Background Of The Study
Infections and diseases is one of the most important problems in any work place worldwide. It constitutes one of the most important causes of morbidity and mortality associated with clinical, diagnostic and therapeutic procedures. Healthcare workers or employees in work places are at a high risk of injuries, infections and blood-borne pathogens as they perform their work activities. They are exposed to blood-borne infections by pathogens, sharp injuries and contacts. According to a World Health Organization (WHO) estimate, in year 2002, injuries resulted in over 16 000 occupational hazards worldwide. Recapping, disassembly, and inappropriate health and safety precautions increase the risk of injury. Developing countries where the prevalence of work-related injuries is very high, record the highest injuries too. Occupational injuries were also reported as the most common occupational health hazard in a Nigerian work place. Interventional measures have been proposed to minimize exposure of healthcare workers to infection/health hazards with the implementation of universal precautions as one of the strategies. In 1983, the United States Centre for Disease Control and Prevention (CDC) published a document that recommended occupational precautions during work hours. In 1987, the CDC recommended that regardless of workers level, occupational precautions must be strictly and consistently adhered to. These precautions include set of precautions devised to prevent transmission of all known air-borne pathogens, blood-borne pathogens and general work accident during the cause of their work. In 1996, the CDC included the universal precautions in a new prevention concept the so called “safety precautions.” The “safety precautions,” which are devised to be used for all workers or staff in workplaces regardless of their place of work, work level and status. The fact that “safety precautions” are recommended for all workers, regardless of their presumed work level, is important when handling work equipment and devices that are contaminated or suspected of contamination, and in situations of contact risk with contaminated surfaces. Safety precautions in work places include hand washing; use of barriers (e.g., gloves, gown, cap, mask); care with devices, equipment and clothing used during care; environmental control (e.g., surface processing protocols, health service waste handling); adequate discarding of sharp instruments including needles; and patient’s accommodation in accordance with requirement levels as an infection transmission source. Another important measure is adequate professional immunization, as this guarantees anticipated protection against immune-preventable diseases.
The level of practice of universal precautions by healthcare workers may differ from one type of worker to another. The differences in knowledge of universal precaution by healthcare workers may be influenced by their different type of training. Various studies carried out among different categories of healthcare workers found that exposure to contaminated surfaces, materials or injurious objects was approximately 9.3%. A similar study conducted in Ibadan found a higher exposure rate of 25.1%. Several factors ranging from personal to organizational causes were responsible for non-adherence to the basic principles of universal precautions among healthcare workers. Universal precaution awareness education has not been pronounced among healthcare workers, particularly in developing countries. According to the most recent guideline published by the Healthcare Infection Control Practices Advisory Committee (HICPAC) in 2007, it has been recommended to apply safety precautions for all people during working hours. These safety precautions include but not limited to hand hygiene, use of personal protective equipment, and instrument processing. In many studies, compliance with safety precautions among healthcare workers was reported to be inadequate with regard to eye and nose protection, glove use when required, and washing hands, use of face masks. According to the literature, major reported factors that affect compliance with safety precautions include but not limited to lack of understanding and knowledge among healthcare workers on occupational safety precautions, shortage of time to implement the precautions (work overload), limited resources, lack of proper training, uncomfortable equipment, skin irritation, forgetfulness, distance from the necessary facilities, and insufficient support from management in creating a facilitating work environment. Moreover, certain socio- demographic variables such as age, sex, job category, marital status, working site in the hospital and work experience were found to be associated with compliance with occupational safety precautions. Interventions tried in other countries to increase the compliance of healthcare workers with occupational safety and health precautions include but not limited to in-service training on occupational safety precautions beyond ordinary level, pre-service training by inclusion of occupational safety and health precautions in educational curricula, and availability of personal protective equipment.
1.2 Statement Of The Problem
The need for occupational safety or infection control in work places is borne out of the need to prevent work associated infections or hazards. Occupational hazards or infections can be defined as an infection or hazard occurring to a worker during the process of his/her work. It contributes to significant morbidity and mortality in both developed and resource poor countries. The prevalence of occupational hazards in developing countries is somewhat higher with up to 19% prevalence of occupational hazards or infections among workers. Even with the paucity of data in subSaharan Africa, occupational hazards or infections remain a major cause of preventable morbidity and mortality in developing countries where work infection rates are relatively higher due to poor occupational safety practices. To curtail this menace, it has become necessary to implement occupational safety, infection or hazard control measures so as to reduce morbidity and mortality that comes with the occupational hazards or infections. Safety guidelines with various components from evidence-based care have been outlined to ensure global safety among healthcare workers for effective occupational infection control especially in Nigeria where work related hazards or infection has been on the rise. In the light of the above, this study aims at ascertaining the occupational safety promotion practices of health care centres in Port Harcourt City, Rivers State.
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