Practice Of Precautions Research Articles

UNIVERSAL PRECAUTIONS: A SURVEY OF HEALTH CARE PROVIDERS’ KNOWLEDGE, PRACTICE AND COMPLIANCE IN A TERTIARY CARE HOSPITAL IN ISMAILIA CITY

Objectives: This study was conducted to assess hospital staff’ knowledge, selfreported compliance and actual practice of universal precautions, identify important non adherence factors, and determine the proportion of participants exposed to blood and other body fluids with identification of the associated risk factors. Subjects and Methods: A total of 152 hospital staff from different job categories at risky departments in a tertiary care hospital in Ismailia City were included in this survey study where a structured questionnaire and a direct observation check list were used. Results: The mean percent score of participants’ self-reported compliance was much higher than those of knowledge and actual practice. Moreover, a statistically significant positive correlation was found only between percent score of participants’ knowledge and practice. A gab between knowledge and practice was detected where 75% of the studied participants had insufficient knowledge while 36.2% of them had insufficient practice.Insufficient knowledge was significantly revealed among males, nurses and surgical departments’ staff; while insufficient practice was significantly detected among nurses, surgical departments’ staff, those with > 48 working hours per week and hospital staff with > 3 constrains. The majority of the participants (65.1%) got their information from sources other than the hospital. Work-related factors were the most important compliance barriers. The majority of the participants had history of sharps injury and exposure to blood or other body fluids splashes at work; however, none of these Objectives: This study was conducted to assess hospital staff’ knowledge, selfreported compliance and actual practice of universal precautions, identify important non adherence factors, and determine the proportion of participants exposed to blood and other body fluids with identification of the associated risk factors. Subjects and Methods: A total of 152 hospital staff from different job categories at risky departments in a tertiary care hospital in Ismailia City were included in this survey study where a structured questionnaire and a direct observation check list were used. Results: The mean percent score of participants’ self-reported compliance was much higher than those of knowledge and actual practice. Moreover, a statistically significant positive correlation was found only between percent score of participants’ knowledge and practice. A gab between knowledge and practice was detected where 75% of the studied participants had insufficient knowledge while 36.2% of them had insufficient practice. Insufficient knowledge was significantly revealed among males, nurses and surgical departments’ staff; while insufficient practice was significantly detected among nurses, surgical departments’ staff, those with > 48 working hours per week and hospital staff with > 3 constrains. The majority of the participants (65.1%) got their information from sources other than the hospital. Work-related factors were the most important compliance barriers. The majority of the participants had history of sharps injury and exposure to blood or other body fluids splashes at work; however, none of these Objectives: This study was conducted to assess hospital staff’ knowledge, selfreported compliance and actual practice of universal precautions, identify important non adherence factors, and determine the proportion of participants exposed to blood and other body fluids with identification of the associated risk factors. Subjects and Methods: A total of 152 hospital staff from different job categories at risky departments in a tertiary care hospital in Ismailia City were included in this survey study where a structured questionnaire and a direct observation check list were used. Results: The mean percent score of participants’ self-reported compliance was much higher thanthose of knowledge and actual practice. Moreover, a statistically significant positive correlation was found only between percent score of participants’ knowledge and practice. A gab between knowledge and practice was detected where 75% of the studied participants had insufficient knowledge while 36.2% of them had insufficient practice. Insufficient knowledge was significantly revealed among males, nurses and surgical departments’ staff; while insufficient practice was significantly detected among nurses, surgical departments’ staff, those with > 48 working hours per week and hospital staff with > 3 constrains. The majority of the participants (65.1%) got their information from sources other than the hospital. Work-related factors were the most important compliance barriers. The majority of the participants had history of sharps injury and exposure to blood or other body fluids splashes at work; however, none of these incidents were reported. These exposures were significantly revealed among nurses, staff in surgical departments and those with insufficient knowledge and practice of universal precautions. Conclusions: Hospital staff are at high risk of exposure to blood borne pathogens, yet universal precautions are not well understood or implemented. So, implementing a specifically tailored infection-control program will be most effective in protecting them. .

