ABSTRACT
Standard precautions are
guidelines recommended by the Centre for Disease Control for reducing the risk
of transmission of blood borne pathogens in the clinical setting. Hospitals
being one of the most hazardous places to work predispose health workers,
especially medical laboratory scientists, to the risk of blood borne infections
and sometimes death. This study aims to assess three major factors that
determine adherence to standard precautions amongst medical laboratory
scientists and the factors are information, motivation and behavioural skill in
order to promote adherence which has been suboptimal even though the risk of
non adherence is high.
The study utilized a cross
sectional design and random sampling method to identify 425 medical laboratory
scientists working in both public and
private hospitals in Lagos State Nigeria and the information motivation and
behavioural skill that predicts adherence to standard precautions were assessed
using a validated questionnaire. Results were analyzed using SPSS 21.0.
Regression analysis was used to measure the relationship between the three variables
information, motivation, behavioural skill and adherence while their percentage
was also measured.
Four hundred and twenty five
participants were enrolled for this study following securing their consent to
participate, Out of 425 participant recruited 41.6% of them
were between the ages of 30-39 and 17 (4.0%) of them were between the ages of
50 and above. Also, 287 (67.5%) of them appeared to be civil servants. Moreso,
232 (54.6%) of them were married and 356 (83.8%) of them were Christians. It
also appeared that 226 (53.2%) of them had years of practice of between 1-5
years. 232 (54.6%) of them were Yoruba.
The results showed that
medical laboratory scientists were well informed on standard precaution and
their behavioural skill was also high as well with a percentage of 91.5%. The
motivation was slightly above average with a percentage of 55.5% and the
overall adherence was 61.4% which was still sub optimal .The regression
analysis showed that all the three variables had a significant effect on
adherence with p value p<0.005 but behavioural skill and information had a
more predictive effect on adherence (R2=0.072, 0.072) and motivation
(R2=0.012)
In conclusion, the overall
information and behavioural skill was good and the productive effect on
adherence was significant but the motivation was low there is need to increase
motivation amongst medical laboratory scientist as this would significantly
improve overall adherence to standard precautions thereby preventing the spread
of infection from patients to the medical laboratory scientist and from the
medical laboratory scientist to the community. Adherence to standard
precautions must be made compulsory in all laboratories at all times as this is
the most effective way of reducing the risk of blood born infections.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Standard Precautions are guidelines
recommended by the centre for disease control and prevention (CDC) 2015 for
reducing the risk of transmission of blood borne and other pathogens in the
clinical setting. Standard Precautions apply to blood and body fluids and it
encompasses all the major features of universal precautions and designed to
reduce the risk of transmission of microorganisms from both known and unknown
sources. Standard Precautions refers to a standard method of infection control
in which all human blood and body fluid specimen are treated as if known to be
infectious for HBV, HCV, HIV, and other pathogens.
Hospitals
are the most hazardous places to work. With the US recording 253,700
work-related injuries and illnesses which is 6.8 work related injuries to every
100 full time employee. Medical laboratory professionals are also a major part
of the health workers who are at significant risk of exposure to blood borne
pathogen from blood and body fluids emerging from occupational risk. Studies by
Janjua et al., (2007) in Pakistan to
predict reasons for non adherence to Standard Precautions showed low knowledge
and poor practise of Standard Precautions. Another study by Aluko et al., (2012) on safety amongst health
workers in Osun State, Nigeria revealed knowledge was at variance with practice.
Therefore, there is a need to assess the information medical laboratory
scientists have and how to promote adherence to Standard Precautions.
Outbreak
of infection is a major problem in public health; therefore public health
focuses on three major levels of controlling and ameliorating outbreak of
infection, these levels includes prevention, treatment and rehabilitation.
Adherence therefore falls under the first level of infection control which
helps to prevent transfer of infection from patients to health care workers and
from healthcare workers to the community.
According
to the American Society for Clinical Laboratory Science, Medical laboratory
professionals are a group of healthcare scientists who provide laboratory
information from analysing patients’ blood urine, tissue or other body
specimen, the results derived from their analysis plays a very important role
in the diagnosis and treatment of the patient as well as in disease monitoring
and prevention.In the analysis of blood and body specimen medical laboratory
professional face a lot of risk, and this could lead to infection and even
death. There is therefore need for adherence to Standard Precautions in order
to prevent infections and death.
