Healthcare workers face occupational exposure to infection with blood-borne pathogens during the cause of their routine work in the wards, intensive care units, and emergency/trauma triage [2]. In 1996, the Centre for Disease Control and Prevention in the United States introduced guidelines, called standard precautions which summarize the strategies to be used to prevent transmission of micro-organisms in health care settings. Standard precautions replaced the previously used guidelines such as universal precautions (Introduced in 1985), and body substance isolation (Introduced in 1987) these previously used guidelines had varied in terms of strategies used and the condition to which they are applied; whereas standard precautions recommend strategies to be used on all patients at all times in all settings [3].

Standard precautions are meant to reduce the risk of transmission of blood-borne and other pathogens from both recognized and unrecognized sources (Use of hand hygiene, use of personal protective equipment [4]). Strategies included in standard precautions are: appropriate hand washing, appropriate use of gloves to disrupt the spread of micro-organisms from one patient to another by healthcare workers contaminated hands, use of gowns to disrupt the transmission of microorganism carried by health care workers uniforms, appropriate cleaning and disinfection of patient care equipment and environment surfaces to reduce transmission by the indirect contact route, use of facial protections for example mask and respirator to reduce exposure of health workers to infectious agents spread by droplet or air-borne route, management of used needles and other sharp objects to prevent percutaneous injury [5,6].

In order to stop the spread of illnesses, standard precautions are essential procedures used in healthcare environments. The safety of healthcare personnel and patients depends on these precautions, which include hand cleanliness, the use of personal protective equipment (PPE), and the correct disposal of trash and sharps. The degree to which healthcare personnel are aware of and feel inclined to take these precautions has a substantial impact on their compliance and adherence, which in turn impacts the general efficacy of infection control procedures in healthcare institutions [6].

Studies have shown that healthcare professionals around the world have differing degrees of compliance and expertise. For example, healthcare personnel at Da Nang Hospital in Vietnam had a high degree of accurate information and favorable attitudes about common preventive measures, with differences according to years of experience, professional credentials, and employment [3]. In a similar vein, healthcare personnel at Pakistan's Bahria International Hospital in Lahore demonstrated adequate understanding of conventional measures but inadequate adherence to them [7].

Abuduxike [8] found that healthcare staff in Northern Cyprus exhibited inadequate adherence to conventional precautions. Specifically, only 57.5% of them shown satisfactory knowledge, 37.3% had satisfactory attitudes, and 30.9% had satisfactory practices. These results emphasize the necessity of ongoing training and education initiatives to improve adherence and guarantee efficient infection control. Additionally, evaluations of universal precaution programs' effectiveness have been conducted in a variety of contexts. The application of these systems at Wahidin Sudirohusodo Hospital in Indonesia shown a high-performance rate of 94.4%; nevertheless, several tasks, like sterilization and appropriate disposal of needles, needed to be improved [9].

Moreover, a study done in the University of Benin Teaching Hospital in Nigeria employed a range of healthcare professionals, with ward attendants exhibiting worse knowledge and compliance than physicians, nurses, and laboratory technologists [10]. Furthermore, a study conducted by Chaudhuri, Baidya, and Gambhir [11] on the majority of the nurses i.e. 86.3% were aware of universal precautions. 61.8% of the nurses mentioned wearing gloves for contact with body fluid, non-intact skin, and mucous membranes as a measure that constituted universal precaution. Moreover, Goje et al, (2017) reported the need to emphasize how crucial it is to design training programs that are specifically designed to fill in knowledge and practice gaps in northern Nigeria.

The hospital is not just only a place where sick people recover from their illnesses, but also where the healthy get infected [12]. Worldwide, infection has been noted as a major problem in healthcare settings [13]. Worldwide, infection has been noted as a major problem in healthcare settings [13].

Due to the annual outbreaks of communicable disease and the high cases reported from northern Nigeria, it is imperative to ensure medical staff have adequate knowledge of standard precautionary measures. This will aid in curtailing hospital aided infections.

STATEMENT OF THE PROBLEM

Healthcare workers are at risk of occupational hazards as they perform their clinical activities in the hospital. The occupational health of the healthcare workforce of about 35 million people representing about 12% of the working population has been neglected. The Occupational Safety and Health Administration estimates that 5.6 million Health Care Workers worldwide who handle sharp devices are at risk of exposure to infectious diseases. WHO (2021).

Due to the increasing risk of exposure of health care workers (HCW) to diseases and infections coupled with the need to mitigate the trend of high levels of communicable disease outbreak in northern Nigeria, this study will aim investigate the knowledge, attitude, and practice of standard precaution measures healthcare workers of State Specialist Hospital, Potiskum.

The objective of the study

1. To assess the knowledge of Standard Precautions among health workers.
2. To determine the Attitude of healthcare workers on standard precaution measures

The Research Questions

1. What is the level of knowledge of standard precautions among health workers?
2. What is the attitude of healthcare workers towards standard precautions?

