Impact of the Knowledge, Attitude, and Practice among Health Workers toward Standard Precautions in Omdurman teaching hospital 2023

Impact of the Knowledge, Attitude, and Practice among Health Workers toward Standard Precautions in Omdurman Teaching Hospital 2023

¹Wathba Garelnabi Abdelrahim Safi.²Manal Bilal.Mohamed .³ Fathia Komi Koko Ali ⁴Nour Alhuda Mohamed. ⁵Nagwa Mansour Gamar Elmazal.⁶Anwer Elsir Mahgoub Sid ahmed.⁷ Hind khaled Altrifee hamad ⁸Aisha Ibrahim Mohmmed  Osman.⁹ Gamila Mohamed Hamid .¹⁰Rowa Hassan Alzubeir ABUALAMA.¹¹Wegdan Adam Ahmed

¹Master of science in medical surgical nursing/ phd candidate Uof Kh/ lecturer in medical nursing department , faculty of nursing science, UOFK,

²Associate professor medical nursing Omdurman Islamic University. Medical nursing Department

³Assistant Professor Department of Medical Surgical Nursing, Faculty of Nursing Sciences, University of Bahri, Khartoum, Sudan

⁴Assistant Professor Department of Medical Surgical Nursing, Faculty of Nursing Sciences, University of Bahri, Khartoum,

⁵Assistant Professor, Department of Medical Nursing, Faculty of Nursing Sciences, AL-Safwaa College of Science and Technology.

⁶ Lecturer. Batterjee Medical Colleges –Jeddah Critical Nursing

⁷lectuter University of Khartoum. Community Health Nursing

⁸ lecturer University of Bhary ,Collage of Nursing Sciences. Medical nursing.

⁹ Assisstant professor. Medical surgical nursing university of Kordofan  

¹⁰ lecturer Medical Surgical nursing Omdurman Islamic university.Hemodialysis department Military hospital Khamis Mushayt.

¹¹ lecturer .edical surgical nursing Alneelain University

DOI: https://dx.doi.org/10.47772/IJRISS.2025.908000592

Received: 18 August 2025; Accepted: 25 August 2025; Published: 23 September 2025

ABSTRACT

The objective was to assess the knowledge level, attitude, and practice of health care workers in Omdurman teaching hospital towards standard precautions, and to identify the related factors. Furthermore, it was attempted to identify the proportion of having the experience of needle stick injuries (NSIs) and associated factors among participants.

Methods

This exploratory cross-sectional hospital-based study was conducted to assess the knowledge, attitude, and practice of participants regarding standard precautions in the Omdurman Teaching Hospital. The study population .Health care workers who include Doctors, Nurses, lab technicians, and waste handlers .Inclusion criteria: All the above populations, both male and female. Accept to participate in the study Exclusion criteria: Those who are not dealing directly with   patient care. The questionnaire included (22) question related   knowledge items, (21) practice items, and (14) attitude items. Based on the mean score of each category, responses were grouped Good knowledge 90% -100.Fair knowledge 50%-70% Poor knowledge less than    50%.same score for attitude and practice. Using p value .000 as significant correlation.

Results                                    

The mean age of the participants 1.5286        SD.50008, and 05)37.5%) of them were female 57.5% of the staff had good   level of correct knowledge 236(84.3%) had a fair knowledge while fair  attitude 270(99.6%) and 140(50%)hand  fair practice towards standard precautions. There is significant correlation of knowledge attitude and practice with occupation received training program regarding infection control and years of service   respectively

Conclusion

The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure.

Keywords: Knowledge, Attitude, and Practice, Health Workers, Standard Precautions, Omdurman teaching hospital 2023

INTRODUCTION AND BACKGROUND

Healthcare workers (HCWs) play an important role in providing prevention, diagnosis, treatment, and care to people in diverse healthcare settings. According to the World Health Organization (WHO), HCWs are all people who are involved in activities that aim at enhancing health, include those who provide health services such as doctors, nurses, laboratory technicians, pharmacists, and those providing health management and supporting services such waste handlers (WHO.2020).

