ABSTRACT
Introduction
Health care workers (HCWs) are at a
high risk of needle stick injuries and blood borne pathogens, such as HIV, and
Hepatitis B and C viruses, as they perform their clinical activities in the
hospital3. Standard
precautions are a set of guidelines that aim to protect HCWs from infections
from blood, body fluids, secretions, excretions except sweat, non-intact skin,
and mucous membranes while providing care to patients.54 Compliance with universal precautions has
been shown to reduce the risk of exposure to blood and body fluids.64
Aims and objectives
This
study was aimed at assessing the level of knowledge, attitude and practice of
standard precautions among HCWs in Central Hospital, Warri, Delta State,
Nigeria.
Methodology
The study was carried out between
June and December, 2011 at Central Hospital, Warri, Delta State, Nigeria. The respondents were doctors, trained nurses,
laboratory scientists, laboratory technicians, health assistants and waste
handlers. They were selected through a
stratified sampling technique. The
instrument was an interviewer administered 98-item semi-structured
questionnaire that assessed the knowledge, attitude and practice of standard
precautions.
Results
A total of 200 respondents were
studied. The age of the respondents (in
years) ranged from 22 – 60, with a mean age of 38.3 +
9.1. The modal age was 30. There were more females 144 (72.0%) than males
56 (28.0%). The respondents with
tertiary level 160 (80.0%)
of education were more represented. Some 124
(62.0%) of all respondents had good knowledge of standard precautions, 140
(70.0%) had good attitude of standard precautions, and 138 (69.0%) had good
practice of standard precautions. The higher the educational level, the higher
the level of knowledge, attitude and practice of standard precautions. Some 87
(43.5%) reported always recapping needles after use, 52 (26.0%) always detach
needles from syringes, 74 (37.0%) had needle stick injuries in the last one
year. Compliance with non-recapping of needles by the HCWs was however good 113
(56.5%). A high percentage usually washed their hands after handling patients.
A large proportion of respondents (80.0%) were not immunized, only (40.0%) had
hepatitis B virus vaccine.
Conclusion
The
level of knowledge attitude and practice of standard precautions was influenced
by certain variables such as age, sex, occupation, level of education. In this study, there is need to increase
awareness and further improve on compliance with standard precautions in this
present day scourge of HIV pandemic .It is recommended that staffs should be
trained regularly on standard precautions, hepatitis B virus immunization should
be made compulsory, though free, needle recapping should be prohibited, unsafe
and unwarranted use of injections should be minimized and a PEP protocol should
be in place with a well-known designated PEP focal person.
KEY WORDS
Standard
precautions, knowledge, attitude, practice, blood-borne infection, needle stick
injury, health care workers, compliance.
TABLE
OF CONTENTS
Title page - - - i
Declaration - - - ii
Certification - - - iii
Dedication - - - iv
Acknowledgement - - - v
Abstract - - - vi
Key words - - - vii
Table of contents - - - viii
List of tables - - - ix
List of figures - - - xi
Definition of terms - - - xii
CHAPTER
ONE: Introduction - - 1
CHAPTER
TWO: Literature review - - 14
CHAPTER
THREE: Methodology - - 43
CHAPTER
FOUR:
Results - - 55
CHAPTER
FIVE: Discussion - - 88
CHAPTER
SIX: Conclusion and recommendations - 97
References - - - 101
Appendix: (Questionnaire,
letter from ethical committee and score-
schedules for Knowledge, Attitude and
Practice of Standard Precautions) - - - 111
LIST
OF TABLES
Table 4.1: Socio-demographic characteristics of respondents showing age
group, sex, marital status, religion.
Table 4.2: Socio-demographic characteristics of respondents showing
ethnicity, educational level, occupation, years of service.
Table 4.3: Occupation of respondents by sex distribution.
Table 4.4: Source of information on standard precaution.
Table 4.5: Diseases transmitted by needle stick injury.
Table 4.6: Facilities methods of disease prevention.
Table 4.7: Attitude towards standard precaution.
Table 4.8: Attitude following needle stick injuries.
Table 4.9: Willingness to perform the procedures on HIV positive
patients.
Table. 4.10: Ways to protect self if managing HIV positive patients.
Table 4.11: Frequency of needle stick injuries in the last one year.
Tale 4.12: Practice following spill of blood and body fluids.
Table 4.13: Injection safety practices.
Table 4.14: Methods of needle disposal.
Table 4.15: Methods of handling used reusable instruments.
Table 4.16: Duration of been immunized with HBV immunization.
