AN ASSESSMENT OF THE IMPACT OF TRAINING ON KNOWLEDGE AND PRACTICE OF UNIVERSAL PRECAUTION AMONG HEALTH CARE WORKERS IN AMINU KANO TEACHING HOSPITAL

AN ASSESSMENT OF THE IMPACT OF TRAINING ON KNOWLEDGE AND PRACTICE OF UNIVERSAL PRECAUTION AMONG HEALTH CARE WORKERS IN AMINU KANO TEACHING HOSPITAL

Abstract

Background and Objectives
The increased risk of healthcare workers to blood borne infections notably HIV, Hepatitis B and C viruses in their workplaces led to the development of Universal Precautions. However, knowledge is crucial for the adoption of any desired behaviour. The main objective of this study was to assess the knowledge and practice of Universal Precautions and determine the impact of training intervention among healthcare workers in a tertiary health centre in Kano, northern Nigeria.
Methods
An interventional study (before and after design) was conducted using structured , close-ended self-administered questionnaire to assess the knowledge and practice of Universal Precautions among 326 trained healthcare workers selected using stratified systematic random sampling from AKTH, and another 326 healthcare workers that were not trained from ABUTH (control). Baseline information on knowledge and practice of Universal Precautions and needle stick injury was collected from both AKTH and ABUTH. One week training on knowledge and practice of Universal Precautions was conducted in AKTH and subsequently post intervention information was collected to assess the impact of the training.
Findings
Fifty one percent and approximately 55% of the respondents had good knowledge of Universal Precautions in the intervention and control groups respectively. There was no statistical difference in the mean knowledge scores between the intervention and control groups. (t = – 1.81, p = 0.07, df = 649). Approximately 29% and 60% of the respondents had good practice of Universal Precautions in the intervention and control groups respectively. Significant statistical difference in the mean practice score was found between the intervention and control groups. (t = – 14.95, p < 0.0001, df = 648). After training intervention, the mean knowledge score increased from 11.95 to 14.46 in the intervention group. This was statistically significant at 5% level of significance. (t = -13.73, p < 0.0001, df = 535). The proportion of respondents with good knowledge in the intervention group also increased from 51.5% to 80% 3 months after training. This was also statistically significant at 5% level of significance (p < 0.0001). Mean practice score increased from 25.1 to 14.48 in the intervention group 3 months after training was given to them on Universal Precautions. This increase was statistically significant at 5% level of significance. (t = -20.82, p < 0.0001, df = 644). The Proportion of respondents with good practice score also increased from 28.5% to 90.2% in the intervention group after training. This was statistically significant at 5% level of significance. (p < 0.0001).
Among the control group, there were no similar changes in both the means and proportions of respondents with good knowledge and practice of Universal Precautions. Mean knowledge of 12 did not change three months after baseline data was taken. The proportion of respondents with good knowledge of Universal Precautions also remained the same (54.9%) 3 months after baseline data was taken. Similarly, mean practice of
Universal Precautions among the control group remained 29 three months after baseline line data was taken. The proportion of respondents with good practice slightly increased from 60.1% to 61.0%. This increase was not statistically significant at 5% confidence level.
While the health care providers indicated that the materials for the practice of Universal Precautions are available, the following factors were identified as hindrances to the practice of Universal Precautions: inadequate knowledge of Universal Precautions, the healthcare workers’ perceived difficulties of protecting themselves in the event of emergencies and the claim that they are sometimes too busy to follow the recommended guidelines on Universal Precautions. Period prevalence (December 2005 to November 2006) of needle stick injury was 23.3% and 20.9% in the intervention and control groups respectively. No statistical difference was found between the two groups at 5% level of significance. (X2 =0.570, df = 1, p =0.450).
Conclusion
Knowledge and practice of Universal Precautions were fair among both the intervention and control groups but improved among the intervention group following training intervention. All healthcare workers should be trained on Universal Precautions and materials should be made available for them to practice these precautions in order to protect themselves.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

AN ASSESSMENT OF THE IMPACT OF TRAINING ON KNOWLEDGE AND PRACTICE OF UNIVERSAL PRECAUTION AMONG HEALTH CARE WORKERS IN AMINU KANO TEACHING HOSPITAL