IMPACT OF UNIVERSAL PRECAUTIONARY MEASURES ON JOB SATISFACTION AND SAFETY OF NURSES

1.1 Introduction

Universal precautions is defined by the centre for disease control (CDC) as a set of precautions or actions designed to prevent the transmission of HIV, HBV, HCV and other body fluid, blood borne pathogens when providing first aid or health care (Jawaid et al., 2009; Kalu et al., 2012; CDC,2021). Universal precautions are intended to prevent parenteral, mucous membrane and non-intact skin exposures of healthcare workers to blood borne pathogens. Job satisfaction is a significant aspect of success in any organization (Amburgey, 2005). Job satisfaction reflects the relative feelings, objective thoughts, and behavioral intentions of employees in an organization that help predict employee behavior (Brown et al., 2013). Therefore, Job satisfaction can be used as part of evaluations that lead to planning for organizational improvement by presenting results from past strategies and future projections of employees.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of technical terms.

1.2 Background of Study

Universal precautions are intended to prevent parenteral, mucous membrane and non-intact skin exposures of healthcare workers to blood borne pathogens. Personal hygiene thus becomes a fundamental principle in observing universal precaution. Immunization with HBV vaccine is recommended as an important adjunct to universal precautions for healthcare workers who have exposures to blood. Clinical applications of universal precautions are important for every healthcare professional that provides dental, medical, or other patient care (Bamigboye and Adesanya, 2006; Maqbool, 2002).

In 1983, CDC disseminated a document called (Guidelines for Isolation Precautions in Hospitals). This document included a section about precautions that must be taken when dealing with blood and body fluid of suspected patient infected by blood-borne pathogen (CDC, 2001). In 1985, in response to HIV /AIDS epidemic (CDC, 2007), CDC developed precautions to be applied to all patients irrespective of their blood-borne infection status. They were called universal precautions. These precautions are defined as a set of precautions devised to prevent, and minimize accidental transmission of all known blood-borne pathogens including HIV, hepatitis B virus, and hepatitis C virus to/from health care personnel when providing first aid or other health care services (Vaz et al., 2010). These universal precautions can also be defined as an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other blood borne pathogens (NIOSH, 2016).

The increasing rate of nosocomial infections from various medical settings have been of much concern for some time. The fact that blood and other fluids from patients are becoming increasingly hazardous to those who provide care for them has become of great concern to public health professionals the world over (Wilson et al 2006, Hesse et al.2006, Gurubacharya et al., 2003). Thus the practice of universal precaution as a way of safeguarding possible routine infections in work places has become more and more widely accepted among various healthcare workers as a simple and effective means of controlling transmission of hospital infections (Hesse et al., 2006, Gurubacharya et al., 2003). Although universal precaution guidelines have been in place since 1987, suboptimal adherence to it especially in developing countries has been documented extensively despite evidence that failure to observe universal precautions increase the risk of transmission of nosocomial infections (Janjua et al. 2007).

Health care professionals need to be updated on the principles of universal basic precautions as it has been proven that there are deficiencies in the knowledge and applications of the practice of the universal precautions (Nduka et al., 2012). To minimize the risks of acquiring HIV, HBV and other blood borne diseases during performance of job duties, workers should be protected from exposure to reduce the incidence of these work related accidents injuries through training programmes and seminars for health workers. This will help to reduce their chances of acquired occupational disease. There is also a need to institute effective reporting system in hospitals through staff clinics (Ofili et al., 2004).

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Impact of universal Precautionary Measures on Job Satisfaction and Safety of Nurses.

1.3 Statement of Problems

Investigation reveals that Nurses get in contact with patients on a daily basis, so they are exposed to sharp injuries and many types of infections due to the nature of their occupation. It is important to follow standard precautions to reduce transmission of infections. In Palestine, despite of the availability of protocol for infection control in hospitals, it is applicable in varied degree from hospital to hospital.

In addition, after reviewing documents from Palestinian Health Information Centre in MOH, it doesn't have any statistics regarding nurses' knowledge and practice of standard precautionary (SP) measures and those related to sharp injuries (SI) among health care workers. In addition, it doesn't have any statistics regarding health care workers who have SI or who acquired infection during work. As an expected outcome, this study will identify the importance of nurses' knowledge about SP measures and those related to SI. Also it will highlight the size of problem of stick injuries among workers during work.

1.4 Aim and Objectives of Study

The aim of the study is to examine the Impact of universal Precautionary Measures on Job Satisfaction and Safety of Nurses. In achieving this aim, the following specific objectives were laid out as follows:

1. To examine the impact of job satisfaction and organizational commitment on patient safety management activities of nurses.
2. To find out the association between knowledge and practices of universal precautions among Nurses;
3. To assess the practices of Nurses towards universal precautionary measures on job satisfaction;
4. To find out association between universal precautions safety and job satisfaction of Nurses; and
5. To assess the knowledge of Nurses regarding the importance of universal precautions in prevention of spread of blood borne pathogens.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What is the association between knowledge and practices of universal precautions among Nurses?
• What are the practices of Nurses towards universal precautionary measures on job satisfaction?
• What are the association between universal precautions safety and job satisfaction of Nurses?
• What is the knowledge of Nurses regarding the importance of universal precautions in prevention of spread of blood borne pathogens?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no association between universal precautions safety and job satisfaction of Nurses.
• H1: There is association between universal precautions safety and job satisfaction of Nurses.

Hypothesis Two

• H0: There is no significant knowledge of Nurses regarding the importance of universal precautions in prevention of spread of blood borne pathogens.
• H1: There is significant knowledge of Nurses regarding the importance of universal precautions in prevention of spread of blood borne pathogens.

1.7 Significance of Study

The findings of this research will be relevant to medical practitioners particularly Nurses. Nurses are the largest occupational group in any health care agency. By virtue of their job responsibility they are frequently exposed to blood and body fluids. The nurse’s risk of exposure to health hazards and the nurse as a cause of iatrogenic infection to the patients are equally challenging issues to the nurses all over the world.

By using simple techniques of universal precautions nurse can avoid dangerous occupational hazards and the knowledge of prevention of blood borne diseases can make nurses confident to deal with patients suffering from HIV and HBV.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on the Impact of universal Precautionary Measures on Job Satisfaction and Safety of Nurses using Enugu State University Teaching Hospital (ESUTH) as a case study.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint:The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure:This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

1.10 Definition of Terms

Nurse Managers: It refers to nurses who are in-charge of wards/units.

Job Satisfaction: It refers to the feeling a nurse has about the job being performed.