Table 4.17: Scores for knowledge, attitude and practice towards standard
precautions.
Table 4.18: Knowledge of standard precautions and socio-demographic
variables of respondents.
Table 4.19: Attitude towards standard precautions and socio-demographic
variables of respondents.
Table 4.20: Practice of standard precautions and
socio-demographic variables of respondents.
Table 4.21: Knowledge, attitude and practice of
standard precautions and ever had needle stick injury.
Table 4.22: Ever had needle stick injuries and
recapping of needles after use.
Table 4.23: Ever had needle stick injuries and
detaching of needles after use.
LIST
OF FIGURES
Figure 4.1: Respondents who have heard of standard precautions.
Figure 4.2: Knowledge of HIV immune status of respondents.
Figure 4.3: Prevalence of needle stick injuries.
Figure 4.4 Respondents immunized against HBV
infection.
DEFINITION OF TERMS
Attitude: Way of feeling, thinking or
behaviour. In this study, the same
definition/assumption applies.
Blood-borne
infections : Occupation Safety and Health Administration (OSHA)
defines blood-borne infections as infections from pathogenic micro-organisms
that are present in human blood and can cause diseases in humans. These pathogens include, but not limited to
HBV, and HIV. In this study, the same
definition applies.
Compliance: Practice of obeying rules or request made by
people in authority. In this study, it
is the extent, to which the HCWs obey or implement the definitions and
recommendations of standard precaution laid down by the Centres for Disease Control
(CDC).
Knowledge: The Oxford Advanced Learner’s Dictionary
(2001:658) defines knowledge as the information, understanding and skills that
one gains through education or experience.
It also defines knowledge as the state of knowing about a particular
fact or situation. In this study,
knowledge refers to the awareness of basic principles of standard precautions.
Practice: Is the usual or expected way of doing
something in a particular organization or situation. In this study, practice refers to the extent
that the HCWs implement or comply with recommended strategies of standard
precautions.
Safety
(sharps) container or box: A
puncture/liquid proof container designed to hold used sharps safety during
collection, disposal and destruction.
Sharps
injury: An injury, which occurs
when a sharp object penetrates the skin or mucous membranes.
Standard
precautions: Care taken in advance to avoid a
risk. In this study, it is an approach
to infection control to treat all human blood and certain human body fluids as
if they were known to be infectious for HIV, HBV and other blood borne
pathogens, by use of barrier equipment like hand gloves, face masks, gowns,
boots.
CHAPTER ONE
1.1 INTRODUCTION
Infection is one of the most
important problems in health care services worldwide. It constitutes one of the most important
causes of morbidity and mortality associated with clinical, diagnostic and
therapeutic procedures.1,2
Health care workers (HCWs) are at a
high risk of needle stick injuries and blood-borne pathogens as they perform
their clinical activities in a hospital.3 They are exposed to blood borne pathogens,
such as human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C
(HCV) viruses, from sharp injuries and contacts with blood and other body
fluids.4,5 According to a WHO
estimate, in the year 2002, sharp injuries resulted in 16,000 hepatitis C
Virus, 66,000 hepatitis B virus and 10,000 HIV infections in health care
workers worldwide.6 There is
no immunization for HIV and hepatitis C.7 It becomes important to prevent infection by
preventing exposure. Recapping,
disassembly, and inappropriate disposal increase the risk of needle stick
injury.8,9 The incidence rate
of these causative factors is higher in developing countries for the higher
rate of injection with previously used syringes.10 Developing countries where the prevalence of
HIV-infected patients is very high, record the highest needle stick injuries
too.10 Needle stick injuries
were also reported as the most common occupational health hazard in a Nigerian teaching
hospital.11 The World Health
Organization (WHO) estimates that about 2.5% of HIV cases among HCWs and 40% of
hepatitis B and C cases among HCWs are the result of these exposures.12 Irrational and
unsafe injection practices are rife in developing countries.13 The practice of recapping needles has been
identified as a contributor to incidence of needle stick injuries among HCWs.5,
14 It is believed that only one out of three needle stick injuries are
reported in the US, while these injuries virtually go undocumented in many
developing countries.15
Unsafe injections and the consequent transmission of blood borne
pathogens are suspected to occur routinely in the developing world.16 It was estimated that each person in
developing countries receives an average of 1.5 infections per annum. 16,
19 About 90-95% of injections are therapeutic, while 5-10% is given for immunization.17
It has been shown that between 70% and 99% of these injections are
unnecessary, while at least 50% are unsafe in 14 of 19 countries in five
developing world regions with data. 17, 18, 19, 20.