Hospitals and other health care setting described as risk area for acquiring infections for health care workers (HCWs) worldwide due to the work environment of Health care workers (can be described as potential risk zone due to numerous hazards endemic to the environment .Infection is one of the most important problems in health care services worldwide(David vid OM, Fauria O. (2010) .Health care workers who prone to hospital infections must know the guide line of universal standard precautions guideline so that can protect themselves from hospital infection like blood -borne infections. (Bennett G and Mansell I. (2014).  Which acquired by HCWs during clinical and laboratory services such as HIV, HBV, HCV have remained a major issue worldwide, particularly in low income countries where there is high morbidity and mortality associated with such infections. Some of these infectious diseases like HIV and HCV have no available vaccination. (Sadoh WE, Fawole AO, et al (2006)

In any healthcare setting, standard precautions are the basic procedures used to prevent the spread of infectious agents during interactions between healthcare personnel and patients. These precautions include preventing infections from spreading from patients to healthcare personnel or from contaminated environmental surfaces when there is a possibility of coming into contact with bodily secretions. Every healthcare professional must use this for every patient interaction

Belal, S., Ahmed, S et al (2020). A successful Infection Prevention and Control (IPAC) plan must be initiated and implemented in any healthcare facility before an evaluation of the knowledge, attitude, and practice (KAP) of standard precautions by healthcare personnel can be conducted. According to their professional group and level of experience, among other things, HCW exhibit variable KAP of standard precautions, according to numerous studies. Improved standard precaution compliance has been linked to increased professional experience, standard precaution knowledge and training, and high risk perception among health professionals. The majority of studies from around the world have shown that healthcare workers are more likely to follow standard precautions

Okechukwu EF et al (2012).Therefore this study aimed to assess knowledge, attitude and practice of health care workers in Omdurman teaching hospital

METHODS

This exploratory cross-sectional hospital-based study was conducted to assess the knowledge, attitude, and practice of participants regarding standard precautions in the Omdurman Teaching Hospital.

Study area

The study was carried out in the Omdurman Teaching Hospital

Study period: data were collected in the period from April to May 2025

Study population

Health care workers who include Doctors, Nurses, lab technicians, and waste handlers

Inclusion criteria

All the above populations, both male and female

 Accept to participate in the study

Exclusion criteria

Those who are not dealing directly with   patient care

Data collection tools

A constructed questionnaire formulated according to an IDI guide and an observation      Manual. Content analysis was used for the IDIs. (WHO(2010) which consists of four parts: the first part about social data (age, gender, occupation, years of service, and whether vaccinated or not, and whether receiving a training program regarding standard Precautions. The second part, 22 questions regarding basic content  and concepts of SP, with 3 possible answers of ‘yes’, ‘no’, and I don’t know a correct answer were scored 1, while a wrong or incorrect answer was scored 0. The maximum score was 22. The respondents’ knowledge was graded as poor, fair, and good based on their score. <50% was graded as poor, 50%-70% was graded as fair while 90% -100%was graded as good. Part 3 used 14 questions to assess attitude response regarding SP 3 possible answers of ‘agree’, ‘neutral’, and disagree using a Likert scale. A Likert Scale range of 1-3 was used, with

1= disagree, 2= disagree, 3=neutral. The maximum score was 14. The respondents’ attitude was graded as poor, fair, or good based on their score. <50% was graded as poor, 50%-70% was graded as fair while 90% -100% was graded as good.  Part four used 21questions in their practice responses regarding SP. The maximum score was 21. 3 possible answers of ‘yes’, ‘no’, and I don’t know a correct answer were scored 1, while a wrong or incorrect answer was scored 0; the maximum score was 21. The respondents’ practice was graded as poor, fair, or good based on their score. <50% was graded as poor, 50%-70% was graded as fair, while 90% -100% was graded as good  practice of the Standard

The significance level was set at p< 0.05 and a 95% confidence level to correlate the association between their knowledge, attitude, and practice, and also to measure the correlation between their knowledge, attitude, and practice with their demographic data.