The
general objective is to explore the determinants of adherence to standard
precautions for prevention of blood borne infections among medical laboratory
scientists in Lagos State. The specific objectives are to:
1
assess the level of
information medical laboratory
professionals have that can promote
adherence to standard precautions;
2
identify the nature and
level of motivation that drive adherence of medical laboratory professionals to
standard precautions to prevent blood borne infections during practice;
3
identify behavioural skills
that promote adherence to standard precautions by medical lab professionals;
4
assess how Information,
Motivation, and behavioural skill influence compliance and adherence to
standard precautions, and
5
assess self reported
adherence to standard precautions.
The
following research questions emerged from the background of the study that the
study requires to address and include;h
1. What
is the level of knowledge medical laboratory scientists have regarding Standard
Precautions to promote adherence
2. What
motivates their adherence to Standard Precautions?
3. What
behavioural skills does medical laboratory scientists have that promotes
adherence to Standard Precautions?
4. How
does information motivation and their behavioural skill influence adherence to
Standard Precautions?
H1: There will be a significant relationship
between Information and adherence to standard precautions.
H2: There will be a significant relationship
between motivation and adherence to standard precautions.
H3: There will be a significant relationship
between behavioural skill and adherence to standard precautions.
H4: There
will be a significant relationship between information, motivation, behavioural
skill andadherence to standard precautions.
Health
Care personnel, particularly Medical Laboratory Scientists, constitute a
subgroup of health care providers who constantly are exposed to
occupational-risk of many blood borne infections because of direct contact with
blood and body fluids during the conduct of their professional clinical
practice. The occupational-risk faced by
them is of serious concern given their inadequate implementation of standard
precautions for prevention of blood borne infections skills. Although, the subject of this study has been
given wide attention in the literature, however the problem persists,
particularly among this category of health care providers in Nigeria.
Accidental exposure to blood borne pathogens is primary source of infections from
most common ones such as Hepatitis B, Hepatitis C and HIV.
Hepatitis
B and other blood borne diseases are important occupational hazard for health
care workers (HCW) [WHO]. In some studies, HCWs have been shown to have an up
to four-fold increased risk of acquiring HBV infection (Jha et al., 2012 and Ziraba et al., 2010). The
main risk factor to contract HBV infection for HCWs is direct contact with
infectious material, especially HBV-infected blood or via a needle stick injury
with HBV-contaminated body fluids (Pellissier
et al., 2012).Based on UNAIDS factsheet, as at November 2016 2.1
million people became newly infected with HIV in 2015 and there are
approximately 36.7millon people living with HIV. This data shows HIV is still a
major public health problem. .
According
to WHO factsheet (2016), between 130 and 150 million in the world have been
infected with HCV, with 4 million infection each year and there is currently no
vaccine for Hepatitis C. Despite the increase of incidence of these blood borne
disease adherence to Standard Precautions among health care workers is still of
major concern. Zaveri et al, (2012), in their research observed that the
knowledge, attitude, perception and compliance among laboratory technicians in
Ahmedabad were poor, also Izegbu et al, (2015) in Nigeria also showed poor
attitude perception and practise of Standard Precautions among workers in the
laboratories in Lagos. This study carried out wasn’t based on any behavioural
theory. This study would use the information motivation behavioural skill model
which has never been used before in the determinants of adherence to standard
precautions amongst medical laboratory scientists.
Many
studies have been conducted but most of which were not based on a conceptually
logically grounded behavioural theory. This study is therefore guided by a
model that would reveal the salient factors that determines adherence to
Standard Precautions among medical laboratory professionals. This study has a
number of distinguishing features that characterise it as innovative and
unique. The findings from this study would provide adequate information about
the information medical laboratory professionals have about Standard
Precautions. The study would uncover what motivates them to adhere and the behavioural
skills they need to adhere with Standard Precautions. This will go a long way
in revealing the determinants of adherence and in promoting adherence to
Standard Precautions and preventing hospital acquired infections and death
amongst medical laboratory professionals.
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Item Type: Postgraduate Material | Attribute: 54 pages | Chapters: 1-5
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