IMPACT OF INFECTION CONTROL PRACTICES ON HEALTH WORKERS IN GENERAL HOSPITAL ABUJA

CHAPTER ONE

INTRODUCTION

BACK GROUND OF THE STUDY

Infection-related infections and diseases are still the major cause of death in Nigeria, according to the 2013 health profile of the World Health Organization (WHO, 2013) estimates. The disease burden in Nigeria includes HIV, TB, malaria, other infectious diseases and respiratory infections The increase in the prevention and control of infections is attributed to an increase in the incidence of infection in Nigeria. This increase in infection-related illnesses has an effect on the increase in health spending in Nigeria, with a government contribution to health care of 57.5 per cent over the estimates budgeted in previous years (WHO, 2014).

Infectious patients are admitted to hospitals and clinics, and so these hospitals have become common hosts for disease transmission and infection. Infected patients are a source of transmission of infection to other patients, healthcare personnel and visitors in health settings (Perl, 2011). Nosocomial infection, also referred to as hospital-acquired infections (HAI), is one of the main causes of death and has a high economic and social cost due to increased hospitalization and prognosis (WHO, 2015). WHO (2010), Hospital acquired infection can be seen as an infection that develops in a patient during the treatment and duration of care in a hospital facility that was not incubated at the time of admission. These infections are those that occur more than 2 to 3 days after admission and 10 days after hospital discharge (Collins 2008). Owing to the admission of patients with multiple diseases, hospitals have been populated by extremely virulent species, namely: Staphylococcus aureus, Streptococcus pyogenic, Escherichia coli, Pseudomonas aureginosa and Hepatitis viruses that live in health care environments. These microorganisms cause diseases ranging from mild skin infections to life-threatening conditions, such as sepsis, which can be extremely serious and can ultimately lead to death if not properly attended (Sydnor, 2011).

Infection prevention activities are at the center of modern health care in Nigeria and Africa as a whole. Infection control practices and controls refer to policies, protocols, measures and procedures used to mitigate the spread of infections and infectious diseases, especially in hospitals and designated human health care facilities. Infection prevention procedures within the health care setting are steps taken by health care professionals to minimize the spread of infectious agents from patient to patient, patient to health care workers and health care workers to patients in the hospital environment. Infection management policies and activities are dictated by the mode of transmission of the infection carrier and include standard operating procedures related to personal safety protocols, as well as those related to the prevention of direct contact with infectious materials (fomites) and body fluids, droplet infections. This focus is on the transmission of blood-borne infections with standard precautions as a control measure. Many infection prevention measures, such as adequate hand hygiene and proper implementation of specific precautions during invasive procedures, are easy and low-cost, but require transparency and behavioral improvement for personnel, in addition to enhancing staff education, monitoring and surveillance systems (Dhidah, & Boujaafar, 2013). In order to use these precautions, the human factor plays an important role in increasing or decreasing the likelihood of catching HCAI (Cole, 2017). Adequate nursing staff is also required as a higher ratio of patient to nurse increases the risk of nosocomial infection. Transmission of infectious agents in a health care setting requires three agents; a reservoir, a susceptible host, and a mode of transmission.

Health care staff and visitors are susceptible hosts in the hospital setting. The dynamic interrelationship between a potential host and an infectious agent causes infection. The mode of transmission may differ by type of organism, as more than one route may be transmitted by some types of organism. The dynamic interrelationship between a potential host and an infectious agent causes infection. Compliance on the part of healthcare professionals with routine precautions has been recognized as an efficient and reliable way of preventing and managing health-related infections in patients and health workers. Health care staff are especially key players in the prevention and control of infections in health care settings or hospitals in Nigeria.

Florence Nightingale developed a relationship between health workers and infection control in 1854, during the Crimean war, when she worked at a hospital in Scutari, Italy (Kamisky, 2014). According to Kamisky (2014), Nightingale promoted the cause of good and improved sanitation and living standards for hospitalized soldiers and civilians by calling for basic public and community health, interventions and procedures to manage illnesses, cleanliness, hygiene and good education as a way of preserving and encouraging the health of patients and health workers. She is seen as the first health professional to monitor infections. In England, the first Infection Control Nurse was hired in 1959 in Torbay, Devon, in response to a rise in the incidence of Staphylococcal infections and health care workers and patients (Ayliffe, 2011). The practice of infection control and measurement was first implemented in Nigeria in the 1970s, when the Departments of Microbiology, College of Medicine, University Hospital, Ibadan and College of Medicine, Lagos Teaching Hospital, Lagos, named infection control practitioners in their respective units to stimulate infection control activities throughout Nigeria (Iwuchukwu-sobayo, 2015).

