Assessment of Infection control knowledge and Attitude related to Needle stick Injuries among nursing staff

Table (3): there was appositive fair correlation between nurses knowledge and hospital resources in which r = 0.015*.

Discussion

This study showed that most of the participants were in the age group less than or equal 30 year (mean 1.25 + 0.43 ) which they work in the intensive care units, these age for nurses with limited experience in  special care for patients in ICUs  and  cause increase risk rate of needle stick and sharps injuries . This finding was similar with the result of Sharma et al. (2010 ) (11)   who assess the knowledge and attitude of health care workers about the NSSIs at tertiary care cardiac hospital  for health care workers (HCWs)  , Karim etal  (2015) (12)  who Assessment of nurse knowledge regarding needle prick injuries and its risks at  Erbil hospitals for health care worker, they  reported  that  maximum participants in their research were in the age group of 20-30 years.  Also this finding is agreement with Lihan et al. (2013) (13) .who assess  Long working hours  in increase the risk of sharp and needlestick injury in nurses  and said that most common factors that increase the risk for needle stick and sharps injuries are the age which   less than twenty-four years, less than four years of nursing work experience, working in the surgical intensive care unit. while  current study results  not agree with Balouchi et al (2015) (14)  who assess Prevalence, causes and preventive of Needle Sticks injuries among nurses in Kerman (south of Iran)and  reported that  most age range of 18 to 52 years  .

According to the current study results, the majority of participants were female this  may be due to the higher number of female nurses like to be work as a nurse   this is consistent with a study conducted by Balouchi et al (2015) (14) ,  Shokouh et al (2015) (15)  who assess knowledge and practice of healthcare workers in relation to injuries caused by needles and viral diseases transmitted in this way in Army Hospital  and stated that the most participants were female, but not consistent  with the study conducted by Joneidi J(2008) (16)  who Evaluate  the frequency of Exposure to Medical Sharp Devices and investigate the risk factors among Nurses at Military University Hospital Karim  et al (2015) (12)   ,stated that  the most participants were male, because most of the female nurses were not agree to conduct the study.

As regards marital status for study sample results found that more than half among study sample was a single. This finding is agreement with that, Labrague, Rosales, Tizon (2012) (17) who assessed the knowledge and degree of compliance regarding standard precautions among student nurses in a government university in Samar,
Philippines and found the great majority of their studied sample single. On another hand  the study incongruent with the current study conducted by Bekele T(2015) (18) who determine the lifetime and past one year prevalence of needle stick and sharps injuries and factors associated with the past one year injuries among hospital healthcare workers in Bale Zone ,Southeast Ethiopia and mention that more than half of the respondents were married at the time of data collection,

As for study participant qualification results revealed that less than half among participants their educational level were graduated from nursing institute this finding disagree with Hossine etal (2015) (19)  who identify the standard precaution and the Incidence of Needle Stick Injury Among nurses working in Maternal and Child Health Centers during Children vaccination in El-Minia Governorate and  illustrated that all nurses 100% had a secondary school degree.

According to nurse's experiences more than two thirds of the participating nurses their experiences less than or equal seven years these correlate with age and new graduate,  this is consistent with a study conducted by Bekele  Tet (2015) (18).  Who mention that seven out of ten (72.6%) health care workers (HCWs) had five years and below work experience.

Regarding to  previous exposures to sharp injury current study results found that the majority of participating nurses exposured to sharp injury this  due to the higher number of invasive interventions on ICUs  units and  lack of experiences and no up dating of safty training or practice .  this  agree  with the study done by  Lihan et al. (2013) (13)  who illustrated that the percentage of nurses experiencing needlestick injuries during the year professionals' time was seventy-nine percent.. This current  results not consistent  of  Arafa (2013)(20) who  study the possible work-related morbidities among street sweepers and waste collectors emphasizing on the occupational risks they are exposed to and the preventive measures at Beni –suif ,Egypt  and reported  that the number of injured health care workers ( HCWs ) (47.5%) . Similar observation was also reported by Moges(2010)(21)  who assess the Prevalence of needle-stick injuries and associated factors among health care workers at Hawassa town, south Ethiopia, and  stated that , the reasons for higher needle-stick injuries among young people could be lack of experience and skill on the job and many workers began work at an early age and often without safety training. Moreover current  results  were similar with  the study of HCW from the hospital at  Alexandria Hanafi etal (2011)(22) who mention that the prevalence of NSIs reported considerably higher ( 85.3% )  Finally current study results revealed that the frequency number of episode of needle stick injury among  studied sample was noticed that 67.6% which exposed from  one  to sex episode of needle stick injury . this study consistent with study conducted by Afridi (2013)(23) who assess the proportion of NSIs and their associated factors among HCWs and also identify the areas in which preventive efforts might be directed to protect against this occupational hazard in Tertiary Care Hospitals in Pakistan and reported that Amongst them, up to  27% workers had it once, while nearly 73% have suffered the injury twice or multiple times.  While this result  disagree with  Jahangir(2016)(24) who  assess Needle Stick Injuries and their Related Safety Measures among Nurses in a University Hospital, Shiraz, Iran  and mention that ,frequency number of episode of needle stick injury among  studied sample was noticed exposed to one  episode of needle stick injury as 30% .

