Practice Of Precautions Research Articles

Sharp injuries in the operative room among residents in surgical specialties: A cross-sectional study

Background and Objective: Surgical residents are at high risk of sustaining sharp injuries. Our aim is to identify predisposing factors of sustaining sharp injuries in operating rooms among surgical residents and their attitudes and behaviors in dealing with sharp injuries. Methods: In this cross-sectional study, a random sampling technique was adopted to recruit a representative sample of surgical residents who were involved in operative procedures in King Abdulaziz University Hospital. Data were collected between September and December 2016 by completing a self-administered questionnaire on attitude toward the most recent sharp injuries, predisposing factors for sharp injuries, and practice of universal precautions during the surgical procedures. Results: Among the 78 recruited residents, 46 (58.9%) had sharp injuries during surgical procedures. Most of the injuries (60%) were self-induced, and (72.9%) of the injuries took place while suturing. Twenty (43.5%) of those who had injuries did not report any injury, 15 (32.6%) reported some, and 11 (23.9%) claim that they reported all their sharp injuries. 44.9% of the participants are fully aware of sharp injuries local policy and procedures in the hospital. Most of the injured participants during surgeries did not follow each step of the local sharp injury policy. The perceived causes of sharp injuries among the participants were due to rushed (61.1%), fatigue (43%), lack of skills (19.4%), lack of assistance (15.3%), lack of sleep (13.9%) and (16.7%) though it is not preventable. 55.1% of all participants have never participated in any sharp-related safety training. 10.2% practiced all three universal precautions of double-gloving, face shields, and hands-free technique. Conclusions: Sharp injuries are common among the surgical residents but are not reported by most of them. Target training about sharp injuries during residency may improve their attitude and behavior toward prevention of sharp injuries in the operative room.

Human Immunodeficiency Virus and Hepatitis B Virus Infection Prevention Following Occupational Exposure among Staff at a Regional Referral Hospital in Western Kenya.

Background:Postexposure prophylaxis (PEP) with antiretroviral therapy (ART) and vaccination against hepatitis B virus (HBV) aides in preventing human immunodeficiency virus (HIV) infection and HBV, respectively, from accidental or occupational exposure. We assessed compliance to guidelines for HIV and HBV prevention after occupational exposure among hospital staff at a referral Kenyan hospital.Methods:We reviewed PEP registers for hospital staff reporting an occupational injury at a referral hospital in Western Kenya between January 2011 and December 2012. Proportions were used to summarize number of participants receiving the recommended services, Kaplan–Meier curves were used to describe time to ART initiation, and Chi-square statistics was used to describe the association between participant characteristics and PEP completion rates. P < 0.05 was considered statistically significant.Results:Majority of documented hospital staff (n = 52) were health workers (63%) and students (27%) and had high HIV risk exposures (97%). All had timely PEP initiation with 50% completing PEP. Completion rates did not vary by gender (P = 0.78), exposure type (P = 1.0), or department of exposure (P = 0.75). Retesting for HIV and negativity rates at months 1.5, 3, and 6 were 96%, 25%, and 17% and 100%, 100%, and 100%, respectively. At the time of exposure, 17% (9) of staff were HBV vaccinated and HBV status of sources was unknown; no intervention was provided for HBV prevention.Conclusions:Low rates of completion and follow-up negate intended benefits of PEP. Efforts should be directed to enforce universal precaution practices and completion of PEP. Low rates of HBV testing and vaccination illustrate the need for support for the implementation of HBV prevention guidelines.

Factors influencing observation of standard precautions among nursing staff in tertiary care setting in Mangalore

Background: Health care professionals and particularly nurses are often exposed to microorganisms, many of which can cause serious infections. Although the potential for HBV transmission in the workplace setting is greater than for HIV, the mode of transmission for these two viruses are the same. Because of the environment in which they work, many health care workers are at an increased risk of accidental needle stick injuries (NSI) and blood borne pathogens such as HIV, Hep B, and HCV. The objectives of the study were to assess the knowledge, attitude and practice of standard precautions among nursing staff working in 5 tertiary care hospitals attached to teaching institutions in Mangalore and to assess the factors associated with non-compliance with standard precautions among nursesMethods: The study was done in 5 tertiary care hospitals attached to teaching institutions in Mangalore among the working nursing staff in these hospitals. A pre-tested questionnaire was used to collect the information regarding knowledge, attitude and practice and the reasons for non-adherence to standard precautions. Results: Regarding standard precautions 66.7% had a good knowledge, 74.7% had good practice and 87.3% had a positive attitude towards it. 26.34% attributed noncompliance to excess workload. Increasing age and increase in duration of nursing practice showed a significant increase in KAP scores. Conclusions: The duration of nursing practice influenced the knowledge and the compliance to standard precautions.

