KNOWLEDGE AND PRACTICE OF INFECTION CONTROL AMONG MIDWIVES

1.1 Introduction

Infection control among midwives prevents or stops the spread of infections in healthcare settings. This site includes an overview of how infections spread, ways to prevent the spread of infections, and more detailed recommendations by type of healthcare setting (CDC, 2021).

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, Limitation of the study and Definition of technical terms.

1.2 Background of Study

Infection-related diseases are still the main cause of death in Nigeria, according to the 2013 health profile acquired by the World Health Organisation (WHO, 2013) statistics. The burden of disease in Nigeria includes HIV, TB, Malaria, other infectious diseases and respiratory infections. Expansion of the infection prevention and control movements occur due to the increase in infection occurrences in the country. This increase in infection-related disease’s impact the increase health financing in Nigeria with a government contribution to health care of 57.5% above the figures budgeted for (WHO, 2014).

Infectious patients are admitted into hospitals and therefore hospitals have become common settings for transmission of diseases. In hospitals, infected patients are a source of infection transmission to other patients, health care workers and visitors (Sydnor & Perl, 2011). Nosocomial infection, also known as hospital-acquired infections is one of the leading causes of death and has much economic cost due to increased hospitalization and prognosis (WHO, 2015). According to WHO (2010), Hospital acquired infection is defined as an infection occurring in a patient during the process of care within a health care facility which was not present or incubating at the time of admission. These infections are those occurring more than 48 to 72 hours after admission and within ten days after hospital discharge (Collins 2008:2). Due to the admission of patients with different organisms, the hospital environment has become saturated with highly virulent organisms, namely: Staphylococcus aureus, Streptococcus pyogenic, Escherichia coli, Pseudomonas aureginosa and Hepatitis viruses that survive in a hospital. These organisms cause diseases ranging from minor skin infections to life-threatening conditions such as sepsis (Sydnor, & Perl, 2011).

The Nigeria Ministry of Health has indicated that Ebola virus disease epidemic is a public health risk as neighbouring country are suffering from the diseases and therefore preparedness in infection prevention and control measures should be strengthened. Efficient knowledge, good attitude and best practices by nurses in infection prevention and control may contribute to decreasing in infection rate in the hospital.

The Nigeria policy on health has stipulates that the health care institution should provide a safe environment for the patients in their care. Hospital nurses form the backbone of infection prevention and control, therefore possibly, will either contribute to infection transmission or prevent and control infection. According to Damani (2012), the environment in which a patient is nursed must be planned to reduce the risk of transmission of infection. Infection prevention and control measures aim to protect the vulnerable people from acquiring an infection while receiving health care (Damani, 2012). Lack of knowledge, bad attitudes and poor practices amongst nurses in the prevention and control of infections can lead to hospital-acquired infections.

In clinical practice, the researcher has observed cases where nurses handle contaminated linen with bare hands, put needles in the patient’s mattress after giving injections, do not clean the stethoscope between patients and do not wash hands regularly in the clinical environment. Poor infection prevention and control practices among nurses increase the rates of hospital-acquired infections.

Hand hygiene is the single most important intervention to prevent transmission of infection and should be a quality standard in all health institutions. An attitude of not washing hands among individuals involved in the provision of health care can increase the rate of hospital-acquired infections. In a study that was conducted in India, where Nair, Hanumantappa, Hinemath,Siraj and Raghunath (2013:3) assessed knowledge, attitude and practices of hand hygiene among medical and nursing students at a tertiary health care centre, the majority of students had poor knowledge with regard to hand hygiene.

The World Health Organisation (2016) has indicated that surgical site infections at this particular tertiary hospital in Nigeria are a research priority as there was an increase in wound infections of those people who had surgery at this hospital and this coincides with the researcher’s experiences and proposal. Therefore, this study determined the knowledge, attitude and practices of nurses in infection prevention and control within a tertiary hospital in Nigeria.

Therefore, in Nibo, Awka South in Anambra State where the research was carried out, the activities that was conducted is to know the Knowledge and Practice of Infection Control among Midwives.

1.3 Statement of the Problem

Investigation revealed the research problem which is an area of concern in the gap of knowledge base needed for midwives practice (Burns & Grove 2011:146). The researcher has observed that nurses do not apply infection prevention and control measures in the hospital setting which is required to ensure patient safety.

Lack of knowledge among nurses can increase the rate of hospital-acquired infections, and lack of knowledge, attitude and practices in infection prevention and control contribute to high rates of hospital-acquired infections (Jain, Dogra, Mishra, Thaku and loomba, 2012 & Hayeh and Esena, 2013). Uncontrollable nosocomial infection contributes to prolonged stay, morbidity and mortality which put stress on health care economics of the country (Mishta, Banerjee & Gosain, 2014).

1.4 Aim and Objectives of Study

The aim of the study is to determine the knowledge, attitudes and practices of midwives regarding infection prevention and control in Nibo, Awka South in Anambra State. In achieving this aim, the following specific objectives were laid out as follows:

1. To determine the knowledge of midwifes in infection prevention and control in Nibo.
2. To examine the attitude of midwife in infection prevention and control in Nibo.
3. To assess the practices of midwife in infection prevention and control in Nibo
4. To make recommendations to the risk programme and policies in Nibo

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:

• Do midwives in Nibo have knowledge of infection control?
• Do midwives in Nibo practice of infection control precautionary measure for health safety?
• What is the level of knowledge, attitudes and practices of health care workers in infection prevention and control in Nibo?
• What are the precautionary measures of infection control practiced by midwives?

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 association between knowledge of infection control and precautionary practice among midwives.
• H1: There is a significant association between knowledge of infection control and precautionary practice among midwives.

1.7 Significance of Study

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 this research is focused on the knowledge, attitudes and practices of midwives regarding infection prevention and control in Nibo, Awka South in Anambra State.

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. Establishment Policies:

   Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this research work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.

3. 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).

4. Lack of Initial Cooperation from Respondents:

   A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.