METHODOLOGY OF THE STUDY

Study Design: A cross-sectional descriptive survey design was used for the study. The design according to Akpabio & Ebong, 2010, can be used to investigate events as they occur in their natural settings therefore, deemed appropriate for investigating healthcare workers knowledge, attitude, and practice of standard precaution in State Specialist Hospital Potiskum. The Health workers were clustered based on their profession, the second-stage respondents were randomly selected from each profession. However, where the cluster has few Health care Workers all of them were selected.

Target Population: the target population is Health workers in State Specialist Hospital Potiskum. According to the Facility Nominal roll (2023) are: 100 Nurses/Midwives, 12 Medical Officers, 16 Laboratory staff, 10 Pharmacist Health workers, and 102 Unskilled thus the facility has 240 Health workers. The target population is 240 Health Workers. According to Oyefubo (2018), when the population is in the hundreds (100) 40% should be used, and if the population is in the thousand (1000)10% should be used. Therefore, the Sampling size is 40% of the target population which is 96 Health workers.

Sampling Technique: Since the target population was made up of professional clusters, stratified random sampling techniques were adopted. To ensure coverage of all the professionals, each Professional cluster was given 40% of the sample size (Table 1).

Instrumentation: The Instrument was constructed Questionnaire that has three sections: Section A - Biodata, Section B - Knowledge of standard precaution among Health workers, and Section C - Attitude on standard precaution among Health workers.

Validity: The Validity of the instrument was done by peers of the researcher and experts in the field to ensure face and content validity and to ensure it measures what is supposed to measure.

Reliability: The reliability test was done through the Test-retest method to ascertain the consistency of the tool. Also, the Cronbach’s Alpha Statistic was used to measure the reliability of the questionnaire. (The value of the Statistic is multiplied by 100 and it should not be less than 70% (0.07) for the questionnaire to be considered reliable) The instrument was found reliable as it scored 0.07 points.

Data Collection: Data were collected from the respondents personally by the researcher and coded.

Delimitation: Non-return of all the questionnaires.

Data Analysis: The Statistical Package for the Social Sciences (SPSS) Software version 20 was used for the data analysis after the responses that were obtained using the Data collecting Instrument (Questionnaire) were coded. The knowledge score of standard precautions for each respondent was calculated by computing the average raw scores of the eight (8) items, ranging from 1 to 2. Each correct response was scored 2 and wrong 1. A total knowledge score of less than 50% is considered poor knowledge while a knowledge score of greater than 50% is considered good knowledge.

On the Attitude of healthcare workers towards standard precautions, the mean score for the Likert scale was used. The response was rated according to the five-point Likert scale (i.e. 5 = Strongly Agree, 4 = Agree, 3=Neutral, 2= Disagree and 1 = Strongly Disagree). The average score was calculated for the nine (9) items each which ranged from 1 to 5 for Attitude. A mean score of 3.00 is considered to be a good attitude and below 3.00 is considered a bad attitude. Descriptive statistics (Means and graphs) were used to summarize the results for easy understanding and comparison.

Results (Table 2)

Comment: The Cronbach’s Alpha Statistic is used to measure the reliability of a questionnaire. The value of the Statistic is multiplied by 100 and it should not be less than 70% (0.7). The above gave 0.07 and hence, the questionnaire is reliable (Table 3).

The result is presented based on the research questions below:

RQ 1. What is the level of knowledge on standard precautions among healthcare workers? (Table 4)

Comment: Table 4 shows the mean level of knowledge of standard precaution measures among healthcare workers on a scale of 1-2. The result shows that the healthcare workers have a mean knowledge of 1.94, which is very high.

Comment: Table 5 shows the mean level of knowledge of standard precaution measures among healthcare workers, based on designation, on a scale of 1-2. The result shows that Doctors both male and female healthcare workers have a mean knowledge of 1.975, followed by Nurses with a mean of 1.9719. Laboratory scientists and Health assistants have the means 1.85 and 1.864, which are relatively lower than those of other designations (Figure 1).

Comment: The result of the analysis of variance shows that the P-value for the Test statistic (F) is 0.000, which is less than the level of significance α (α=0.05). This indicates that there is a significant difference in the mean level of knowledge of standard precaution procedures among the different designations of healthcare workers in the hospital (Table 6).

To determine which designations, differ in the level of knowledge, a Post hoc test for multiple comparisons of means was carried out using the Least Significance Difference (LSD) Procedure as shown in Table 7.

Comment: In Table 5, the mean level of knowledge of the standard procedures of each designation (column 1) is compared to those of the remaining designations (column 2). The differences between each pair of means are shown in column 3. The means that differ significantly are asterisked (*). Also, the P-value for the comparison of the means is in column 4. A P-value that is less than 0.05 indicates that the pair of means differ significantly. The last two columns show the 95% confidence interval of the difference between the pair of means that are being compared. Any interval that does not include zero (0) shows that the means differ significantly.

The results show Doctors, Nurses, and Midwives do not differ significantly in their levels of knowledge of the standard procedures. Also, Laboratory scientists and Health assistants do not differ in their levels of knowledge but the two designations have significantly lower knowledge of the procedures than Doctors, Nurses, and midwives.

