CHAPTER ONE

                                                            INTRODUCTION

1.1 Background of study

Healthcare workers (HCWs) are at direct risk of exposure to blood and other body fluids and aerosols during the course of their job. Consequently, they are at risk of infection of blood borne viruses including hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Occupational exposure to blood can result from percutaneous (needle stick or other sharps injury) and muco-cutaneous injury (splash of blood or other body fluids into the eyes, nose, or mouth), or blood contact with non-intact skin. Needle stick injury (NSI) is the most common form of occupational exposure to blood which results in transmission of blood borne infection (Baker, 2013). WHO (2008)  reports that the global prevalence of hospital acquired infections among the healthcare workers rise by 12% annually and continue to press on a huge burden in public health arena. Despite this worrying trend, relevant literature reports that, compliance with Standard Precautions is low among healthcare workers, leading to high rates of exposure to microorganisms among health care workers via several modes (needle sticks, hand contamination with blood, exposure to air-transmitted microorganisms).

Nurses are at risk of acquiring and transmitting hospital acquired infections in the course of delivering the nursing care. Thousands of nurses are being exposed to blood, body fluids that contain blood products, used needles, scalpels and other sharps objects in hospital wards (obstetrics, general, emergency), clinics and theatres. In health care services, nurses are particularly at risk of being exposed to blood and sharp devices because they perform more bedside nursing care and procedures than any other health care worker (Dummy, 2010). Measures to prevent the transmission of these infectious microorganisms are therefore a significant component of nursing care. This prevention is achieved through the practice of infection prevention, including the implementation of infection prevention standard precautions (Amadu  &Saka, (2012).

Preventing and controlling infection in health care facilities involves two levels of approach, standard precautions and additional (transmission-based) precautions. Standard precautions are taken to reduce the risk of transmitting blood-borne microorganisms and other pathogens from both recognized and unrecognized sources. These precautions are used as a minimum, in the care of all patients in health care facilities and settings, regardless of their diagnoses or presumed infection status. SPs guide health care workers (HCWs) to practice regular hand hygiene , use personal protective equipment (PPE) like gloves, masks, eye protection, face shield and gowns when contact with mucus membranes , blood and body fluids of patients is anticipated, correct disposal of sharps and other clinical waste.

 Major reported factors that affect compliance with standard precautions include but not limited to lack of understanding and knowledge among healthcare workers on SPs (Fayaz et al, 2014; Sreedharan  et al, 2011), shortage of time to implement the precautions (work overload),because there are limited staffs,  limited resources, uncomfortable equipment, skin irritation, forgetfulness, distance from the necessary facilities, and insufficient support from management in creating a facilitating work environment (Efstathiou et al, 2011). 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 standard precautions (Felix, et al, 2013). In view of this, the study will be looking at the compliance level and factors affecting Nurses and Midwives compliance to Standard Precaution in a government owned hospital in Ogun State (Olabisi Onabanjo Teaching Hospital).

1.2       Statement of Problem

Occupational exposure to blood or other body fluids in healthcare facilities constitutes a significant risk of transmission of HIV and other blood borne pathogens to healthcare workers (nurses). HIV/AIDs in particular is a major threat in the workplace (ILO, 2011).  The prevalence of Hospital Acquired Infections (HAIs) has increased globally especially among the health-workers (Nurses and mid wives) and so, emphasis on strict implementation and compliance with standard precautions among health care workers is emphasized. Compliance with standard precautions among healthcare professionals was reported to be inadequate with regard to eye protection, avoidance of needle recapping, glove use when required, washing hands before and after patient contact, use of facemasks, and avoidance of a used needle that is disassembled from a syringe and in implementation of precautions for all patients (Jawad et al, 2013; McGaw et al, 2012 and Alice et al, 2013).

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