Community-Based Measures for Mitigating the 2009 H1N1 Pandemic in China

Since the emergence of influenza A/H1N1 pandemic virus in March–April 2009, very stringent interventions including Fengxiao were implemented to prevent importation of infected cases and decelerate the disease spread in mainland China. The extent to which these measures have been effective remains elusive. We sought to investigate the effectiveness of Fengxiao that may inform policy decisions on improving community-based interventions for management of on-going outbreaks in China, in particular during the Spring Festival in mid-February 2010 when nationwide traveling will be substantially increased. We obtained data on initial laboratory-confirmed cases of H1N1 in the province of Shaanxi and used Markov-chain Monte-Carlo (MCMC) simulations to estimate the reproduction number. Given the estimates for the exposed and infectious periods of the novel H1N1 virus, we estimated a mean reproduction number of 1.68 (95% CI 1.45–1.92) and other A/H1N1 epidemiological parameters. Our results based on a spatially stratified population dynamical model show that the early implementation of Fengxiao can delay the epidemic peak significantly and prevent the disease spread to the general population but may also, if not implemented appropriately, cause more severe outbreak within universities/colleges, while late implementation of Fengxiao can achieve nothing more than no implementation. Strengthening local control strategies (quarantine and hygiene precaution) is much more effective in mitigating outbreaks and inhibiting the successive waves than implementing Fengxiao. Either strong mobility or high transport-related transmission rate during the Spring Festival holiday will not reverse the ongoing outbreak, but both will result in a large new wave. The findings suggest that Fengxiao and travel precautions should not be relaxed unless strict measures of quarantine, isolation, and hygiene precaution practices are put in place. Integration and prompt implementation of these interventions can significantly reduce the overall attack rate of pandemic outbreaks.

Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy

BackgroundThis survey assessed knowledge, attitudes, and compliance regarding standard precautions about health care-associated infections (HAIs) and the associated determinants among healthcare workers (HCWs) in emergency departments in Italy.MethodsAn anonymous questionnaire, self-administered by all HCWs in eight randomly selected non-academic acute general public hospitals, comprised questions on demographic and occupational characteristics; knowledge about the risks of acquiring and/or transmitting HAIs from/to a patient and standard precautions; attitudes toward guidelines and risk perceived of acquiring a HAI; practice of standard precautions; and sources of information.ResultsHCWs who know the risk of acquiring Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) from a patient were in practice from less years, worked fewer hours per week, knew that a HCW can transmit HCV and HIV to a patient, knew that HCV and HIV infections can be serious, and have received information from educational courses and scientific journals. Those who know that gloves, mask, protective eyewear, and hands hygiene after removing gloves are control measures were nurses, provided care to fewer patients, knew that HCWs' hands are vehicle for transmission of nosocomial pathogens, did not know that a HCW can transmit HCV and HIV to a patient, and have received information from educational courses and scientific journals. Being a nurse, knowing that HCWs' hands are vehicle for transmission of nosocomial pathogens, obtaining information from educational courses and scientific journals, and needing information were associated with a higher perceived risk of acquiring a HAI. HCWs who often or always used gloves and performed hands hygiene measures after removing gloves were nurses, provided care to fewer patients, and knew that hands hygiene after removing gloves was a control measure.ConclusionsHCWs have high knowledge, positive attitudes, but low compliance concerning standard precautions. Nurses had higher knowledge, perceived risk, and appropriate HAIs' control measures than physicians and HCWs answered correctly and used appropriately control measures if have received information from educational courses and scientific journals.