RQ 2. What is the attitude of healthcare workers on standard precaution measures? (Table 8 & Figure 2)

Comment: The mean level of attitude of the different designations of healthcare workers at the Hospital are all high (above 4.4) on a scale of 1-5.

Comment: The mean level of attitude of healthcare workers on standard precaution measures is 4.6063 on a scale of 1-5. This shows that the level of attitude of the professionals towards precautions is very high (Table 9).

Comment: The result of the analysis of variance shows that the P-value for the Test statistic (F) is 0.172, which is greater than the level of significance α (α=0.05). This indicates that there is no significant difference in the mean levels of attitude on standard precaution procedures among the different designations of healthcare workers in the hospital. There is, therefore no need to conduct a post hoc test to make multiple comparisons of the means to determine which ones differ significantly (Table 10).

DISCUSSION OF FINDINGS

Socio-demographic data

A total of 45 healthcare workers participated in the study majority of the respondents 33(35%) aged 41-50, 32(33%) within 31-40years age group, and only 8(8%) being under the age group >50. 39(41%) are female, while 56(59%) as male. This is expected because the study was conducted in the northeastern part of Nigeria where the majority of the women are housewives. The majority of the respondents 35(37%) worked for 6-10 years.

Level of healthcare workers' knowledge of standard precaution measures

The study revealed that there is a high level of standard precaution awareness among healthcare workers with a total knowledge score of 76.4%. However, a previous study in Nigeria revealed a knowledge score of above 90% [14]. These findings are also in line with the study carried out by Okhiai [15] at Irrua Specialist Teaching Hospital Edo state, where the results show that 80% of the respondents know standard precaution measures. It is also similar to a study conducted by Goje et al., 2017. The study aimed to assess knowledge, attitude, self-efficacy, and practice of SP measures among nursing and midwifery students in Damaturu Nigeria where all the respondents agreed that hand washing is a hand hygiene method and that gloves should be worn before carrying out invasive procedures. Only one respondent reported that hand washing is not necessary after contact with one patient before touching the other and another respondent also believed that it was not necessary to wear protective goggles and a facemask when there is a chance of blood splashes.

The study is also similar to the study conducted by Chaudhuri, Baidya, and Gambhir [11] on knowledge and attitude toward universal precaution among nursing staff in the tertiary hospital in Manipur India where the majority of the nurses 86% were aware of universal precaution 62% of the nurses mentioned wearing of gloves for contact with body fluid, non-intact skin and mucous membrane as a measure that constitutes universal precaution. More than half of them knew about the use of PPEs and the importance of hand washing.

However, the study is in contrast with the study conducted by Sandra, Akagbo, Nortey, and Ackumey [16] on their study on knowledge of SP and barriers to compliance among healthcare workers in the lower Manya Krobo District Ghana where the knowledge of the basic concept of SP was low; only 37.0% knew that SP includes hand washing before and after any direct contact with the patient.

Attitudes of healthcare workers toward the practice of standard precautions

From the findings, the responses from the respondents show that they have a good attitude towards standard precautions. All the responses from the respondents have a mean score of greater than 3.00 which is significant according to the rule. This is similar to a study conducted by Agofure and Adidatimi, (2017) on knowledge, attitude, and practice of standard precautions among healthcare workers in Federal Medical Centre Yenagoa, Nigeria. The study shows that the majority of the respondents were aware of standard precautions as a form of universal precaution against infection. Furthermore, the majority of the respondents demonstrated good knowledge, attitude, and practice toward standard precautions. This is equally in line with the findings of a previous study [15]. It is further in line with the study conducted by Goje et al, 2017 where the respondents agreed that observing these measures was very necessary for protecting both their health (97%) and that of their patients (96%).

Furthermore, the study is also in line with the study conducted by Arinze-Onyia, Ndu, Anguwa, Modebe and Nwamoh [17] in their study they reported a positive attitude toward the use of SP, over 90% agreed that SPs are useful in protecting biohazards in the workplace and that employers should provide SP training for their workers on the other hand 90% disagreed that SPs are not necessary for the hospitals and that they are meant for only theater workers.

The appreciable knowledge of standard precautions is probably the cause of the encouraged positive attitude towards standard precautions by the respondents.

CONCLUSION AND RECOMMENDATION

In summary, the knowledge, and attitude of basic standard precautions among the healthcare workers at Potiskum Specialist Hospital is very much encouraging. There is a considerable high level of knowledge and attitude of standard precautions recorded among the healthcare workers. Furthermore, they adequately practice some of the basic standard precaution measures as they can correctly identify most of the components of standard precautions.

RECOMMENDATIONS

1. Other research should be conducted in Primary health facilities and out-posts to ensure knowledge levels are at par across the health sector.
2. Exploratory research should be done to understand the reason for high nosocomial disease outbreak in the state hospitals.
3. Efforts should be made to ensure knowledge is being applied effectively curtail communicable disease outbreak in the state.

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  Table 1
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  Table 2
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  Table 3
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  Table 4
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  Table 5
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  Table 6
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  Table 7
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  Table 8
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  Table 9
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  Table 10