Standard Precautions Among Health Care Workers
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Standard Precautions Among Health Care Workers
Chapter one
INTRODUCTION
According to legend, whatever Midas touched turned to gold. There is power in the touch. As healing can result from a touch, so can infection, sickness, and, ultimately, death, whether for the person touching or the person being touched.
The typical skin is designed to prevent water loss, protect against abrasions, and function as a permeability barrier1. It is often colonised by bacteria classified as either resident or transient flora.
Resident flora are less likely to produce healthcare-associated illnesses, whereas transitory flora are more commonly implicated in such diseases.
The transitory flora is acquired by hand contact with patients, their belongings, beddings, bodily fluids, and so on. These hands are employed to spread infections from one to person.
Because the hands play a significant part in the transmission of infection, hand cleanliness is critical in preventing infection. For this reason, the Centres for Disease Control and Prevention (CDC) added hand hygiene to the list of universal or standard precautions.
Health care personnel who have occupational exposure to blood are more likely to contract blood-borne illnesses. The amount of risk is determined by the number of patients in the health care facility who have that infection, as well as the precautions that health care staff take when dealing with them.
There are over 20 blood-borne diseases, but the most important for health care professionals are hepatitis caused by either the hepatitis B virus (HBV) or the hepatitis C virus (HCV) and acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV)2.
Contaminated sharps, including needles, lancets, scalpels, shattered glass, specimen tubes, and other equipment, can spread bloodborne infections such as HIV, Hepatitis B (HBV), and Hepatitis C viruses (HCV)3.
Unsafe injections and the subsequent transfer of blood-borne viruses are thought to occur on a regular basis in impoverished countries. Furthermore, 18 research provide solid evidence linking unsafe injecting practices to the spread of blood-borne diseases such as hepatitis B and C, Ebola, Lassa virus infections, and malaria.
Such behaviours contribute to a significant proportion of hepatitis B and C infections. A analysis of published and unpublished WHO publications yielded quantitative data on injection use and unsafe injections (defined as the reuse of a syringe or needle between patients without sterilisation).
It is estimated that each person in underdeveloped countries receives 1.5 injections each year, but those confined to hospitals receive 10 to 100 times as many.
Approximately 95% of these injections are beneficial, with the majority being unneeded. In developing nations, at least 50% of these injections are considered unsafe4.
Injection overuse and improper techniques are responsible for a significant burden of death and disability globally5. The nature and design of the instrument, as well as specific work practices, all have a role in causing needle-stick injuries.
Recapping needles is a common cause of needle stick injuries. It has been observed that 10-25% of injuries occurred while recapping a used needle(6). The OSHA blood-borne pathogen standard7 prohibits the recapping of needles.
There are a rising number and diversity of needle devices with safety features on the market. Needleless or shielded needle I.V. systems have reduced the number of needle-stick injuries by 62% to 88%8.
The prevalence of HBS Ag in healthy blood donors in Kathmandu valley has been observed to be approximately 1.67 percent.9. According to a sero prevalence survey, the total anti-HCV positive rate among blood donors in Nepal is approximately 0.3%10. In Nepal, the prevalence of HIV seropositivity among healthy blood donors has been estimated as 0.2%10.
In Saudi Arabia, the prevalence of HBs Ag in healthy blood donors varies between 2.7% and 9.8% 9-10. Sero-prevalence studies indicate that the total anti-HCV positivity ranges from 3.5% to 5% 10=11.
Thalassaemia and Sickle Cell disease are frequent in Saudi Arabia, and the incidence of hepatitis C virus antibodies among this high-risk group is approximately 40%.12. HIV seropositivity is estimated to be at 0.09% in the Kingdom13.
These data indicate that a sizable number of people are at danger of transmitting blood-borne infections to doctors, laboratory technicians, blood bank employees, nurses, professionals working in renal dialysis and transplant units, and other health care workers.
It has been determined that the probability of HIV/AIDS transmission to health care professionals through needle stick occurrences is 0.3% (1 case every 300 needle stick incidents).
