from the government so that the Permanent Secretary can allocate enough resources specifically for Infection Prevention and Control. To mention but a few.

Table of Content

  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Test of Hypotheses
  • 4.5 Discussion of Findings

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One

Introduction

1.1 Background of the Study

Healthcare Associated Infections (HAIs) are a huge burden in our world today. In 2002, there was an estimated 99,000 deaths due to HAIs in the United States alone with the government spending over $20 billion in cost (Almeida, 2015). HAIs vary from specialty to specialty depending on the kind of service offered and are they are mostly as a result of lack of compliance with standard precautions. These services include surgical, medical, urological, obstetric, paediatric and dental. The common types of HAIs in sub Saharan Africa are surgical site infections whereas urinary and respiratory tract infections are common in developed countries (Rothe et al, 2013).
These infections may be from bacteria such as staphylococcus aureus, enterococci, and viruses such as Rhino viruses, HIV, Hepatitis B and Hepatitis C. Infection and Prevention Control (IPC) protocols were designed to reduce the risks of spread of HAIs in health care settings, thus protecting both the patient and the healthcare worker (MOH, 2015). Strict adherence to these protocols have proven to reduce drastically the risks of HAIs in many healthcare settings. In recent times, loss of HCWs to the outbreak of deadly diseases such as Ebola virus disease calls for health workers to know and to strictly comply with IPC measures (Almeida, 2015).

World Health Organization (WHO) estimates that more than 2 billion people worldwide are exposed to hepatitis B virus and out of this number, more than 350 million people are living with chronic hepatitis B infection with no physical signs of ill health (Rufai, Mutocheluh, Kwarteng, & Dogbe, 2014).

Non adherence to standard protocols range from minor to grave consequences such as longer stays in hospitals, increased cost of healthcare, loss of productivity and working hours, loss of wages, loss of jobs and death. HAIs may also lead to legal suits against hospital staff and the facilities (Kingston, O’Connell, & Dunne, 2018). The European Union (EU) estimates that at least 25,000 persons die annually from multidrug resistant microorganisms’ infections with an approximated overhead cost of 1.5billion Euros. Similarly, in the United States of America, 1 in 25 hospital patients are estimated to develop at least one HAI and the US government spends about 9.8 billion dollars on common HAIs annually.

Again, a study done to assess the incidence of TB among health care workers worldwide revealed that health care workers are averagely at higher risks of developing tuberculosis as a result of exposure at work places. The good news is that, there is evidence to support that incidence can be greatly reduced if health facility administrators strongly commit and champion the cause of prevention of exposures at work places through supply of adequate resources such as personal protective equipment like N95 respirators, surgical, and medical face masks (Baussano et al., 2012).

Several factors account for poor compliance of healthcare workers to IPC protocols. Among them is, inadequate quality of education given at the training schools including universities, medical and nursing schools (Cheung et al., 2015). In order to forestall this, it is important that from the very start of their education, healthcare professionals’ knowledge and competencies in IPC be strongly established and followed through each academic year until the completion of the various studies. One critical point to help protect students from the risks of HAI is through adequate knowledge from well-trained Infection Prevention tutors or instructors before and during their clinical placements (Tavolacci et al., 2008). Frequent assessment of knowledge and practices of students in IPC has also proven to improve students’ attitudes and further compliance to standard IPC protocols in clinical settings (Darawad & Al-Hussami, 2013). Although every part of the disease transmission chain can be delinked, the easiest and most practical point for most infections is at the mode of transmission point, where IPC measures are effective and appropriate (MOH, 2015).

1.2 Statement of the Problem

The advantage of IPC in good healthcare service delivery and attainable patient fulfilment guarantees less spending on health care service in every Nation. It is a rule that each country achieves a score of at least 70% obedience with IPC protocols (WHO, 2002).

The IPC Policy is intended to give a path to healthcare staff and patients for the preclusion and control of infectious diseases within the health care system to guarantee patients protection and that of healthcare officials. The policy is grounded on scientific research findings and suggestions from professionals as well as specialized judgement indicating the essential for approaches to dealing with infections. Standard protocols, enumerated in the strategic guidelines are founded on the belief that all “blood, body fluids, secretions, excretions, non-intact skin and mucous membranes” may well contain communicable infectious agents. These standard safety measures consist of “hand hygiene, the use of appropriate personal protective equipment (PPE), the use of an aseptic technique to reduce exposure to microorganisms and management of sharps, spills, linen, and waste to maintain a safe environment”(Agreli et al., 2019).

According to Malliarou, Sarafis, Zyga, and Constantinidis (2013), health staff normally have an encouraging attitude towards infection prevention activities such as hand cleaning, however, compliance is often low (Malliarou, Zyga, Constantinidis, & Sarafis, 2013). Scientific works have shown that knowledge, attitude and compliance with IPC protocols among health staff including nurses are generally low. For example, a study conducted by Stein, Makarawo and Ahmed, (2003) found that in “Birmingham Teaching Hospitals”, knowledge of health staff concerning blood-borne virus spread was 44% for hepatitis B virus (HBV) and 54% for HIV (Stein, Makarawo, & Ahmad, 2003). In Hong Kong, a study conducted by Tai, Mok, Ching and Pittet, (2009) reported that healthcare staff admit that 75% of HCAI can be controlled by hand hygiene (Tai, Mok, Ching, Seto, & Pittet, 2009). The burden of healthcare-related disease in Africa is up to twenty times higher than in high-income countries (Maher, Smeeth, & Sekajugo, 2010). Therefore to combat this threat, infection control measures must be implemented in order to minimize morbidity and mortality associated with HCAIs, standard guidelines based on evidence-based care have been developed to establish worldwide standards for effective infection control among healthcare workers (WHO 2019). Therefore, this study seek to examine practice of infection control among health workers.