During this time, the first qualified infection control health worker was assigned to the University Hospital in Ibadan. She has gained her professional experience in the United States, Saudi Arabia and Nigeria (Iwuchukwu-Sobayo, 2015). Despite this rapid emphasis on infection prevention and measurement, infections in health facilities in Nigeria continue to be a major source of concern for the delivery of good and reliable health services in both developed and developing countries in Africa and beyond (Jackson, 2013). Health-related illnesses and diseases have long been seen as key factors in the quality and outcomes of health care delivery in Nigeria and sub-Saran Africa.

Health-associated infections (HAIs) are a significant and root cause of adverse health effects, such as morbidity rate, mortality rate, and increased health care economic costs, with potential resulting litigation. "Infection is known to be nosocomial or hospital-based if it becomes evident after 2 days or more after hospital admission or within one month after inpatient treatment (Bello et al., 2011) The advent of life-threatening and severe infectious diseases has demonstrated the need for strong and efficient infection control systems and interventions in all health care settings such as hospita (WHO, 2014). Cole argued in 2016 that the evaluation of health care and infection management procedures has historically relied on quantitative research methods since they were considered to be robust, reliable and generalizable. However, it was also noted that qualitative methods may provide a valuable understanding of possible behavioral antecedents, including interpersonal relationships.

Inadequate prevention and control of infections in hospitals has been shown to have a variety of effects, including increased bed occupancy and drug burden and other limited medical resources. Lack of attention to infection control contributes to drug resistance by the micro-organism, lengthens the time spent by admitted patients in the hospital, resulting in high hospital and hospital costs.

The research was therefore critical in evaluating if there were any gaps in accordance with the prevention of infection in order to take corrective measures by the hospital administration.

STATEMENT OF THE PROBLEM

Nosocomial infections often occur in hospitalized patients due to gaps in the prevention and control of infections, regardless of the type of institution. Studies have shown that the prevalence of hospital-acquired infections ranges between 6 and 15% in all patient admissions. Serious concerns have been raised in Nigeria about the prevention of infection among health workers due to a lack of frequent updates on current infection prevention practices. Studies have shown inadequate instrument decontamination and unsuccessful infection control measures frequently contribute to outbreaks of nosocomial infections.

The lack of compliance with infection prevention and control by health workers has a number of implications, including increased bed occupancy and a strain on limited hospital resources. In addition, nosocomial infections are a significant cause of concern due to related morbidity and possible mortality. Preventing nosocomial infections among hospitalized patients is therefore of vital importance to all health care professionals.

OBJECTIVE OF THE STUDY

The main aim of this study is to analyze the evaluation of infection prevention practices among health workers at the Abuja General Hospital. The basic goals are as follows;

1) To determine the level of infection prevention procedures among health workers in hospitals.

2) To determine the extent of awareness of standard measures taken by health workers in the Abuja General Hospital.

3) To investigate the effect of infection control initiatives on the lives of health workers in the Abuja General Hospital.

4) To analyze the significance of infection control among health workers in Nigerian hospitals.

5) To explore the problems that affect measures to manage infections in Nigeria

6) To propose solutions to the challenges posed by infection control activities among health workers in hospitals.

RESEARCH QUESTIONS

1) What is the level of infection control practices among health workers in hospitals?

2) What is the level of knowledge of standard precautions by the health workers in general hospital Abuja?

3) What is the impact of infection control measures on the lives of health workers in general hospital Abuja?

4) What is the importance of infection control among health care workers in Nigerian hospitals?

5) What are the challenges that affect infection control measures in Nigeria?

6) What are the solutions to the challenges of infection control practices among health workers in hospitals?

RESEARCH HYPOTHESIS

HO: There is no significant impact of infection control practices on the lives of health care workers in general hospital Abuja

H1: There is a significant impact of infection control practices on the lives of health care workers in general hospital Abuja

SIGNIFICANCE OF THE STUDY

The study will help educate society about the evaluation of infection prevention procedures among health workers at the Abuja General Hospital. It would also prepare the ground for interested researchers who may wish to carry out more research in related areas and could contribute to established literature.

SCOPE OF THE STUDY

The study is restricted to the assessment of infection control practices among health workers in general hospital Abuja.

LIMITATION OF THE STUDY

Financial constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview)

Time constraint: The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

DEFINITION OF TERMS

Health workers: are individuals whose role it is to protect and improve the health of their communities. Together these health professionals make up the global health workforce with all their diversity.

Nosocomial Infection: is caused by an infection or toxin that occurs at a certain location, such as a hospital. People are also using nosocomial infections interchangeably with the words health-related infections (HAIs) and hospital-acquired infections.

Infection Prevention Procedures: Standard precautions are a series of infection control practices used to prevent the spread of diseases that can be caused by contact with blood, body fluids, non-intact skin (including rashes) and mucous membranes.

Hospitals: Hospital, an institution that is constructed, staffed and prepared for the diagnosis of illness; for the care, both medical and surgical, of the sick and injured; and for their accommodation during this period. The modern hospital most sometimes acts as a research and teaching facility.