Risk of infection among primary health workers in the Western Development Region, Nepal: knowledge and compliance

Abstract

Introduction: Without protective practices such as antiseptic hand washing, the use of sterile/surgical gloves, safe needles, sterile equipment, and safe instrument and waste disposal procedures outlined in universal precaution guidelines, basic health workers (BHWs) are at substantial risk of blood-borne infections. Methodology: This paper draws on research conducted in 28 primary health care centers in two districts of the Western Development Region, Nepal, between 2003 and 2004. Interviews were conducted to identify the infection control knowledge and practice compliance of basic health workers. Results: Of 100 BHWs studied, only 22% had correct knowledge of universal precautions and 73% said they follow universal precaution guidelines. A total of 62% reported that they regularly used protective gloves while handling patients and 72% reported that they never used high-level disinfection to eliminate all microorganisms (bacteria, viruses, fungi, and parasites, including bacterial endospores) from instruments and other items that would come into contact with broken skin or intact mucous membranes. Reasons for noncompliance included irregular supply of materials (31%); lack of an autoclave and other high-level disinfection equipment (50%); lack of knowledge and insufficient technical skills regarding universal precaution procedures (20%). Conclusion: Results showed that poor knowledge and an irregular supply of materials, equipment, and instruments prevented BHWs from using infection control measures. Formal training in universal precautions is urgently needed, and protective equipment must be provided and use must be monitored. Compliance to infection control procedures must be improved at primary health care units, especially among the basic health workers.

Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals

“…In other international studies, low knowledge and professional adhesion to SP were also observed (15)(16)(25)(26)(27) , indicating that there are still differences in participation rates between developed countries and developing ones.…”

“…The training on the SP is an essential and immediate need, but health institutions also need to provide PPE and monitor their use (25) . In this study, respondents had difficulty recognizing the PPE and said they had not received in-house training on the SP.…”

Adherence to precautions for preventing the transmission of microorganisms in primary health care: a qualitative study

“…They said that they should think and talk more about the subject as a way to dissipate misconceptions and better translate knowledge into practice. Knowledge is known to be a first step for awareness of self-protection and patient protection [26]. Even fundamental knowledge on hand hygiene is far from being good in many outpatient settings [6, 10, 26].…”

APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

“…Compliance with universal precautions varies in the AsiaPacific region; it is lowest in Turkey at 33.6 % [120], 40 % in India [121], and 64.7 % in China [122]. The knowledge of universal precautions was inadequate in some countries in Asia [121][122][123][124]. The factors influencing compliance were irregular supply of materials, lack of other high-level disinfection equipment, and lack of training [121,[123][124][125].…”

“…The knowledge of universal precautions was inadequate in some countries in Asia [121][122][123][124]. The factors influencing compliance were irregular supply of materials, lack of other high-level disinfection equipment, and lack of training [121,[123][124][125].…”