Knowledge And Practice Of Infection Control Among Nurses

INTRODUCTION
Background of Study
Infection control is an issue of concern within the clinical setting, public health and among health care consumers. Viruses and blood borne infection constitute an occupational risk to healthcare workers and healthcare consumers. Nevertheless, the outcome of such exposures depends on the prevalence of blood borne infections in the patient population and the nature and frequency of contact with blood and body fluid through percutaneous or mucosal membrane (Yokoe & Classen, 2010).
Besides, the risk of infection is also affected by inoculation and route of exposure as well as the susceptibility of the exposed to the infection. It is estimated that 3 million health care workers are affected by blood borne viruses (BBV) each year, resulting in about 16,000 hepatitis C, 66,000 hepatitis B and 250 to 5,000 human immune deficiency virus (HIV) infection per year (Kemode, 2015).
Hepatitis B virus is endemic in China. South East Asia and Sub-Sahara African which includes Nigeria which has a carrier rate exceeding 8% (Moro, Sansa Oludoro, Abdulahi & Femurewa, 2010). The chronic carrier rates of HBV among the general population ranges from 12% to 48.7% affecting different states and cities. A growing number of Nigerians estimated by the National Population Commission reports that about 2.4 – 5.4 million people are living with HIV/AIDS. The prevalence of HIV infection in the adult population in Nigeria is 3.1%. It was estimated that as at 2005, 14.000 new infections occurred each day, more than 75% were in low and middle income countries which Nigeria is equally among (Centre for Disease Control and Prevention, 2019).
Furthermore, evidence suggests poor hygiene practices in the hospital and patients’ fears about safety with regard to infection in the hospital indication are that some patients have instituted legal claims as a result of nosocomial infections. Lack of knowledge of infection control and practice among health care workers leads to reduced quality of life of individuals because of disabling conditions that increases the economic cost and hospital stay. Also doctors and nurses are burdened by extra healthcare including morbidity and mortality rate as a result of complications (Moro, 2016).
Knowledge and practice of infection control is important in the healthcare setting in order to ensure the safety of healthcare workers, patients, clients, visitors and the community at large Infection control is the responsibility of all healthcare professional including nurses, doctors, microbiologists, and pharmacists among others. Prevention of infection to patients may require special precautions and measures to limit transmission of organisms to other patients, it requires additional precautions to be in place, and when there is a high level of protection, transmission of infectious diseases is prevented. When removing used protective equipment, they should be discarded into the waste bin in the adjacent rooms; hands should be washed before and after glove use (Dawson, 2015)
There should be specialized equipment for cleaning and disinfecting both equipment and the environment, all linen handling should be done with care to avoid dispersal of micro-organisms. Appropriate personal protective equipment should be worn when handing linen that is soiled with body substances. Used linen should be bagged and placed in a leak proof bag and securely tied, appropriate use of antibiotics, nutrition and vaccination, prevention of infection among staff members and excuse duty for those who are infected, all aimed at preventing infection transmission to patients (Berman & Synder, 2012). In operating theatre, all staff should use operating room attire such as gowns, masks, gloves, caps, the number of persons entering the theatre should be minimized and unnecessary taking and movement should be avoided (Cozad & Jones, 2016).
When performing nursing procedures and assisting physicians and surgeons in various procedures, there is need to prevent and manage infections among nurses by reviewing nurses health at recruitment and immunization history should be obtained including previous exposures to tuberculosis and immune status. The following immunization are recommended; hepatitis A and B yearly, influenza, measles, mumps, rubella, tetanus and diphtheria. Specific post exposures polices must be developed and compliance ensured for cases of Human Immunodeficiency Virus, (HIV), Meningitis. Mycobacterium Tuberculosis, Varicella zoster virus and Rabies. The transmission of some of these micro-organism may be rare, so policies to manage nurses who are exposed should be developed (Berman & Snyder, 2012).

Statement of Problem
Infections have a significant burden to patients, staff and public at large. Nosocomial infection is one of the major causes of death and increase morbidity in the health care system. Reports have it that non-adherence to infection control measures such as the use of gloves and changing it after each use for each patient is associated with many complexities not just forgetfulness or knowledge. Therefore, there is need to adopt an educational strategy that will focus on behavior change, empower health care workers and reduce infections in the health sector in Nigeria, the National Health Strategic Development Plan Frame Work, all emphasize on control of communicable diseases which are still prevalent. Nurses attend seminars, workshops which create awareness on infection control but the practice is still questionable. However, some studies have focused on knowledge of and compliance with standard precautions (Edet & Samson-Akpan, 2016). Additionally, the outbreak of Ebola virus has given more impetus to assess knowledge and practice of infection control among nurses in Nigerian Christian Hospital, Nlagu in order to design intervention if there is need.

Specific Objectives of the Study
The following objectives gave focus to the study:
1 To determine the level of knowledge of infection control among nurses.
2 To examine the extent to which nurses practice barrier precautions.
3 To ascertain methods of disposal of sharps, refuse and handling of contaminated materials.

Research Question
1 What is the level of nurses’ knowledge on prevention and control of infection at the selected hospital?
2 What are the ways to examine the extent to which nurses practice barrier precautions?
3 What are the methods of sharps disposal, refuse disposal and handling of contaminated materials?

Significance of the Study
The results of the study will help nurses in Nigerian Christian Hospital, Nlagu to ascertain their level of knowledge and practice of infection control and if there is need; management will be able to use this study as baseline for developing infection control intervention program for nurses. The study will assist in policy and decision making in health care delivery as to infection control. It will also add to the data base on infection control. The study will also serve as a reference point to further research.
Scope of the Study
The study is aimed at assessing the level of knowledge and practice of infection control among nurses in Nigerian Christian hospital, Nlagu.

Operational Definition of Terms
Knowledge: Is defined as an awareness of information, understanding or skill that you get from experience or education.
Practice: It simply means doing something regularly in order to become better at it. Infection control: It is the disciple concerned with preventing healthcare associated infection, a practical (rather than academic) sub-discipline of epidemiology.
Nurses: International Council of Nurses (ICN) defined a nurse as a person who has completed a program of basic nursing education and is qualified and authorized in his/her country to provide responsible and competent professional services for the promotion of health, prevention of illness, care of the sick and rehabilitation.