Data analysis:

The data were analyzed using SPSS VERSION 26. Descriptive statistics, including frequency, percentage, mean, and standard deviation (SD), were performed to describe the characteristics of the study sample. For inferential statistics using bivariate analysis, the Chi-square test is used to find the correlation between knowledge, attitude, and practice with their social data characteristics. P-value. .000 As significant.

Ethical approval:

For ethical approval, the researcher obtained it from the director of Omdurman Teaching Hospital, and verbal consent was also obtained from participants after explaining to them the goal of the study and that there was no hazard for them. And participation in the study was completely voluntary.

RESULTS

Table (1): Shows that 50% of the studied health care workers age was between 30 – 39 years old with a mean age and SD1.5286.5000 8,while175 (62.5%)of them were males and

186(66.4%) were married. Most of them were nurses which represent 113(40.4%).laboratory technician 65(23.2%), doctors 59(21.1%) and the rest were waste handlers

191 (68.2%) their occupation service 5-10 years of them had less than 5 years of experience. Finally, half of them receiving training program regard standard precaution and received total dose of hepatitis vaccine 161(57.5%), 165(58.9%) respectively

 Table (2):

Concerning the knowledge regard SP 194(69.3%) they answer by yes for statement hospital-acquired infection can be transmitted by medical equipment such as syringes, needles, catheters, stethoscopes, thermometers, etc., majority of the

HCWs agreed that 182(65%) report with no to the statement Nosocomial infection is the patient’s infection from home. Also they knew Washing your hands with soap or an alcohol-based antiseptic decreases the risk of transmission of hospital-acquired pathogens which is 229(81.8%), on other hand 255(91.1%) knew the use of an alcohol-based antiseptic for hand hygiene is as effective as soap and water if hands are not visibly dirty while,269(96.1%) said If my hands are not visibly dirty, there is no need to wash my hands before patient contact, half of them 135(48.2%) said  no need to wash hands before doing procedures that do not involve bodily fluids. Also, majority of the HCWs230 (82.1%)  knew with hospital-acquired infection guidelines, also knew and realize that all personnel and patients are possibly infectious 245(87.5%) and  how to prevent and control hospital-acquired infections 262(93.6%)  finally their mean knowledge were fair regard SP  236(84.3%) and only 44(15.7%)had good knowledge.

Table (3):concerning their attitude towards SP 240(85.7%) agreed that SP can prevent the spread of infectious diseases, while 250(89.3%) disagreed that SP are not really necessary in hospitals .Concerning wearing double hand gloves , Wearing googles/face mask that ,and Wearing gowns/ aprons, Wearing boot/wear 238(85%), 241(86.1%), 226(80%),  253(90.4%) they agreed respectively . their mean attitude were fair regard SP  279( 99.6%) and only 44(15.7%) and one had good knowledge 1 (.4%)

Table (4) : concerning their practice regard SP, all of them said Washing hands before  and after caring for a wound  and all Supplies necessary for adherence to hand hygiene (e.g., soap, water, paper towels, alcohol-based hand rub) are readily accessible in patient care areas, all of them also said screening of patients is being done to detect colonization even if no evidence of infection, regard hand hygiene 212(75.7%) Washing hands before patient contact, 248(88.6%) Washing hands after Patient Contact, while 223(79.6%) washing hands after removing gloves, 260(92.9%) said yes   infection prevention and control program provides infection prevention education to patients, family members, but 216 (77.1%) said   personal protective equipment is not   always accessible, finally their mean practice toward SP were fair regard SP 139(49.6%) had good practice and the half of them reported fair practice.

