Knowledge and practice of standard precautions among healthcare workers in primary and tertiary health facilities in Enugu state, Nigeria; a qualitative study

Abstract

Background: Standard precautions (SP) is a broad concept involving measures that should be applied in hospital setting to reduce infection transmission. Most hospital acquired infections occur due to breach in SP practices. The objective was to determine the knowledge and practice of SP among HCWs in primary and tertiary health facilities in Enugu State Nigeria.Methods: The study used a qualitative design with case study in primary and tertiary health care workers (HCWs) in Enugu Metropolis, Enugu State Nigeria. A total of 74 HCWs; 24 from the primary and 50 from the tertiary health facilities were observed while 37; 12 from primary and 25 from the tertiary health facility were interviewed. The qualitative study used in-depth interview and triangulation with observational checklist.Results: The HCWs had good knowledge but poor practice of SP. Higher proportion of the tertiary HCWs had better practice of hand hygiene than those in the primary health facilities (OR=17.637, p<0.001). Also, the tertiary HCWs used personal protective equipment (PPE) more adequately (OR=11.417, p=0.001) and practiced injection safety better than the primary HCWs (OR=22.369, p<0.001) except in detaching of needles from syringes where higher proportion of the tertiary HCWs were involved in such practice (tertiary =40.0%, primary =29.2%).Conclusions: There was good knowledge of SP among the HCWs but their practice was poor.