Improving knowledge and compliance with infection control Standard Precautions among undergraduate nursing students in Jordan

IntroductionThe recent emergence and reemergence of infectious diseases have made the knowledge and practice of standard infection control precautions in developing countries more important than ever. However, schools of nursing in Jordan do not have a prescribed curriculum in Standard Precautions.PurposeTo test the effectiveness of using of an online education module and a learning contract on knowledge and compliance with infection control Standard Precautions among undergraduate nursing students in Jordan.MethodsA sample of 256 undergraduate nursing students participated in an online education module in infection control Standard Precautions. A pretest–posttest design tested effectiveness using an online questionnaire (Questionnaires for Knowledge and Compliance with Standard Precautions) before and after the online instruction.ResultsInitially, subjects reported low levels of knowledge and compliance with Standard Precaution practices and relatively few (15.2%) had high scores. Compliance with Standard Precautions was somewhat better (27%). Significant differences in the mean scores of knowledge and compliance between pretest and posttest were found.ConclusionOnline instruction offers a consistent and effective method to include Standard Precautions into nursing education. Organizations that oversee nursing in Jordan have the option to strengthen all nursing curricula by mandating a standardized infection control curricula across all schools of nursing.

Knowledge and practices of isolation precautions among nurses in Jordan

BackgroundImplementation of isolation precautions from the Centers for Disease Control and Prevention (CDC) has been justified through research and clinical evidence. However, nurses' understanding and compliance with these precautions is still unknown. The aim of this study was to assess nurses' knowledge and practices in relation to isolation precautions in Jordan.MethodsA cross-sectional, descriptive design was used. The study took place in 8 hospitals in Jordan. A self-reported questionnaire and an observational checklist were developed based on the CDC (2007) isolation precautions guidelines.ResultsA total of 247 questionnaires were returned out of 400, for a response rate of 61.7%. The results show that most nurses (90%) have good knowledge of isolation precautions. However, only 65% of nurses reported good compliance with isolation precautions. The results of a t test revealed that nurses with Bachelor's degrees perform better in knowledge examinations than nurses with 2-year diplomas (P < .001). However, there was no significant difference in knowledge and self-report practices scores based on nurses' previous training and existence of isolation guidelines in their units or wards (P > .05). The results of the checklists confirm that there is a low compliance with standard isolation practice. In addition, the checklist shows that a high percentage of units and wards do not use isolation signs (46.4%) and posters (34.5%).ConclusionsThis study revealed that educating nurses about isolation is not enough strategy to improve their compliance. It is important to adapt other strategies, such as supporting nurses by giving them a manageable workload, and providing more supplies and reminders of isolation precautions in the hospitals.

Knowledge and Practice of Biosafety Among Laboratory Staff Working in Clinical Laboratories in Yemen

This study was conducted to assess the knowledge and practices of laboratory standard precautions (LSP) among laboratory staff working in Yemen clinical laboratories. A cross-sectional study was co...

Utilizing a Novel Online Learning System to Reinforce and Standardize Transmission Precaution Practices in Ambulatory Cancer Clinic

BACKGROUND: Providing dedicated education on infection prevention (IP) practices in ambulatory environments can be both challenging and time-consuming for healthcare workers (HCW). In order to address these challenges, our IP team developed an online module to reinforce IP standards.

