Knowledge Attitude and Practice on Infection Prevention and Control of Healthcare Workers During Covid-19 In A Tertiary Hospital

Abstract

Health care workers are the first to be on the front lines of the epidemic. Increased infection and mortality rates among health care workers will paralyze a country's response to the COVID-19 epidemic, and it will certainly have a significant long-term impact on health care delivery, especially in health systems that are already struggling with workforce shortages due to lack of skilled personnel, skilled labor migration, and geographic location. Assessing IPC knowledge, attitude, and practice remains important in determining the level of compliance with IPC measures.It is in this context that our study aims to assess the knowledge, attitude, and practice of health care workers at Befelatanana University Hospital. Our population was predominantly female (n= 60; 57%) with a sex ratio of 0.76. The average age was 28 years with an extreme age of 21 and 57 years. More than a third of the staff interviewed were residents (n=42; 39.62%), followed by nurses and midwives. More than half had less than 5 years of work experience (n=60; 56.82%) and more than half also reported no training in ICC (n=63; 59%). The majority of health workers (n=103; 97.17%) had previous contact with a suspected and confirmed case (Covid-19). Of the health workers (n=69; 65.09%) contracted Covid-19 of which (n=62; 59%) were confirmed cases and (n=7; 6%) were suspected cases Our study revealed that more than one third of the participants had insufficient knowledge of hand hygiene (34.91%), almost half of the participants (42.45%) had insufficient knowledge of wearing PPE, insufficient knowledge of donning (35.85%), insufficient knowledge of removal (42.45%). We noted the non-compliance of IPC measures in their practices: the majority reported using surgical masks for more than 4 hours, very few CHWs (n=17; 21%) changed their masks every 8 hours and 29 (36%) . Only 37.71% (n=40) of participants performed a leak test on their FFP2 masks.The majority of staff (98.11%) reported using the gowns; half of the staff (53.17%) did not wash the cloth gowns. We found noncompliance in the use of face shields: 95.3% discarded face shields and 88.7%. We identified factors associated with contamination of healthcare workers, namely midwives/nurses, physicians, residents, and specialty residents, lack of knowledge of hand washing with alcohol-based disinfectant, lack of knowledge of the indication for gowns as universal precautions. Knowledge and skill deficiencies in terms of IPC during Covid- 19 was observed in our study. Thus, establishing a national IPC program and strengthening the training of health workers remains crucial to implement IPC measures at all levels of the health structure in order to reduce the spread of infection either before or during an outbreak . This allows each health worker to be better prepared for a potential outbreak.