Standard precautions: knowledge and practice among nursing and medical students in a teaching hospital in Brazil

Compliance with standard precautions measures is essential to prevent and control healthcare-associated infections. The objective of the study was to evaluate the knowledge and practice of hand washing, use of gloves and the handling and disposal of needlesticks and other sharp objects among nursing and medical students. This is a descriptive observational study, which used a questionnaire and a check list. Knowledge of standard precaution measures was evaluated in 48/48 (100.0%) nursing students and 93/112 (83.0%) medical students. At the teaching hospital, 26/37 (70.3%) nursing students and 78/93 (83.9%) medical students belonging to the population being investigated were observed during their clinical practice. These results were compared intra groups. Knowledge of hand hygiene procedures was higher than what was observed in the clinical practice in both groups of students, (X²; p≤0.001). Compliance with the use of sterile and non-sterile gloves, and handling and disposal of needlesticks and other sharp objects was higher than the knowledge of these procedures among nursing students, and a statistically significant difference was observed with regards to sterile glove usage (X²; p=0.009). Regarding medical students, there was no statistical difference between knowledge and practice insofar as these two types of gloves were concerned, as well as regarding the handling and disposal of needlesticks and other sharp objects. Performance of both groups in terms of knowledge of hand hygiene showed a dichotomy between the teaching and the practice of these standard precautions. Results have shown a deficiency in the teaching-learning process for the other measures evaluated.

Knowledge and practice of standard precautions among health care workers in the Federal Medical Centre, Asaba, Delta State, Nigeria

Health care workers (HCWs) are exposed to blood and other body fluids in the course of their day to day activities in the health care setting. Standard precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognised sources. This study is to determine the knowledge and practice of standard precautions among health care workers in Federal Medical Centre, Asaba, Delta State, Nigeria. This descriptive, cross sectional study was carried out among Health Care workers in Federal Medical Centre Asaba, Delta State. A total population of all the doctors and laboratory workers was used while the nurses were selected using a stratified sampling method. A semi-structured, self-administered questionnaire was the tool for data collection. A total of 167 respondents participated in this study. The mean age of the HCWs was 36.9 ± 6.8 years made up of 47 (28.1%) doctors, 100 (59.9%) nurses and 20 (12.0%) laboratory workers. There were more females (65.3%) than males (34.7%) in the study. One hundred and thirty seven (82.0%) respondents had heard about standard precautions. Only 63 (37.7%) of them had correct knowledge of it. There was fair practice and adherence to the standard precautions by those who knew of it. Findings from this study emphasised the need for intensive enlightenment programme to educate health care workers on various aspects of standard precautions and infection control programmes and policies.

Knowledge and practice of universal precautions against blood borne pathogens amongst house officers and nurses in tertiary health institutions in Southeast Nigeria.

To examine the knowledge and practice, as well as factors influencing universal precautions practices amongst Nigerian House officers and Nurses. A Cross-sectional descriptive study. Sample selection was by stratified random sampling. Information was elicited using pretested, structured, self-administered questionnaire. Data were analyzed using EPI-info. Most Doctors, 66.6%, were aged 26-30 years while the Nurses, 41.1%, were aged 40 years. 57.6% of the Doctors were males, while 85.7% of the nurses were females. Knowledge of universal precautions measures was high for both categories of respondents--97.0% for doctors and 92.0% for nurses, although practice was better for the nurses, 75.0%, compared to the doctors, 15.2%, p < 0.05. The most important factor influencing universal precautions practice is the lack of provision of adequate protective equipments. Other factors, all of which show significant difference between the doctors and nurses (p < 0.05), include carelessness; lack of display of universal precautions guidelines; emergency nature of the procedure; insufficient water supply; patient perceived to be at low risk of blood borne pathogens; pressure of time; and universal precautions equipments interfering with technical skills. Although knowledge of universal precautions is high for both house officers and nurses, practice is however better amongst the latter than the former. The effective knowledge and practice of universal precautions amongst hospital workers are of absolute necessity to prevent infections from blood and body fluid pathogens.