Hauri et al of the Department of
Essential Health Technologies, WHO estimates 3.4 injections per person per year
in developing countries.16, 18
In Nigeria, the annual mean was found to be 4.9 injections per year.21 Injection over use and unsafe practices
account for a substantial burden of death and disability worldwide.16 Eighteen studies reported a convincing link
between unsafe injections and the transmission of hepatitis B and C., HIV,
Ebola and Lassa virus infections and malaria.19 Injuries from sharp devices have been
associated with the transmission of more than 40 pathogens, including HBV, HCV,
HIV, haemorrhagic fevers, malaria and tetanus, thereby increasing the risk and
burden of infectious diseases.22, 23, 24, 25 Contaminated sharps such as needles, lancets,
scalpels, broken glass, specimen tubes and other instruments, can transmit
blood borne pathogens such as HIV, Hepatitis B (HBV) and Hepatitis C viruses
(HCV).26 The circumstances
leading to needle stick injuries depend partly on the type and design of the
device and certain work practices.27
Also, the level of risk depends on the number of patients with that
infection in the health care facility and the precautions the health care
workers observe while dealing with these patients.27 It is documented that 10 – 25% injuries
occurred while recapping a used needle.5 The recapping of needles has been prohibited
under the Occupation Safety and Health Administration (OSHA) blood-borne
pathogen standard.28
A data combined from more than 20
prospective studies worldwide of health care workers exposed to HIV infected
blood through percutaneous injury revealed an average transmission rate of 0.3%
per injury,4, 15, 27, 29 and after a mucous membrane exposure
approximately 0.09.30 The
commonest mode of transmission of HIV –contaminated blood to health care
workers is via needle stick injury.27 The greater the size and depth of the blood inoculation,
the greater the risk.4
Transmission through the conjunctiva and open lesions in the skin can
also occur when in contact with HIV containing fluids.4
An increasing number and variety of
needle devices with safety features are now available. Needleless or protracted needle I.V. systems
have decreased the incidence of needle – stick injuries by 62% - 88%.31Some
of these injection devices are; Auto-disable syringe, manually retractable,
automatically retractable, standard disposable and needle remover.31
The World Health Organization
defines a safe injection as one that is given using appropriate equipment, does
not harm the recipient, does not expose the provider to any waste that is
dangerous to the community.32 A safe injection is only given when
there is no other suitable alternative. Developing countries, especially those
in sub-Saharan Africa, that account for the highest prevalence of HIV-infected
patients in the world also report the highest incidences of occupational
exposure.12, 25, 33 HCV and
HBV infections are generally considered endemic in sub-Saharan Africa.33
Occupational safety of HCWs is often
neglected in low-income countries in spite of the greater risks associated with
occupational exposure to blood, inadequate supply of personal protective
equipment (PPE), and limited organizational support for safe practices.33
National data are unavailable for
these blood borne infections in Ethiopia.
However, surveys in different parts of the country indicate the
prevalence of HCV to be 0.9 to 5.8%34,35 and estimates for HBV range
from 4.7% to 14.4%.35-39
According to projections for 2010, the prevalence of HIV/AIDS for
Ethiopia is estimated at 2.8%.40
In a study on standard precautions carried out from February to May,
2010 in 10 hospitals and 20 health centres in two administrative regions of
Ethiopia (Harare and Dire Dawa), projected estimates of HIV/AIDS prevalence for
2010 as 4.4% for Harare and 5.7% for Dire Dawa.40 The prevalence of HBS Ag in healthy blood
donors in Kathmandu Valley has been reported to be about 1.67%.41 Sero-prevalence study suggests that the
overall anti-HCV positivity in blood donors is about 0.3% in Nepal.42 The prevalence of HCV sero positivity in
health blood donors has been reported to be about 0.2% in Nepal.43 The prevalence of HBS Ag in healthy blood
donors in Saudi Arabia ranges from 2.7% to 9.8%.39-40 Sero-prevalence studies suggest that the
overall anti HCV positivity is about 3.5 – 5%.43-45
Thalassemia and Sickle cell disease
are common in Saudi Arabia and prevalence of hepatitis C virus anti-bodies
among this high-risk group is about 40%.45 The prevalence of HIV sero-positivity has
been reported to be about 0.09% in the Kingdom.46 These figures suggest that a sizable number
of individuals are a potential risk for transmission of blood-borne diseases to
doctors, laboratory technicians, blood bank workers, nurses, personnel working
in renal dialysis and transplant units, and other health care workers.27,
47
Recognizing this threat, the U.S.