Assessment of knowledge and practice of standard safety precautions among Primary Health Care Workers in Plateau State North Central Nigeria

Background: Standard safety precautions are the basic level of infection control precautions which are to be used, as a minimum, in the care of all patients. The control of spread of pathogens from any source is key in avoidance of transmission among health care worker.The practices of standard safety precaution helps to protect the patient by ensuring that the health care workers does not transmit infectious agents to the patients through their hands or equipment during patient care.Hence, this study was conducted to assess the knowledge and practice of standard safety precautions among Primary Health Care workers in Plateau State.Methodology: A cross sectional study conducted among 50 primary health care workers from 30 publicly owned Primary Health Care centers using quantitative method of data collection. Epi info statistical software version 3.5.4 was used for data analysis with a 95% confidence interval was used in this study and a p-value of ? 0.05 was considered statistically significant.Result: The mean age of the respondent was 34.5 9.9 years with more than half of the respondents, 28 (56.0%) as females. Most 34 (68.0%) of the health care workers had good overall knowledge of Standard Safety Precautions. Good practice of Standard Safety precaution was found among 39 (78.5%) of the respondents. Prior attendance of training had statistically significant influence on the respondents practice of standard safety precautions (odds ratio 12.9; p = 0.005).Conclusion: This study has demonstrated a reasonable good level of knowledge and practice of standard safety precaution among health care workers at the primary level care though with significant need for improvement in order to attain full compliance.

Association of hospital contact precaution policies with emergency department admission time

Contact precautions are a widely accepted strategy to reduce in-hospital transmission of meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). However, these practices may have unintended deleterious effects on patients. To evaluate the effect of a modification in hospital-wide contact precaution practices on emergency department (ED) admission times. During the study period, the hospital changed its contact precaution policy from requiring contact precautions for all patients with a history of MRSA or VRE to only those who presented with clinical conditions likely to contaminate the environment with pathogens. An interrupted time series analysis of ED admission times for adults for one year preceding and one year following this change was performed at a two-campus hospital. The main outcome was admission time, defined as time from decision to admit to arrival in an inpatient bed, for patients with MRSA or VRE compared with all other patients. The in-hospital MRSA and VRE acquisition rates were evaluated over the same period and have been published previously. At one campus, admission time decreased immediately by 161min for MRSA patients (P=0.008) and 135min for VRE patients (P=0.003), and both continued to decrease over the duration of the study. There was no significant change in admission time at the second campus. Modifying contact precaution requirements for MRSA and VRE may be associated with improved ED admission time without significantly altering in-hospital MRSA and VRE acquisition.

Role of knowledge and attitude in determining standard precaution practices among nursing students

Background: Standard precaution practice (SPP) is aimed at protecting both patients and health professionals alike. The high rate of occupational hazards among health workers especially in developing countries is counterproductive and therefore requires thorough investigation and intervention. This study aims to determine the role of knowledge and attitude in determining SPP among nursing students.Methods:This research involved 172 nursing students at the teaching hospital of University of Maiduguri. Sampling was done using simple random sampling. Knowledge and attitude on towards one of the filoviruses (Ebola) including recommended SPP towards its prevention were assessed by a self-administered questionnaire after written consent. For bivariate correlation, Pearson’s correlation was used between knowledge and SPP, attitude and SPP, then knowledge and attitude. Subsequently the determinants of SPP were analyzed by multiple linear regression using SPSS (IBM Inc.) version 22. Significance level was 0.05 at 95% confidence interval.Results: The mean scores were knowledge 26.27(±6.6), attitude 80(±8.9) and SPP 61.08(±9.04). Correlation results was significant between knowledge and SPP (r=0.485, p&lt;0.05) as well as knowledge and attitude (r=0.134, p&lt;0.05). Knowledge of nursing students was a significant determinant of SPP (b = 0.663, 95% CI = 0.48-0.84, p&lt;0.05).Conclusions:There is an association between knowledge and SPP despite the low level of knowledge among respondents. Improvements in the nursing program curriculum is recommended.

Knowledge and practice of biosafety precautions in a developing tertiary care institute of North India.

Knowledge and practice of biosafety precautions in a developing tertiary care institute of North India.

Measuring the observance of contact precautions when treating Buruli ulcer patient in a tertiary hospital in Benin