A data set compiled from over 20 prospective trials of healthcare professionals exposed to HIV-infected blood via percutaneous injury found an average transmission rate of 0.3%14.
The above studies, including the study conducted by Ofili et al on nurses in Central Hospital in Benin City, clearly revealed that healthcare workers’ knowledge of the risk associated with needle stick injuries and blood-borne infections in their day-to-day activities at work, as well as their use of preventive measures, is inadequate 15.
It is estimated that just one in every three needle stick injuries are recorded in the United States, whereas these injuries go totally undetected in many underdeveloped nations.16
The frequency of Hepatitis B virus infection among healthcare professionals has decreased in recent years, owing primarily to widespread immunisation with the hepatitis B vaccine.17 Despite the fact that many health-care workers are vaccinated, their sero-conversion status is not evaluated following vaccination.
All blood and body substances are potentially infectious, necessitating the application of infection control techniques and policies.
In 1985, the Centres for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA) in the United States introduced the “universal precaution Guidelines,” which became the global standard in both hospital and community care settings until 1996.18
The Centres for Disease Control and Prevention (CDC) changed the definition and guidelines of universal precautions in 1996 and renamed them standard precautions.
Today, routine precaution is the major technique for reducing the risk of bloodborne pathogen transmission via wet bodily substances, and it applies to all individuals, patients, clients, and staff, regardless of diagnosis or suspected infectious status.
Their deployment is intended to limit the danger of microorganism transmission from both known and unknown sources of infection within the health-care system.
Standard precautions have been the major approach to preventing nosocomial infections in hospitalised patients. The Nigerian government has prioritised the health, safety, and wellbeing of its workforce. ”
The Workmen’s Compensation Act” of June 11, 1987 demonstrates the Federal Government’s concern for the health, safety, and welfare of Nigerian workers.
Standard precautions in everyday practice include hand washing, personal protective equipment (PPE), a safe waste disposal system, proper sterilisation and disinfection processes, appropriate use of instruments and equipment, vaccination, education, and a post-exposure protocol (PEP).
Statement of the Problem
Health Care Workers (HCWs) are at risk of contracting blood-borne diseases from pathogens such as HW, Hepatitis B, and C viruses while performing clinical duties in hospitals. Hospital-acquired infections are causing an increase in morbidity and mortality.
There is continuous unjustified and hazardous injection use, a lack of adequate sharps containers and disposal facilities, and a shortage of injection equipment, all of which have contributed to an increase in needle stick injuries and blood-borne diseases among health care workers. Health care personnel face serious health hazards due to a lack of information and failure to follow standard safeguards.
Identified and comparable problems occur in Central Hospital, Warri, other health establishments in Delta State, and other states, but no research has been conducted to address the issue.
JUSTIFICATION FOR STUDY
The increased prevalence of morbidity and mortality as a result of noncommunicable and blood-borne infections is due to a lack of awareness, a negative attitude towards, and noncompliance with standard precautions’ definitions and recommendations. It has been demonstrated that following conventional measures reduces the chance of being exposed to blood and body fluids.
This study will reveal the level of awareness, attitude, and practice of standard precautions among HCWs, and so it could serve as a baseline for intervention. It could highlight deficiencies that should be addressed through interventions.
Also, depending on the study design, an evaluation could be pre- or post-test. This study could also be utilised to track changes in events related to knowledge, attitude, and practice of standard precautions among health care personnel at Central Hospital in Warri by periodically examining the incidence of needle stick injuries as well as the morbidity and mortality patterns.
AIMS AND OBJECTIVES
The overall goal is to analyse the knowledge, perception, and practice of standard precautions among health care staff at Central Hospital in Warri, Delta State.
Specific objectives:
1. Determine the level of knowledge of standard precautions among health-care personnel at Central Hospital in Warri.
2. Determine the attitude of health care personnel at Central Hospital, Warri, regarding standard precautions.
3. Determine the level of standard precautions practiced by health care staff at Central Hospital in Warri.
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