Nursing students’ knowledge and practice of infection control precautions: an educational intervention

This paper is a report of the effectiveness of a purpose-designed education program in improving undergraduate nursing students' understanding and practice of infection control precautions. The severe acute respiratory syndrome outbreak in 2003 highlighted that healthcare workers were under-prepared for such an epidemic. While many in-service education sessions were arranged by institutions in response to the outbreak, preservice nursing education has overlooked preparation for handling such infectious disease epidemics. A quasi-experimental design was used and a 16-hour, purpose-designed infection control education programme was implemented for preservice nursing students in southern Taiwan. Self-administered questionnaires were distributed at three time points during the period September 2005 to April 2006 to examine the sustainability and effectiveness of the intervention. A total of 175 preservice nursing students participated in the study. Following the education programme, students in the intervention group showed a statistically significant improvement across time in their knowledge of these precautions [F(2, 180) = 13.53, P < 0.001] and confidence in resolving infection-related issues [F(1.79, 168.95) = 3.24] when compared with those in the control group. To improve nursing students' capacity in responding to infectious epidemics, an educational programme that integrates the theme of infection precautions, learning theory and teaching strategies is recommended for all nursing institutes.

Estudio sobre la exposición ocupacional a sangre y fluidos corporales en el personal de enfermería de un hospital de referencia de Buenos Aires, Argentina

To determine the frequency of occupational blood and body fluids exposure (OBBFE) among the nursing staff at the Dr. Diego Paroissien Hospital in Buenos Aires, Argentina; analyze the possible risk factors associated; and assess the level of knowledge regarding universal precautions and control procedures following exposure: A cross-sectional descriptive study was performed using a voluntary and anonymous survey administered between April and May 2005. In addition to personal and professional data, information was collected on knowledge and practice of universal precautions and procedures, OBBFE experienced, barriers to following the standards, and whether or not the Hepatitis B vaccine had been received. The dependent variable in the analysis was ever having experienced an OBBFE accident: Of the 186 responses analyzed, 77.7% were female, the mean age was 44.6 +/- 8.9 years, and the institution was 13.3 +/- 6.4 years old. Of those surveyed, 91 (48.9%) indicated that at some time they had an OBBFE, with 33 (17.7%) of these having occurred during the previous year; 73.0% confirmed that the tools necessary for complying with universal precautions were available always or almost always; 76.2% felt they had complete information, although 56.3% said they had not received adequate training; and, 94.1% claimed to have been vaccinated against Hepatitis B. Being overworked (54.5%), insufficient training (21.8%), and a lack of protective tools (18.8%) were the reasons most often identified as impeding compliance with universal precaution guidelines. Not having received training during the preceding year and having recently started work in a clinical or adult intensive-care unit were significantly associated with having experienced an OBBFE: These results signal a risk alert for OBBFE among health care workers and underscore the need for improving standards and surveillance.

Hepatitis C Virus Infection in Haemodialysis: The ‘No-Isolation’ Policy Should Not Be Generalized