Centers for Disease Control and prevention (CDC) proposed a series of
procedures for preventing occupational exposures and for handling potentially
infectious materials such as blood and body fluids.48 These procedures, known as standard
precautions (SPS), advise health care workers (HCWS) to practice regular
personal hygiene; use protective barriers such as gloves and gown whenever
there is contact with mucous membranes, blood and body fluids of patients; and
dispose of sharps, body fluids, and other clinical wastes properly.48, 49,
50
The potentially infectious nature of
all blood and body substances necessitates the implementation of infection
control practices and policies. There are more than 20 blood-borne diseases,
but those of primary significance to health care workers are hepatitis due to
either the hepatitis B virus (HBV) or hepatitis C virus (HCV) and acquired
immunodeficiency syndrome (AIDS) due to human immuno-deficiency virus (HIV).51
In order to minimize the risk of HIV/AIDS, HBV and HCV through unsafe
injection, practices, the Federal Ministry of Health has phased out the use of
sterilizable injection equipment in Nigeria.51 Standard precautions
apply to blood; all body fluids, secretions and excretions (except sweat)
regardless of whether or not they contain visible blood; non-intact skin, and
mucous membranes,22, 23, 52, 53, 54 any unfixed tissue or organ
(other than intact skin) from human (living or deed), human immunodeficiency
virus (HIV) or hepatitis B virus (HBV) containing culture medium or other
solutions.54
Universal precautions are a set of
guidelines that aim to protect health care workers (HCWs) from blood-borne
infections.55 In 1981, the
CDC proposed the concept of “universal precautions, originally designed to
protect HCWs from exposure to blood-borne pathogens.56, 57 The
definition and recommendations of universal precautions was revised by the
Centres for Disease Control and prevention (CDC) and given the new name of
standard precaution,58 which combines the major features of universal
precautions and Body Substance Isolation (BSI)59, 60. Under the Standard precautions, blood and
body fluid of all patients are considered potentially infectious for HIV, HBV
and other blood borne pathogens.54,58 In addition, standard
precautions stipulate that HCWs take precautions to prevent injuries caused by
needles, scalpels, and other sharp instruments or devices during procedures and
disposal.5 The term “Standard precautions” is replacing “Universal
precautions”, as it expands the coverage of universal precautions by
recognizing that any body fluid may contain contagious and harmful
micro-organisms.60 Standard
precautions is regarded as an effective means of protecting HCWs, patients, and
the public, thus reducing hospital acquired (nosocomial) infections.51
The components of standard
precautions include; hand hygiene, personal protective equipment (PPE) such as
use of gloves, cap, gowns, mask, safe waste disposal system, correct
sterilization and disinfection processes, appropriate use of instruments and
equipment, vaccination, education, screening of blood for transfusion and post
exposure protocol (PEP).62 To reinforce the above existing
components, three other areas of practice have been added and include;
respiratory hygiene/cough etiquette, safe injection practices, and use of masks
for the insertion of catheters or injection of materials into spinal or epidural
spaces via lumbar puncture (e.g. myelogram, spinal or epidural anaesthesia).62
Reports indicate that standard
precautions are effective in preventing both occupational exposure incidents
and associated infections.25, 63
Compliance with universal precautions has been shown to reduce the risk
of exposure to blood and body fluids.64 However, studies have extensively reported
suboptimal and non-uniform adherence to standard precautions by HCWs in both
developed and developing countries.12, 55, 65, 66 Standard precautions are designed to reduce
the risk of transmission of infectious agents from both recognized and
unrecognized sources of infection in health care settings.
