KNOWLEDGE, ATTITUDE AND IMPLEMENTATION OF UNIVERSAL PRECAUTIONARY MEASURES AMONG NURSES

1.1 Introduction

The Centres for Disease Control (CDC) defines universal precautions as a collection of measures used during first aid or medical care delivery that are intended to stop the spread of blood-borne viruses such as HIV, HBV, HCV, and other bodily fluid infections (Jawaid et al., 2009; Kalu et al., 2012; CDC, 2021). Healthcare personnel who come into contact with blood-borne infections by parenteral, mucous membrane, or non-intact skin exposure have to be protected against by universal precautions. For every organisation to succeed, a key component is job satisfaction (Amburgey, 2005). According to Brown et al. (2013), job satisfaction is a measure of how individuals in an organisation feel about themselves, their objective ideas, and their behavioural goals. These factors may be used to predict employee behaviour.

This chapter will address the background information that motivated this study, the challenges that prompted it, its aim, and its objectives as a preface to subsequent sections of the study. Additional factors include the study's significance, scope, limitations, research questions and hypotheses, and the definition of technical terms.

1.2 Background of Study

Over the years, the goal of universal precautions is to shield healthcare personnel from blood-borne diseases by preventing parenteral, mucous membrane, and non-intact skin exposure. Consequently, maintaining personal cleanliness becomes essential to practicing universal caution. Healthcare professionals who come into contact with blood should consider receiving the HBV vaccination as a crucial addition to standard measures. For every healthcare provider who treats patients in a dental, medical, or other setting, clinical applications of universal precautions are critical (Bamigboye and Adesanya, 2006; Maqbool, 2002).

Guidelines for Isolation Precautions in Hospitals are a paper that was distributed by the CDC in 1983. The CDC (2001) published a document outlining the safety measures that need to be followed while handling bodily fluids, such as blood, from suspected blood-borne pathogen illnesses. In 1985, the CDC created precautions to be used on all patients regardless of their status for blood-borne infection in response to the HIV/AIDS epidemic (CDC, 2007). Universal precautions was the name given to them. Known blood-borne pathogens, such as HIV, hepatitis B, and hepatitis C, can be prevented or minimised by healthcare personnel when they are administering first aid or other medical services. This definition of precautions is given by Vaz et al. (2010).

This strategy of infection management, known as "universal precautions," can alternatively be described as treating all human blood and some bodily fluids as though they were known to be infectious for blood-borne viruses including HIV, HBV, and others (NIOSH, 2016).

Many have long expressed worry about the rising incidence of nosocomial infections in a variety of medical settings. Worldwide public health experts are increasingly concerned about the fact that patient blood and other fluids pose a growing risk to those who offer care for them (Wilson et al 2006, Hesse et al.2006, Gurubacharya et al., 2003). Therefore, healthcare professionals are increasingly accepting of the practice of universal precaution as a simple and efficient way to prevent hospital infection transmission (Hesse et al., 2006, Gurubacharya et al., 2003). This is because it safeguards against potential routine infections in places of employment. Despite the fact that universal precautions have been in place since 1987, there is substantial evidence of suboptimal adherence to them, particularly in developing nations. This is despite the fact that not following universal precautions increases the risk of nosocomial infection transmission (Janjua et al. 2007).

According to Nduka et al. (2012), there is evidence of inadequacies in the understanding and implementation of universal precautions, therefore health care workers should be brought up to speed on fundamental precautions. Worker protection against exposure to lower the frequency of work-related accidents and injuries through health worker training programmes and seminars is necessary to minimise the chances of contracting HIV, HBV, and other blood-borne infections while carrying out job activities. Their risks of contracting an occupational illness will be lessened as a result. In hospitals, staff clinics must also have an efficient reporting system (Ofili et al., 2004).

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge, Attitude and Implementation of Universal Precautionary Measures Among Nurses.

1.3 Statement of Problems

Investigation revealed that due to the nature of medical work, nurses are constantly in contact with patients, putting them at risk for both chronic illnesses and acute injuries. To stop illnesses from spreading, it's critical to take the recommended measures. Hospital to hospital in Palestine, the applicability of infection control protocols varies, despite their existence.

Furthermore, upon examination of MOH's Palestinian Health Information Centre papers, no data was found pertaining to nurses' awareness and use of standard precautionary (SP) measures or those associated with sharp injuries (SI) among healthcare professionals. Furthermore, there are no data about healthcare professionals who have SI or who become infected while on the job. The purpose of this study is to determine how important it is for nurses to know about SI-related and SP metrics. Additionally, it will draw attention to the extent of the Nurses' Knowledge, Attitude, and Application of Universal Precautionary Measures.

1.4 Aim and Objectives of Study

The aim of the study is to examine the Knowledge, Attitude and Implementation of Universal Precautionary Measures Among Nurses. In achieving this aim, the following specific objectives were laid out as follows:

1. To find out the correlation between knowledge and implementation of universal precautions among Nurses;
2. To assess the knowledge of Nurses in the study area on patient safety management activities;
3. To ascertain the attitude of Nurses towards universal precautionary measures practices; and
4. 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:

• Are Nurses informed about the importance of universal precautions in prevention of spread of blood borne pathogens?
• What is the attitude of Nurses towards universal precautionary measures practices?
• What is the knowledge of Nurses in the study area on patient safety management activities?
• What is the correlation between knowledge and implementation of universal precautions among Nurses?

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 significant factor inhibiting the utilization of universal precautionary measures among Nurses.
• H1: There is significant factor inhibiting the utilization of universal precautionary measures among Nurses.

Hypothesis Two

• H0: There is no correlation between knowledge and implementation of universal precautions among Nurses.
• H1: There is correlation between knowledge and implementation of universal precautions among Nurses.

1.7 Significance of Study

The research findings will be useful to medical professionals in general and nurses in particular. Nurses are the largest occupational group in any healthcare company. They frequently come into contact with body fluids, including blood, due to their line of work. Two equally challenging obstacles face nurses across the world: the risk of exposure to health hazards and the possibility of causing iatrogenic illnesses in patients.

Furthermore, Nurses may prevent severe work risks by employing basic universal precautions, and their understanding of blood-borne illness prevention can give them confidence while caring for patients with HIV and HBV.

Finally, this study will be extremely helpful to other researchers who want to learn more regarding it, and non-researchers can utilize it to further their own research accomplishments. This research advances our understanding and may function as a model for future investigations.

1.8 Scope of Study

The scope of the research is focused on the Knowledge, Attitude and Implementation of Universal Precautionary Measures Among Nurses. The study area selected in the course of this research is the Madonna Medical Centre Aguneze located at Ahiazu Mbaise Local Government Area of Imo State.