Hepatitis C virus (HCV) infection is the most common blood-borne viral infection in haemodialysis. It causes significant morbidity and long-term mortality. Practice of universal precautions has been reported to be sufficient to prevent HCV seroconversion in dialysis units. However, the seroconversion rate remains very high in many dialysis units. A previous study from 1995 to 1998 at our own hospital without isolation showed that nosocomial transmission is the major cause of HCV seroconversion. The present study was therefore conducted with the aim to study the impact of isolation on HCV seroconversion. In this prospective cohort study, with non-probability consecutive sampling, patients with HCV infection were dialysed in an isolated room. In addition, standard universal precautions were practiced. HCV seroconversion rate was compared with the previous study. All patients with end-stage kidney disease (ESKD) admitted to our hospital for renal replacement therapy were included in the present study. At the time of admission, HCV screening was done. All anti-HCV-positive patients were dialysed in an isolated room. While on maintenance haemodialysis, all patients were monthly tested for anti-HCV, aspartate aminotransferase and alanine aminotransferase. Any patient who had HCV seroconversion was transferred to an isolated room for maintenance haemodialysis. Patients with HCV infection were managed by further testing for HCV-RNA and liver biopsy. Every patient who ultimately received renal transplantation at our hospital was also tested for HCV just prior to renal transplantation as well as 3 months after renal transplantation. HCV infection was diagnosed by detecting anti-HCV antibodies using an ELISA-based third-generation diagnostic test kit. Serum bilirubin, aspartate aminotransferase and alanine aminotransferase were assayed using standard laboratory techniques. From March 2003 to February 2006, 1,417 patients were admitted for haemodialysis in our unit. Of these 1,077 (76%) had ESKD. Mean age of patients was 42.47 ± 16.2 (14–94) and 70.39% were males. Patients with ESKD had had more dialysis sessions (10.9 ± 39.5 vs. 4.4 ± 5.95, p = 0.009), more blood transfusions and more pre-existing HCV infections (4.72 vs. 1.5%, p = 0.009) than patients with acute renal failure. Of the ESKD patients, 65.7% were discharged, 9.47% died, 1.85% were shifted to chronic ambulatory peritoneal dialysis and 22.46% patients received renal transplantation. Of the patients who received renal transplantation, HCV seroconversion was detected in 2.75%. In the previous study without isolation practices, the HCV seroconversion rate in transplanted patients was 36.2%. The hazard of HCV seroconversion was 0.97 (95% CI 0.93–1.02, p = 0.2) for each additional dialysis and 1.09 (95% CI 0.88–1.36, p = 0.37) for each additional blood transfusion. The study concludes that isolation of HCV-infected patients during haemodialysis significantly decreases the HCV seroconversion rate.

A Brief HIV Stigma Reduction Intervention for Service Providers in China

This study assessed the effect of a brief intervention aimed at reducing HIV-related stigma among service providers in China. From December 2005 to June 2006, 138 service providers from four county hospitals in the Yunnan province of China were randomly assigned into either an intervention or a control condition. HIV stigma reduction concepts were conveyed through participatory small group activities, including role-plays, games, group discussions, and testimony by an HIV advocate. Participants were assessed at baseline before the intervention, and at 3- and 6-month follow-ups. Data were analyzed using a logistic regression mixed-effects model. Service providers in the brief intervention condition were significantly more likely to report better protection of patients' confidentiality and right to HIV testing, lower levels of negative feelings toward people living with HIV/AIDS, and more accurate understanding and practice of universal precautions. This brief intervention pilot showed potential in reducing HIV stigma and discrimination among service providers in China. Further intervention trials are needed to test the efficacy and long-term outcomes of this intervention.

Use of Personal Data Assistant for Monitoring of Compliance with Expanded Precautions Practices

Use of Personal Data Assistant for Monitoring of Compliance with Expanded Precautions Practices

Practice of standard precautions among health care workers in a large teaching hospital

Practice of standard precautions among health care workers in a large teaching hospital

Universal Precaution Compliance by Orthopaedic Trauma Team Members in a Major Trauma Resuscitation Scenario

We determined the compliance rates of orthopaedic trauma team members in applying universal precautions in major trauma resuscitation scenarios and the availability of universal precautions in accident and emergency (A&E) departments throughout England. A national telephone survey was implemented contacting the first on-call orthopaedic surgeon and A&E departments in hospital trusts accepting major trauma throughout England. A questionnaire was employed to ascertain current practice, experience and availability of universal precautions when managing a major trauma patient. Overall, 112 first on-call orthopaedic surgeons and 99 A&E departments responded. There was good compliance for using gloves (99%) and aprons (86%). There was poor compliance in using eye protectors (21%), face masks (18%), shoe covers (4%) and head caps (4%). Trainees applied universal precautions according to the level of risk they subjectively perceived. All A&E departments had gloves and aprons but the availability of the other universal precautions was less. Of trainees, 76 reported that all universal precautions were not readily available in the A&E department. Orthopaedic trauma team members are very compliant in using gloves and aprons, but should be more compliant in using eye protectors. It is questionable whether face masks, head caps and shoe covers need to be used in all trauma scenarios. In general, universal precautions should be more available in the A&E departments. There should be better communication between A&E departments and the trauma team regarding the availability of universal precautions.