The incidence of infection with
Hepatitis B virus has declined in health care workers in recent years largely
due to the widespread immunization with hepatitis B vaccine.67 In
many health facilities, even though the personnel are vaccinated, the
sero-conversion status after vaccination is not assessed.27 Standard precautions is also intended to
protect the patient by ensuring that health care personnel do not transmit
infectious agents to patients through their hands or equipment during patient
care.62
Employee exposure to blood borne
pathogens from blood and other potentially infectious materials (OPIM) occur
because employees are not using universal precautions.68 OPIM is
defined as:
·
The following human body fluids: semen,
vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid,
pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental
procedures, anybody fluid that is visibly contaminated with blood, and all body
fluids in situations where it is difficult or impossible to differentiate
between body fluids.68
·
Any unfixed tissue or organ (other than
intact skin) from a human (living or dead);68 and
·
HIV – containing cell tissue cultures, organ cultures, and HIV or
HBV – containing culture medium or other solutions, and blood, organs, or other
tissues from experimental animals infected with HIV or HBV.68
The
Blood-borne pathogens standard allows for hospitals to use acceptable
alternatives to universal precautions.69 Alternative/concepts in
infection control are called Body Substance Isolation (BSI) and standard
precautions.69 These methods define all body fluids and substances
as infectious.69 These
methods incorporate not only the fluids and materials covered by the blood borne
pathogens standard but expands coverage to include all body fluids and
substances.69
These concepts are acceptable
alternatives to universal precautions, provided that facilities utilizing them
adhere to all other provisions of the standard.69 For compliance
with OSHA standards, the use of either universal precautions or standard
precautions are acceptable.69
Since it is not feasible or
cost-effective to test all patients for all pathogens prior to giving care, and
identification of patients infected with blood borne pathogens cannot be
reliably made through medical history and physical examination, standard
precautions are therefore recommended for use on all patients by the United
states Centres for Disease Control (CDC), regardless of diagnosis and treatment
setting.70, 71
Statement
of the Problem
Healthcare workers (HCWs) are at
risk of occupational hazards as they perform their clinical activities in the
hospital.72 The occupational
health of the health care workforce of about 35 million people representing
about 12% of the working population has been neglected.72 They are exposed to blood borne infections by
pathogens such as HIV, hepatitis B and hepatitis C viruses, from sharps
injuries and contacts with deep body fluids.4, 5, 58 In an era of
HIV epidemic in sub-Saharan Africa,73 this occupational risk is real
and significant. It has been found that
the risk of transmission of HIV/AIDS via needle stick incidents is 0.3 %;4,15,27,29;
i.e, 1 case per 300 needle stick
incidents.
The
Occupational Safety and Health Administration estimates that 5.6 million HCWs
worldwide who handle sharp devices, are at risk of occupational exposure to
blood borne pathogens.74
These injuries are usually under-reported for so many reasons such as
stigmatization, should HIV result from such incidents.15 The sero-prevalence
of HIV varies widely from country to country and from one region to another
within the same country.75
Sub-Saharan Africa (SSA) has the highest HIV sero-prevalence in the
world.75 The 2005 sero-sentinel survey conducted in Nigeria reported
an overall HIV sero-prevalence of 4.4%.75 This high prevalence in
the country poses an occupational risk to HCWs.
HIV/AIDS constitutes a major health problem in Nigeria.76
Nigeria is one of the countries worst hit by the HIV/AIDS epidemic, with about
2.99 million people currently infected.76 Over a million people (» 1.70 million) have already died from
AIDS76 since it was first reported and confirmed in Nigeria in 1986.77
The health consequences of these
infections are enormous; symptoms of HCV infection may not manifest until 20-30
years after viral transmission.78 Also, about 60-85% of HCV
infections result in liver cirrhosis and liver cancer.61 There is no
immunization for HCV and HIV, it becomes important to prevent infection by
preventing exposure.7
The rising prevalence of morbidity
and mortality following exposure to blood borne infections is due to the lack
of knowledge, wrong attitude towards and non-compliance to standard precautions
as well as bad practices such as bending of needles, recapping of needles,
detachment of needles, reuse of needles and lack of adequate sharps containers
and disposal facilities, shortage of supply of injection equipment and
unwarranted and unsafe use of injections, that put both patients and HCWs at
risk of occupational exposure. The
improper disposal of used sharps and needles is known to cause needle stick
injuries.81
WHO estimates that annually, 16
billion injections are given each year in developing and transitional countries
with an annual mean 1.5 injections per person per year.17 70 to 99% of these injections are
unnecessary, while 50% are unsafe in 14 of 19 countries in five developing
world regions with data.18,19,20
In Nigeria, the annual mean was found to be 4.9 injections per person
per year.21 The
socio-economic and psychological burden of unsafe injections occur at
individual, family, community and national levels. It is estimated that each year, the annual
global burden of indirect medical cost due to hepatitis B and C and HIV/AIDS is
estimated to be US $535 million.83
Globally,
in 2000, unsafe injection was responsible for an estimated 21 million cases of
Hepatitis B virus (HBV) infection, 2 million cases of Hepatitis C virus (HCV)
infection and 260,000 cases of HIV infection, making up 32%, 40% and 5% of
infections due to unsafe injection practices respectively.84
It
is estimated that 9.18 million DALYs would be lost between 2010 and 2030
although interventions implemented in the year 2000 for the safe and
appropriate use of injections could reduce it. 22, 84
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.7
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.