CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Healthcare workers are regularly in contact with various microorganisms, some of which have the potential to cause severe or fatal infections. Nosocomial infections, also known as "healthcare-associated infections" or "hospital infections," are infections that develop in patients while they are receiving care at a healthcare facility, but were not present or developing when they were admitted. Typically, these infections are acquired after being admitted to the hospital and become evident within 48 hours of admission (World Health Organization, 2010; Monegro et al., 2023).
Nosocomial infections can impact patients in various healthcare settings and may even occur after they have been discharged. These infections can also affect the healthcare staff themselves, leading to occupational infections. It is important to note that healthcare-associated infections (HAI) are the most common adverse events during the delivery of care, and no institution or country can claim to have completely resolved this issue. Based on data collected from multiple countries, it is estimated that every year, hundreds of millions of patients worldwide are affected by HAI (World Health Organization, 2010).
In developed countries, the occurrence of healthcare-associated infections (HCAI) among patients admitted to hospitals is around 15%, whereas for those admitted to the Intensive Care Unit (ICU), it can be as high as 37%. On the other hand, developing countries tend to have a slightly higher prevalence, with up to 19% of hospitalized patients experiencing HCAI (World Health Organization, 2009). Even though there is a lack of comprehensive data specific to sub-Saharan Africa, HCAI remains a significant contributor to preventable illness and death in developing nations. This is primarily attributed to insufficient infection control measures and the overcrowding of healthcare facilities, resulting in comparatively higher rates of infection (Emori and Gaynes, 1993).
Employing aseptic techniques is crucial in reducing the risk of hospital-acquired infections among patients. These techniques help prevent the transmission of microorganisms between healthcare staff and patients, especially during invasive procedures. s (Denton and Hallam, 2020).
Aseptic technique refers to a method or series of procedures implemented to achieve asepsis, which aims to prevent the transfer of harmful microorganisms to a vulnerable site, thereby reducing the risk of infection development (Parnikh, 2022). According to Johnson (2012), the aseptic technique encompasses a defined set of practices and procedures conducted under meticulous control to minimize the presence of microorganisms and safeguard patients from infections. Johnson further explains that asepsis is the approach utilized by healthcare professionals to prevent the introduction of microbial contaminants during invasive procedures.
The 19th century marked the emergence of the modern concept of aseptic technique, driven by significant advancements in medical understanding and practices. It was during this period that the importance of hand washing prior to medical procedures became evident in reducing the risk of puerperal fever (Perry and Potter, 2012; Perry and Potter, 2014). Additionally, the pioneering work of Louis Pasteur in the mid-19th century played a vital role in solidifying the germ theory and discrediting the prevailing notion of spontaneous generation. Pasteur's experiments provided compelling evidence for the existence and role of microorganisms in causing infections. Concurrently, the development of anesthetics enabled surgeons to perform longer and more intricate surgeries, albeit with an increased risk of infection.
During the 1840s, Ignaz Semmelweis, a Hungarian surgeon, made an important observation regarding mortality rates on maternity wards. He noticed that wards where doctors who also worked in other hospital areas were present had significantly higher mortality rates compared to wards exclusively managed by midwives. Semmelweis implemented hand washing procedures on the affected wards and observed a remarkable reduction in deaths caused by infections.
During the Crimean War, Florence Nightingale observed the dire state of hospitals where wounded soldiers were being treated. Driven by a strong desire to bring about positive change, she diligently gathered detailed data on the mortality rates and causes of death among these soldiers over a period of two years. Nightingale's analysis revealed a shocking fact: a significant proportion of deaths in these hospitals could have been prevented if aseptic techniques had been implemented. Consequently, she introduced crucial changes that focused on improving hygiene and infection control measures. As a result, many lives were saved during this critical period through Nightingale's interventions (Greenwood, 2023).