Table (5) revealed a statistical significant relation between nurses’ level of knowledge, attitude and practice to standard precautions and their socio-demographic characteristics (years of service, occupation, received training program regarding infection control)

Table (1) sociodemographic data                                                              (no=280)

Table (2) Knowledge of Standard Precautions among healthcare workers   (no=280)

Table (3) attitude of Standard Precautions among healthcare workers    (no=280)

Table (4) practice of Standard Precautions among healthcare workers     (no-280)

Table (5) Correlation between knowledge, attitude and practice   level among health staff and their social data

DISCUSSION

Most of the respondents knew that HIV and HBV are transmitted by NSSI. Studies conducted in Ethiopia (Kasse T, ET AL(2024).( Malaysia(Cheah .(2024),reported similar findings. However, a lesser proportion of the HCWs knew that HCV is transmitted by NSSIs. The findings indicate that HCWs were well informed about HIV and HBV but ignorant about HCV which could lead to a risk for themselves and their patients. The poor knowledge regard HCV is blood borne can be   transmitted to patients through wrong and incorrect information from HCWs especially with blood donation and disease transmission our participants repot good that prevent them from acquiring theses disease.  A report from the Canadian Centre for Occupational Health and Safety (CCOHS) [Canadian Centre for Occupational Health and S a f e t y ( C C O H S ) reported that the risk of transmitting HCV through NSI ranges from 0.1- 7%. It is also known that the risk of contracting HBV can be significantly reduced if HCWs receive HBV immunization but no such immunization presently exists for prevention of  HCV. This calls for more awareness in order to increase HCWs knowledge of HCV and hence reduce its transmission. Majority of the HCWs 178(63.6%) knew that SP is applicable to all patients irrespective of their diagnostic status. This finding is comparable to similar studies in Nigeria (Okechukwu EF et al (2012)

.and Ugand. (Gordon M, Afayo R. (2007). but higher than the  findings in a study in North East Nigeria(Abdulraheem IS, ET AL(2012).        Once more, the demonstrated favorable attitude  279(99.6%) may be the result of their trust in standard precaution (SP), as the SP policy is a solid package intended to stop the spread of nosocomial diseases and guarantee the safety of HCWs while at work. Wearing of PPE was optimally practiced, which is positive because it is essential for infection management in addition to being a key element of SP. This is consistent with a prior study   (Punia S., et al. (2014) It might be assumed that the respondents’ great familiarity with standard precautions prompted them to view them favorably.

In this study, the respondents 238(85%) have a good attitude toward wearing gloves, a mask, aprons, and boots although in an  another study, only 34% of respondents reported wearing gloves and coveralls on a regular basis. The primary explanations for this poor PPE use included sporadic access to PPEs, a lack of time to wear them, and the fact that doing so interferes with clinical duties [Mukherjee S., et al(2012).. This demonstrated the need for management and HCWs to work together as closely as possible to implement Standard precaution completely which is inconsistently with our participants report. Secondly, the management should establish an enabling atmosphere by routinely providing PPEs and other necessary resources and supervising their use, while the HCWs should guarantee complete compliance by adhering to established protocols and constantly utilizing resources.

This study shows that standard precaution is highly practiced in our participants. Over 261(93.2%)of the respondents asserted that whenever there is spill of blood or body fluid, such is cleaned immediately with either of antiseptic, use of soap and water

This is a better standard precaution as detaching and capping after use 229(81.8%) may dispose a health worker to infections. This practice is in line with research conducted by (Tobin EA., et al. (201320-27).where respondents some of the respondents confirmed that they do not recap needle after use and detach needles from syringe after use

CONCLUSION

The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure

RECOMMENDATION

In order to promote good standard precaution and mitigate the risk of hospital acquired infections, it is necessary for health authorities tot make it compulsory to establish IPAC (infection control and prevention) committees in all hospitals. Such policies should also outline measures that ensure that IPAC resources are made routinely available and that knowledge and practice of standard precautions are improved through regular IPAC training of hospital staff, with special emphasis on newly qualified health workers such as house officers and staff nurses.

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