Background: Buruli ulcer, caused by Mycobacterium ulcerans, remains a public health issue in Benin. Treatments are based on antibiotics and surgery. Good hygiene is important for its management.Objective: assess the observance of contact precautions practices by healthcare workers.Methods: between 1st March and 30th October 2015 an investigation was carried out that involved the promotion of hands hygiene and basic infection prevention practices in health care. An effective education system was implemented to improve healthcare workers knowledge and compliance. The study period was divided in two. Period I corresponds to the promotion of standard precautions, based on training, direct observation and providing hygiene equipment and materials. Period II: hand hygiene audits were conducted using the World Health Organization ‘five moments for hand hygiene’ observational tool. Samples; taken from hands of medical personnel, and various hospital environment were screened for presence of pathogens bacteria. Susceptibilities to antimicrobial agents were tested by the disk diffusion method.Results: before and after intervention there is no significant change for hand hygiene compliance globally, from 24.2%; (95% CI 21·1−36·9) to 33·3% after (31·8−41·3, but hand hygiene technique improved significantly. About 95% of personnel preferred hand washing with soap and water more than hand rubbing with alcohol based solutions. Pathogens bacteria were still present on hands (89%) and environment samples (42%) despite good knowledge of hand hygiene by 80% of medical personnel. Multi resistance bacteria represented 76% of strainsConclusion: Inadequate compliance was noticed despite good knowledge of standard precautions. Antimicrobial resistance is particularly harmful to the Buruli ulcer secondary wound infection treatment. The lack of qualified personnel and financial resources allocated for this program is one of the causes of weak compliance.Key words: Benin, hand hygiene, observance, Healthcare workers, Buruli ulcer, Multiresistance.

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital

The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR) bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.

Community Health (CH) Nurses’ knowledge, attitude and practice of standard and transmission-based precautions in Sydney Local Health District (SLHD)

Community Health (CH) Nurses’ knowledge, attitude and practice of standard and transmission-based precautions in Sydney Local Health District (SLHD)

Knowledge and practice of injection safety among nurses at university of Calabar Teaching Hospital (UCTH), Calabar, Nigeria: implications for nursing education

Exposure to blood borne viruses, by health care workers has been on the increase with nurses mostly affected. These exposures constitute serious challenges in the health care setting as they are common causes of illness and mortality among health care workers including hospitalized patients. Practice of standard precautions has been shown to reduce the risk of exposure to blood and body fluids. Over the years, injection safety has become an integral part of infection control in view of many diseases that are transmitted through unsafe injection practices. This study was conducted to assess the knowledge and practice of injection safety among nurses in UCTH, Calabar using a descriptive research design. The specific objectives were to assess the level of knowledge of nurses about injection safety, assess injection safety practices and ascertain the barriers to injection safety practices among nurses in UCTH. Purposive sampling was used to select one hundred and ninety one (191) nurses across the wards in UCTH Calabar. A checklist containing 37 items was used to elicit information. Frequency and percentages were used for descriptive data while the hypothesis was tested using Chi square (X 2 ) analysis at 0.05 level of significance. Result revealed that 59.7% of the respondents had good knowledge of injection safety and 66.0% had good practice of injection safety while 6.8% had poor practice. Barriers to injection safety practices included inadequate supply of injection safety material, none display of injection safety guidelines. Statistical analysis revealed a significant relationship between level of knowledge and practice of injection safety among nurses (P = 112.8 < 0.05). Recommendations: health care administrators and nurse leaders should display injection safety guidelines, supply injection safety materials and ensure that more nurses are recruited into the workforce.

How do laboratory technicians perceive their role in the tuberculosis diagnostic process? A cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia.

PurposeDetection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB) diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians.MethodsThis was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables.ResultsAmong 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%–75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled.ConclusionMost of the laboratory technicians believed that they have an important role in TB patients’ treatment and should display proper self-efficacy in performing laboratory activities. The result may serve as a basic consideration to develop a policy for enhancing motivation of laboratory technicians in order to improve the TB control program.

Knowledge, practice and factors associated with poor compliance with universal precautions among healthcare workers at Bugando Medical Centre, Mwanza, Tanzania