The effectiveness of infection control practices relies on the diligent and consistent application of proper aseptic techniques by healthcare providers. Complying with these techniques is crucial for ensuring the safety of both patients and personnel. By reducing the occurrence of nosocomial infections within healthcare units, patients' hospital stays can be shortened, leading to cost savings in medical resources. In contrast, when infections occur, it results in increased institutional costs due to prolonged hospital admissions (Kilpatrick and Keilly, 2002)
The primary objective of the aseptic technique is to attain a state of asepsis, and different healthcare settings have their specific principles and guidelines for achieving this goal (Pankaj et al., 2014). Effectively preventing contamination necessitates the collaborative efforts of everyone involved in patient care, utilizing their theoretical knowledge and practical experience in implementing aseptic practices. By adhering to these practices, healthcare providers can deliver optimal care to patients, ultimately leading to positive outcomes (Varshney et al., 2014).
Its on this background that this study seeks to investigate the knowledge, attitude and practice of current aseptic technique among health care providers in Civil Service and Sobi Specialist Hospital, Ilorin.
1.2 Statement of the Problem
The issue addressed in this study is the significant global public health concern posed by healthcare-associated infections (HAIs), with a particular focus on the insufficient implementation of aseptic technique as a major contributing factor. Despite the existence of guidelines and recommendations pertaining to aseptic technique, multiple studies have indicated that healthcare providers often exhibit inadequate knowledge, negative attitudes, and substandard practices when it comes to aseptic technique. These shortcomings in healthcare providers' approach to aseptic technique contribute to an elevated risk of HAIs being transmitted within healthcare settings (Ezeama et al., 2019; Owolabi, 2015; Singh et al., 2016).
However, the level of knowledge, attitudes, and practices regarding aseptic technique among healthcare providers in Civil service and Sobi Specialist Hospital, Ilorin is unclear. Therefore, this study seeks to assess the level of knowledge, attitudes, and practices regarding aseptic technique among healthcare providers in these two healthcare facilities in Ilorin, Nigeria, in order to identify areas for improvement and promote better infection prevention and control practices.
1.3 Aim of the Study
The aim of this study is to assess the knowledge, attitude, and practice of current aseptic technique among healthcare providers in Civil Service and Sobi Specialist Hospital, Ilorin, Nigeria.
The specific objectives of the study are:
- To determine the level of knowledge regarding current aseptic technique among healthcare providers in Civil Service and Sobi Specialist Hospital, Ilorin
- To assess the attitudes of healthcare providers towards current aseptic technique in Civil Service and Sobi Specialist Hospital, Ilorin
- To evaluate the practices regarding current aseptic technique among healthcare providers in Civil Service and Sobi Specialist Hospital, Ilorin
- To compare the knowledge, attitudes, and practices regarding aseptic technique between healthcare providers in civil service hospital and Sobi Specialist Hospital.
1.4 Research Questions
- What is the level of knowledge regarding current aseptic technique among healthcare providers in Civil Service and Sobi Specialist Hospital, Ilorin?
- What are the attitudes of healthcare providers towards current aseptic technique in Civil Service and Sobi Specialist Hospital, Ilorin?
- What are the practices regarding current aseptic technique among healthcare providers in Civil Service and Sobi Specialist Hospital, Ilorin?
- Are there differences in the knowledge, attitudes, and practices regarding aseptic technique between healthcare providers in civil service hospital and Sobi Specialist Hospital?
1.5 Research Hypothesis
H0: There is no statistically significant difference in the knowledge, attitudes, and practices regarding aseptic technique between healthcare providers in civil service hospital and Sobi Specialist Hospital.
Ha: There is a statistically significant difference in the knowledge, attitudes, and practices regarding aseptic technique between healthcare providers in civil service hospital and Sobi Specialist Hospital
1.6 Justification of the Study
Assessing the knowledge, attitudes, and practices of healthcare providers regarding aseptic technique is essential for identifying areas for improvement and promoting better infection prevention and control practices. Furthermore, comparing the knowledge, attitudes, and practices between healthcare providers in different healthcare facilities can help identify best practices and inform interventions to improve infection prevention and control practices across healthcare settings.
1.7 Scope of the Study
The study focuses on assessing the knowledge, attitudes, and practices regarding aseptic technique between healthcare providers in Civil Service hospital and Sobi Specialist Hospital. Data for the study will be obtained from doctors and nurses working in the mentioned hospitals