Soil compaction—indicators for the assessment of harmful changes to the soil in the context of the German Federal Soil Protection Act

Soil compaction in agriculture induced by large-scale equipment is of growing concern. Heavy wheel loads used in arable cropping have the potential to cause irreversible damage to the subsoil structure and may lead to harmful soil compaction. In order to sustain or improve soil health or fitness on a sustainable basis, indicators are needed to assess the changes in the soil structure and the respective soil functions. This requires an adequate verification of methods for distinguishing between the impairment of soil structure and the disruption of soil functions, and for the respective subject of protection. In this article the link between existing models of soil physical prognosis, practical guidelines, and criteria for the identification of affected soil structure is demonstrated, and a viable concept to distinguish harmful changes to the soil is presented. The concept consists of methods for soil physical analysis such as “ pre-compression stress” and “ loading ratio”, practical recommendations for best management practice, and an indicator-based model for the identification of harmful subsoil compaction derived from a research project for the German Federal Environmental Agency, making it possible to determine for a respective location the required level of action far beyond the common practice of precautions against harmful soil compaction.

Needle stick injuries: a comparison of practice and attitudes in two UK District General Hospitals*

Hospital staff are at risk from occupational exposure to blood-borne viruses due to needle stick injuries. Occupational health departments have invested considerable resources in the prevention of these injuries, which can be very distressing to the affected individuals. We surveyed health care workers, i.e. doctors, nurses and operating department practitioners, in the operating theatre and critical care units of two UK hospitals located in the Midlands and Merseyside to compare attitudes and experiences. There were significant deficiencies in several aspects of the safe practice of universal precautions. These deficiencies were similar in the two hospitals surveyed and may reflect a national trend. We conclude that every individual, department and trust needs to reflect on their practice and address these deficiencies.

本院における院内感染予防対策としての院内査察

Factors affecting infection are the existence of infectious microorganisms, sensitivity of hosts, number of microorganisms, and infectious routes. Efforts to prevent infection focus on not allowing these factors to reach the threshold level. Inspection by an infection control team (ICT) of a hospital is one countermeasure for preventing nosocomial infection. We summarize here the problems for complete prevention of nosocomial infection based on the results of inspection by our ICT, so that staff working in the hospital can recognize the importance of preventing nosocomial infection. The following were commonly observed problems in our clinics found by the ICT : (1) incomplete practice of standard precautions and/or isolation precautions, (2) noncompliance with guidelines for the prevention of cross-infection, and (3) inappropriate management of medical rejectamenta. Infection control can be accomplished by strictly observing the standard precautions and isolation precautions. The ICT inspection round in the hospital could be an effective metaff working in the hod to clarify and overcome the problems involved in infection.

False consensus and accuracy of perceptions of nurses regarding universal precaution practices

This study aimed to investigate the presence of the false consensus effect (FCE) in relation to nurses' self-reported use of universal or standard precautions (UPs) and risk-related beliefs. The study also aimed to investigate the accuracy of estimated consensus. The sample consisted of nurses (N = 301) from a variety of specialities. Through self-report questionnaires, respondents were presented with a list of 10 behaviours and beliefs (of which eight were used in the analysis). They were asked to indicate whether they performed the behaviour or held the belief, and, separately, to estimate the percentage of peers who would do so. Independent sample t-tests (comparing “subscribers” with “non-subscribers” to each behaviour or belief) revealed a significant FCE on all items: subscribers always estimated a significantly greater consensus for the position than did non-subscribers. Significant deviation from accuracy was found on all items, and significant differences were found on seven of the eight items between subscribers and non-subscribers in their deviations from accuracy. In addition to theoretical implications, the results are discussed in terms of the implications for educational intervention.

