CHAPTER ONE
1.1 Background of the Study
Infection prevention and control (IPC) is an effective and efficient strategy for preventing infections among patients and healthcare workers. It is a vital element of patient safety and high-quality care, and it is relevant to all patients and healthcare workers in all healthcare settings (World Health Organization, 2023).
According to Chua et al. (2021), IPC continues to be a fundamental approach in the prevention of healthcare-associated infections (HCAIs) and antimicrobial resistance (AMR). A patient is said to have a healthcare-acquired infection (HCAI) if the infection did not exist or was not incubating when the patient was admitted but develops while the patient is receiving care in a hospital or any healthcare institution. This type of infection results in substantial morbidity and mortality, a longer hospital stay, and increased treatment costs in developed and resource-limited countries alike.
In developed countries, the prevalence of HCAI among hospitalized patients is approximately 15%, while for patients admitted to the Intensive Care Unit, it can be as high as 37%. Conversely, developing countries have a slightly higher prevalence, with up to 19% of hospitalized patients suffering from HCAI (WHO, 2009). Despite the scarcity of data in sub-Saharan Africa, HCAI remains a significant cause of avoidable morbidity and mortality in developing countries where infection rates are comparatively higher, largely due to inadequate infection control measures and overcrowding of healthcare facilities (Emori and Gaynes, 1993).
Healthcare-associated infections place a significant financial and logistical burden on the healthcare system (Allegranzri et al., 2011; Tess et al., 1993). Additionally, HCAIs have been shown to contribute to severe mental health problems such as anxiety, depression, adjustment disorder, panic attacks, and post-traumatic stress disorder (Wicker et al., 2014; Zhang and Yu, 2013).
Moreso, low and middle-income countries (LMICs) have a strong association between HCAIs and antimicrobial resistance (AMR), as reported by Laxminarayan et al. (2013). In 2019, bacterial AMR was responsible for approximately 1.27 million deaths globally, and an estimated 495 million deaths without infection were attributable to AMR (Antimicrobial Resistance Collaborators, 2022). It is predicted that by 2050, AMR will result in 9 million additional deaths and a financial loss of $100 trillion in LMICs (O'Neill, 2016). The transmission of HCAIs and AMR in healthcare settings can be prevented by implementing efficient and organized infection prevention and control (IPC) strategies (Storr et al., 2016). Furthermore, IPC is a cost-effective approach to reducing infections in healthcare settings.
In order to prevent HCAIs, various preventive measures are employed. These include implementing standard precautions such as practicing good hand hygiene, using personal protective equipment, observing respiratory hygiene/cough etiquette, maintaining sharps safety, following safe injection practices, using sterile instruments and devices, and ensuring clean and disinfected environmental surfaces. Additionally, isolation precautions such as contact, droplet, and airborne precautions are widely recommended and employed to minimize the risk of pathogen transmission (Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, 2018; United States Center for Disease Control and Prevention, 2007).
The successful implementation of these preventive measures relies heavily on the human factor and their adherence to the protocols, which can either increase or decrease the likelihood of acquiring HCAI (Cole, 2007). In particular, the knowledge and compliance of healthcare workers, especially nurses, are critical for effective infection prevention and control (IPC) (WHO, 2009; WHO, 2012; Siegel, 2007). Given their frontline role in healthcare, nurses are often at higher risk of exposure to infectious agents and must possess sufficient knowledge and skills in IPC to prevent the transmission of infections in healthcare settings.
Its on this background that this study seeks to investigate knowledge and practice of IPC among nurses.
1.2 Statement of the Problem
HCAIs are a significant global health issue that affects millions of people annually. To prevent and control HCAIs, healthcare workers must possess sufficient knowledge and skills in IPC. However, research indicates that inadequate knowledge of IPC guidelines, combined with a lack of awareness regarding preventive measures during daily patient care and the potential risks of pathogen transmission to patients, can pose significant obstacles to IPC compliance (Albano et al., 2014; Geberemariyam et al., 2018; Assefa, 2020). Poor compliance with IPC measures is often attributed to a lack of knowledge concerning the suitability, effectiveness, and appropriate use of IPC measures (Aloush et al., 2018; Haile et al., 2017). Compliance with IPC practices, such as hand hygiene and use of PPE, can vary greatly among healthcare workers (Ganczak and Szych, 2007; Mody et al., 2010; Haile et al., 2017) and is likely affected by their knowledge and behavior towards infection risk (Albano et al., 2014; Mody et al., 2010; Geberemariyam et al., 2018). However, having good knowledge does not necessarily guarantee good IPC practice (Iliyasu et al., 2016; Madan et al., 2002; Ogoina et al., 2015). Studies have shown that HCWs may have poor compliance with hand hygiene practices despite established guidelines for preventing HCAIs (McGuckin et al., 2009; Allegranzi and Pittet, 2009).
Research has indicated that there are gaps in nurses' knowledge and practice of IPC, which can increase the risk of HCAIs (Fashafsheh et al., 2015. Harun et al., 2022). Therefore, it is important to investigate and improve nurses' knowledge and practice of IPC to enhance patient safety and prevent the transmission of HCAIs. This is particularly important in Nigeria, where limited research has been conducted on this topic.
1.3 Aim of the Study
The study aims to assess the knowledge and practice of infection prevention and control among nurses.
1.4 Objectives of the Study
The study had the following specific objectives:
- To assess the knowledge of nurses in infection prevention and control.
- To assess practices of nurses in infection prevention and control.
- To determine the relationship between the knowledge and practice of infection prevention and control among nurses.
1.5 Research Questions
- What is the knowledge of nurses in infection prevention and control?
- What are the practices of nurses in infection prevention and control?
- What is the relationship between the knowledge and practice of infection prevention and control among nurses?
1.6 Research Hypothesis
H0: There is no significant relationship between the knowledge and practice of infection prevention and control among nurses.
H1: There is a significant relationship between the knowledge and practice of infection prevention and control among nurses.
1.7 Justification of the Study
Assessing the knowledge and practices of nurses in IPC is crucial to identify gaps and improve IPC measures in healthcare settings. This study's findings can inform the development of IPC training programs for nurses, improve IPC policies and guidelines, and enhance the quality of patient care. Furthermore, the study can contribute to the body of knowledge on IPC in healthcare settings, particularly on the role of nurses in IPC. Ultimately, the study's outcomes can benefit both healthcare professionals and patients by reducing the incidence of healthcare-associated infections and improving patient outcomes.
1.8 Scope of the Study
The study focuses on assessing the knowledge and practices of nurses regarding infection prevention and control within 3 selected tertiary hospitals in Nigeria.