1.3 Objective of the Study

The overall aim of this study is to critically examine practice of infection control among health workers in General Hospital Lafiagi. Hence, the study will be channeled to the following specific objectives;

  1. Establish the level of healthcare workers awareness of healthcare associated infections.
  2. Examine the practices of health care workers regarding infection control measures in General Hospital Lafiagi.
  3. Ascertain the attitude of health care workers towards infection control practices in General Hospital Lafiagi.

1.4 Research Questions

The following research question will guide the study:

  1. What is the level of healthcare workers awareness of healthcare associated infections?
  2. What are the practices of health care workers regarding infection control in General Hospital Lafiagi?
  3. What is the attitude of health care workers towards infection control practices in General Hospital Lafiagi?

1.5 Research Hypotheses

  • Ho: Healthcare workers do not carry out effective infection control practices in General Hospital Lafiagi.
  • Ha: Healthcare workers carry out effective infection control practices in General Hospital Lafiagi.

1.6 Significance of the Study

Infection-related diseases are still the main cause of morbidity and mortality in tertiary hospitals in Rivers State, Even with regular infection control training in the hospital, gaps have been identified in knowledge and practice of infection control among doctors and nurses. Findings of this study will be of significance to hospitals, other medical facilities, healthcare workers and patients. The study will emphasize on the need for health facilities to prioritize health care delivery as Nurses with inadequate knowledge, bad practices in infection control and prevention, jeopardize the safety of the patient. Furthermore NCDC will benefit from the nosocomial infection study due to the timeliness to be able to contain and issue standard policy guidelines on Hospital Acquired Infections by this therefore preparedness in infection prevention and control measures is strengthened. More so, the study will acquint healthcare workers with efficient knowledge, good attitude and best practices by the nurse in infection prevention and control which in turn contribute to decreasing in infection rate in the hospital. Finally, the study will contribute to empirical body of knowledge on Hospital-acquired infection (HAI) and serve as reference material to student and scholars who wishes to conduct further studies in related field.

1.7 Scope of the Study

The scope of this study borders on the practice of infection control among health workers. The study will be delimited to general hospital Lafiagi, Edu Local Government Area of Kwara State.

The respondents for this study will be obtained among healthcare workers in the selected hospital.

1.8 Limitation of the Study

As every human endeavor is once faced with a constraint, the same was tenable during the period of this study. In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other tertiary institutions in other , states, and other countries in the world.

1.9 Operational Definitions of Terms

Infection

The capability of microorganisms to enter or invade the underlying tissues of the human body and discover conducive conditions that can facilitate its growth, survival and replication.

Nosocomial Infection:

Nosocomial infection is an infection or toxin that exists in a certain location such as a hospital, now Nosocomial infections is use interchangeably with the terms health-care associated infections and hospital-acquired infections.

Prevention:

Prevention is an action taken to decrease the chance of getting a disease or condition. For Nosocomial infection it includes fully disinfecting skin and equipment, washing hands regularly, wearing protective equipment like face masks and gloves. regularly changing urinary catheters, and removing them as soon as possible, removing hair near a surgical area and prescribing antibiotics only when needed.

Control:

In health care and public health practice settings, infection control includes various measures that prevent and contain the spread of infectious disease.

1.10 Organizations of the Study

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.

Chapter Five

Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the practice of infection control among health workers in General Hospital Lafiagi, Edu Local Government Area Kwara State. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was to examine the practice of infection control among health workers in General Hospital Lafiagi, Edu Local Government Area Kwara State. The study is was specifically carried out to establish the level of healthcare workers awareness of healthcare associated infections, examine the practices of health care workers regarding infection control measures in General Hospital Lafiagi, and ascertain the attitude of health care workers towards infection control practices in General Hospital Lafiagi.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 50 responses were validated from the enrolled participants where all respondent were healthcare workers in General Hospital Lafiagi, Edu Local Government Area Kwara State.

5.3 Conclusions

Based on the findings of this study, the researcher concluded that;

  1. The level of healthcare workers awareness of healthcare associated infections is high.
  2. The practices of health care workers regarding infection control in General Hospital Lafiagi includes: Washing of hands before and after direct contact with the patients, Putting on a mask and glasses when performing invasive and body fluid procedures, Recapping needles after use and before disposal, Following aseptic techniques strictly, and Screening patients to detect colonization even if no evidence of infection.
  3. The attitude of health care workers towards infection control practices in General Hospital Lafiagi is positive.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

  1. The Minister of Health to lobby for sufficient funds from the government so that the Permanent Secretary can allocate enough resources specifically for Infection Prevention and Control.
  2. Resources should be allocated for Infection prevention and control conferences locally and internationally.
  3. Nursing schools should emphasize the importance of infection prevention and control (Hospital acquired infections) in the syllabus.
  4. The General Nursing Council of Nigeria should continue to emphasize on the introduced a Continuous Professional Development Booklet for Nurses.
  5. Training on infection prevention and control be mandatory yearly and that it should be a requirement for yearly nursing registration.

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Frequently Asked Questions

What is the best way to prevent infection?

“The best advice is the same advice we give to anyone with an upper respiratory infection,” he said. “Keep your distance, wear a mask, stay home if you can and try not to spread infection to anybody else.” For each person, the decisions they make about attending gatherings becomes an assessment of the risks versus the benefits of a gathering.

How often does infection control IDT meet?

Infection control in the workplace aims to prevent pathogens from coming into contact with a person in the first place. Employers are obliged under the Occupational Health and Safety Act 2004 to provide a safe workplace for their employees, including the provision of adequate infection control procedures and the right equipment and training. 

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