The majority of the studied sample was had high   knowledge's regarding to needle stick injury, 91,2% this due to the most of them receiving educational training on infection control recently from a year  , this result supported  to Kariem et al, (2015) (12) who showed that the most of nurses had good knowledge regarding the needle stick  injuries      . While another study done by   Shah et.al., (2016)(25). disagree with current study  revealed that knowledge of health care workers about the risks associated with needle stick injuries and use of preventive measures was inadequate ,also  Siddique et al., (2012) (26) who  assess the knowledge, attitude and practices amongst health care workers on needle stick injuries amongst  health care providers in the  Departments of Holy Family Hospital  , revealed that inadequate knowledge amongst health care workers about the risk associated with needle-stick injuries , lack of use of preventive measures and regarding risks and hazards associated with NSI is inadequate.

In the area of attitude of the studied sample, it has been found that the majority of participating sample had negative attitude despite them had good knowledge regarding needle stick injury the causes may be related to no present regular supervision on the staff during their practice no hospital police for implement of punishment or motivation for the staff, This result disagree with the Salekar et al and Pavithran (2015) (27). Who assess the knowledge, attitude, practice, and prevalence of NSIs and SIs among dental professionals in a dental college at Bangalore and has been noticed that the participants of the studied had a positive attitude about NSI precaution. This may be due to the good awareness about the blood-borne diseases that could be spread through these injuries . in the same line  result with the study done by   Haggai , (2009)  and  Bhargava  (2013 ) (28) who assess healthcare workers’ needle-stick injury (NSI) knowledge, attitudes and practices (KAP) in a tertiary care hospital for health care workers (HCWs)    and  reported  that the attitude scores were best for nurses.    Results from current study offer an interesting insight into the availability of hospital resources most nurses agreed that there are curriculum provides enough information on Infection control and Infection Control Team, hand disinfectants, disposal containers disposable gloves were readily available in their work area,   These findings are similar to stud done by  Smithi etal  (2010) (29) who investigate the interactions between safety climate, psychosocial issues and Needlestick and Sharps Injuries (NSI) among nurses in Japan with the study conducted by Gershon (2013) (30),  who assess the relationship between hospital safety climate and employee compliance with safe work practices and incidents of workplace exposure to blood and other body fluids in  dustrial setting. Who   reported that 94% disposable gloves were readily available, 95% agreed that a health and safety manual was available. This study incongruent with current result conducted by  Afridi (2013) (23)who assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard in Tertiary Care Hospitals in Pakistan and reported that  availability of sharp disposable containers in hospitals as reported by only 10% of HCWs in this study. Similarly, very low statistics were reported for the availability of infection control guidelines and use of gloves. In the same  line with a study from Pakistan Aslam et al.,( 2010) (31) who estimate the frequency of needle stick injuries (NSI) among health care workers (nurses, student nurses and paramedical staff) in public hospitals of Karachi  and also reported the very low use of gloves and other Protective equipment.

On another hand, according to current study result   found that there are shortage of staff in each department which the majority of nurses stated that not having enough nursing staff in the department due to increase of beds in all critical units and opening of another three critical units in the hospital with the same number of nurses may be a risk factor for work load and exposure of NSI. regarding of vaccination  the study  showed that there are lack of adequate vaccine which  only thirty-two percent of the healthcare workers had received vaccination ,which was similar to the study  conducted by Afridi  (2013) (23) who mention that  the percentage  of vaccine  was 33.2%. Another study   agree with current study conducted by, Di Giuseppe et al. (2011) (32) who revealed that HBV vaccine was not available to the healthcare workers studied. As reported by, wicker,s (2012) (33) who  investigate the frequency and causes of needlestick injuries in a German university hospital  and  Seham A. Abd El-Hay (2015) (34). Who assess the effect of educational program on knowledge and practice of undergraduate nursing students toward prevention of needle stick and sharp injuries during clinical training to undergraduate nursing students at   in Dammam University at Hafr Al Batin Governate, KSA.  They found that the nursing staff were generally well covered by hepatitis B vaccination The finding was not supported by Efstathiou et al. (2011) (35)    who examines the extent of Cypriot nurses’ compliance with the main aspects of Standard Precautions and explores the possible associations with the nurses’ characteristics and reported that the majority of nurses had been vaccinated against Hepatitis B virus (HBV) .  There was significant correlation between occurrence of needle stick injury and knowledge regarding infection control and needle stick injury and each of attitudes and availability of hospital resources. This result not consisted with Bhargava (2013)(28) . Which explore that the exposure to NSI does not correlate with HCW knowledge and attitudes? Ironically, most HCWs experiencing NSI have higher knowledge and attitude scores.

Conclusion

This study accentuates that the majority of studied sample have high knowledge and low attitude regarding needle-stick injuries and there was significant correlation between knowledge and each of attitude and availability of hospital resources with needle stick injury

Recommendations

• Continuous education for staff nurses about importance of application of standard infection control precautions and ensure that HCW are properly trained regard the safe use and disposal of needles.
• Healthcare institutions should apprise themselves of developments in safety devices, e.g. needle-less technology and reduce risk within their organization or modify work practices that pose a needle stick injury hazard to make them safer.
• All HCW must be immunized against HBV, unless immunity to HBV as a result of natural infection or previous immunization has been established.
• Promotion of safety awareness and encouragement of reporting and timely follow up of all needle sticks injury in the work environment.
• It is also necessary to establish a monitoring system for NSIs at a hospital level.