Background: Healthcare workers (HCWs) are exposed to blood-borne infections by pathogens, such as HIV, and Hepatitis B and C viruses, as they perform their clinical activities in hospitals. Compliance with universal precautions has been shown to reduce the risk of exposure to these pathogens. This aimed at assessing the knowledge, practices and factors associated with poor compliance to universal precautions among HCWs at Bugando Medical Centre in Mwanza, Tanzania.Methods: This was a cross sectional study carried out from December 2014 to February 2015.Results: There were 200 participants including 62 (31.0%) doctors, 74 (37.0%) nurses, laboratory personnel 34 (17.0%) and 29 (14.5%) auxiliary HCWs. More than three quarters (82%) of participants had adequate knowledge of uni­versal precautions. There was statistically significant difference between knowledge of universal precautions and sex, job category, working experience (≥ 5 years) and previous training on universal precautions. Out of 200 HCWs, 154 (77.0%) practiced universal precautions. Working experience (≥ 5 years) and previous training on universal precautions were significantly associated with good practice of universal precautions (P &lt; 0.001). There was a strong correlation between knowledge and compliance (practice) with universal precautions (r=0.76, p&lt;0.001). Factors associated with poor compliance with universal precautions included lack of personal protection equipment (69.5%), lack of knowledge (65.0%), emergency situations (63.0%), presumption that patient is not infected with HIV or HBV (59.0%), time constraints (53.0%), heavy workload (48.0%) and absence of penalties (34.0%).Conclusion: There was adequate knowledge and a fair level of compliance among HCWs towards universal precautions. These findings sug­gest that training of health care workers to increase their knowledge about blood-borne pathogens and universal precau­tions could improve their compliance and thus reduce health care workers’ risk of blood-borne patho­gen exposure.

Knowledge, Attitude, and Practices Regarding Occupational HIV Exposure and Protection among Health Care Workers in China: Census Survey in a Rural Area.

Health care workers (HCWs) seek, treat, and care for patients living with HIV/AIDS on a daily basis and thus face a significant risk to work-related infections. To assess the knowledge, attitude, and practices regarding occupational HIV exposure and protection among HCWs in low HIV prevalence areas of rural China. A cross-sectional questionnaire survey was carried out among all medical units in Pucheng County, Shaanxi, China. Response rate of this study was 94%. The average overall knowledge score of HCWs was 10.9 of 21.0. Deficiencies in general, transmission, exposure, and protection knowledge were identified among HCWs at all levels. A high rate of occupational exposure (85%) and lack of universal precautions practice behavior were recorded. Significant predictors of universal precautions practice behavior were female sex, prior training, and greater knowledge about HIV/AIDS. Health care workers at various levels have inadequate knowledge on HIV/AIDS and do not practice universal precautions. Nurses and medical technicians at the county level faced more occupation risk than other HCWs. The key of AIDS training for different levels of HCWs should be distinguished.

Knowledge and practice of universal precautions among nursing students at a teaching hospital

Background: Health care Personnel are at higher risk to acquire blood born infections especially nurses who are in continuous contact with the patient during their routine work in health care settings. Needle stick injuries are more frequently occurred among nursing staff and students during their regular works due to improper knowledge about precautions. Methodology: A cross sectional study was conducted among Bachelor of Science (B.Sc) nursing students of Mamata Nursing College, Khammam. A 22 item multiple choice close ended questionnaire was used to assess knowledge and practice of universal precautions among nursing students. The data was analyzed using percentage and t- test. Results: Among the 228 respondents, 75% of them thought that the used needles can be recapped after giving an injection. About 65% of the students thought that the universal precautions are not necessary in situations that might lead to contact with saliva. There was indeed a lack of knowledge regarding universal precautions and their self reported practice. Conclusion: The study on nursing students revealed that they have inadequate knowledge and improper practice of universal precautions. Hence further knowledge on universal precautions should be improved by conducting continuous educational interventional programmes in their regular curriculum.

Knowledge and practice of universal precautions among nursing staff at a tertiary care hospital in South Gujarat, India

Background: Health care providers are at an increased risk of exposure to various infections like HIV, Hepatitis B, Hepatitis C etc. These infections are prevented if proper universal precautions are observed by health care providers consistently in their day to day clinical work. In study we have explored knowledge and practice of universal precautions among nursing staff. Methods: A cross sectional study carried out among staff nurses in December 2013. Self-administered semi structured proforma was used for data collection. Information regarding knowledge and practice of universal precautions was collected. Results: Out of 88 participants interviewed, almost all of them reported of having awareness about universal precautions and personal protective equipments. Only 44.3% nurses mentioned all the correct measures for universal precautions. 89.77% nurses were aware about health hazards of needle stick injury but only 67.05% correctly reported about how needle stick injury can be prevented. 38.64% nurses had experienced needle stick injury while working and most of them (79.41%) followed proper guidelines. Conclusions: correct knowledge regarding universal precautions among nursing staff is still not of satisfactory level and training at repeated interval needs to be given to ensure correct knowledge as well as implementation of universal precautions.