Knowledge, attitudes, and practices of contact precautions among Iranian nurses

Knowledge, attitudes, and contact precaution practices were surveyed in nurses at Shiraz University of Medical Sciences. Two hundred seventy nurses, midwives, and auxiliary nurses completed a questionnaire consisting of 8 knowledge items with corresponding attitudes and practices items. Compliance with precaution practices was low, 19.5%, and little more than half, 51.8%, held positive attitudes toward the guidelines, whereas 65.5% could correctly answered all precaution knowledge items. Nurses with correct knowledge were 11.3 times more likely (P < .0001) to hold positive attitudes toward the guidelines and 14.2 times more likely (P < .0001) to comply with all 8 precaution practices, and compliers were 6.3 times more likely (P < .0001) to hold positive attitudes than noncompliers. Although correct knowledge was associated with compliance and positive attitudes, the proportion of nurses who held positive attitudes also had good knowledge, and compliance with practices was not abundant. Better training coverage may result in compliance with precaution practices becoming the norm.

Implication of the prevalence of needlestick injuries in a general hospital in Malaysia and its risk in clinical practice

To determine the prevalence of cases and episodes of needlestick injury among three groups of health care workers in the past one-year, the level of knowledge on blood-borne diseases and universal precautions and the practice of universal precautions. Other factors associated with the occurrence of needlestick injuries and the reporting of needlestick injuries were also analysed. A cross-sectional study was conducted in May 2003 to study the needlestick injuries among 285 health care workers (doctors, nurses, medical students) in a public teaching hospital in Negeri Sembilan, Malaysia. The prevalence of needlestick injuries among the respondents was 24.6% involving 71 cases i.e. 48.0% among doctors, 22.4% among medical students, and 18.7% among nurses and the difference was statistically significant (p<0.001). There were a total of 174 episodes of needlestick injury. Prevalence of episode of needlestick injuries was highest among doctors (146%), followed by nurses (50.7%) and medical students (29.4%). Cases of needlestick injuries attained lower scores on practice of universal precautions compared to non-cases (p<0.001). About 59% of cases of needlestick injury did not report their injuries. The study showed that needlestick injuries pose a high risk to health care workers and it is underreported most of the time. Many needlestick injuries can be prevented by strictly following the practice of universal precautions.

Use of Cultural Practices, Economic Impact of Insecticide Use, and Awareness and Practice of Insecticide Safety Precaution on Okra Production

ABSTRACT This study was undertaken to determine the effects of cultural practices (cropping pattern and use of insecticides) on okra production (yield), the economics of insecticide use and the users' awareness and practice levels of insecticide safety precautions. The sampled populations were users and non-users of insecticides. Data were collected on cultural practices, okra field size, number of farms, yield and prices of okra production inputs, prices and types of insecticides, and awareness and practice of safety precautions. Data were analyzed using descriptive and inferential statistics, partial budgetary and regression techniques, and residual and sensitivity analyses. Results indicated that cropping pattern and use of insecticides have significant effects on yield. Partial budgetary and regression analyses showed that insecticides use on okra farms was economically superior to non-use providing an additional Net Benefit of 8,560 per ha ( = Naira, Nigerian currency, exchange rate $1US = 130). Marginal analysis indicated a marginal rate of return of 3.14. Sensitivity analysis revealed that prices of insecticides will have to increase by more than 145.5%, and/or yield and the price of okra has to fall by more than 51.7% for insecticide use to be less favored only on economic grounds. The insecticides used by okra farmers were hazardous, and high proportions of the local farmers were not aware of, and did not practice safety precautions. In order to realize the full economic benefit of insecticide use without its adverse effects, efforts should be directed at creating awareness and encouraging the use of insecticide handling and application safety precautions.