KNOWLEDGE, ATTITUDE AND COMPLIANCE WITH STANDARD PRECAUTIONS IN PATIENT CARE AMONG NURSES

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KNOWLEDGE, ATTITUDE AND COMPLIANCE WITH STANDARD PRECAUTIONS IN PATIENT CARE AMONG NURSES

CHAPTER ONE

INTRODUCTION

Background of the study

It is generally known that health-care workers (HCWs) often come in contact with blood-borne pathogens and other microorganisms.[1] These exposures commonly occur during major or minor surgical procedures, during routine clinical and nursing services like simple physical examination, while handling laboratory specimen, and during disposal of hospital wastes as well as during accident and life-saving emergency procedures. On exposure, HCWs can equally transmit healthcare-associated infections (HAI) to their patients and may be the source of infection for their families and communities. Occupational exposure to HAI is of great concern in developing countries where there are higher risks of exposure to blood-borne pathogens, frequent contacts with patients’ body fluids and little or no protection against airborne infections.[2]

To prevent spread of nosocomial infections, the United States’ centers for disease control (CDC) in 1985 introduced Universal precautions to protect HCWs from contact with blood and a number of other body fluids visibly contaminated with blood.[3] However, research around stigma and discrimination in health-related settings implicated Universal precautions as a means by which HCWs discriminate against patients because by failing to mainstream Universal precautions in practice, health professionals are making judgment based on individual’s health status.[4],[5]

As a result, in 1996, CDC revised the infection control practice from Universal precautions to Standard precautions (SP). SPs are the minimum infection prevention practices that apply to all patients regardless of suspected or confirmed infection status of the patient in all settings where health care is delivered.[6] These practices are designed to protect both the HCWs and the patients from nosocomial infections. Thus, SPs are crucial in hospital infection control as well as in issues related to biosafety and security of patients, professionals, and students in direct or indirect health-care delivery. For SP to be effective, consistency of application is of the essence. Hence, a combination of an enabling environment (in terms of regular supply of necessary facilities and equipment) and the willingness by HCWs to observe SP at all times is vital for a successful compliance.

Although SPs’ policy was introduced 20 years ago, adherence to these precautions is poor in health-care facilities particularly in resource-limited countries.[7] Hence, HAIs remain a critical challenge for the public health sector. Poor knowledge of infection control practices among HCWs has been noted to hinder compliance with SP.[8] In addition, strengthening SP’ training for HCWs is variously recommended as a major means of promoting adherence to SP and protecting HCWs and patients from nosocomial infections.[9],[10] Nonavailability of materials, limited organizational support, and lack of knowledge regarding infection control practices among HCWs were some of the factors responsible for poor compliance to SP.[7],[8]

Changing current behavior requires knowledge of the factors that can influence HCWs’ compliance with SP and implementing programs and preventive actions that contribute to the avoidance of occupational exposure.[10] The objective of the present study is to assess the knowledge and practices of SP among tertiary level HCWs in Enugu, Nigeria. It is also hoped that findings will be of value in determining ways of promoting compliance with SP in all public health institutions in Nigeria.

Statement of the problem

There may have been previous researches in this subject. This work gives further explanations and analysis in knowledge, attitude and compliance with standard precautions in patient care among nurses

Objectives of the study
To understand the impact of knowledge, attitude and compliance with standard precautions in patient care among nurses
To understand the relationship between knowledge, attitude and compliance with standard precautions and the improvement of patient care among nurses

Research questions
What is the impact of knowledge, attitude and compliance with standard precautions in patient care among nurses
What is the elationship between knowledge, attitude and compliance with standard precautions and the improvement of patient care among nurses