DEMOGRAPHIC, INTRAPERSONAL AND INSTITUTIONAL FACTORS AS PREDICTORS OF COMPLIANCE WITH STANDARD PRECAUTIONS AMONG NURSES IN TERTIARY TEACHING HOSPITALS IN OYO STATE, NIGERIA

Abstract

Standard Precautions (SPs) are a set of infection control measures formulated to ensure health workers and patients’ safety against infections in health care facilities. However, available data indicated poor compliance with standard precautions among nurses. Previous studies focused largely on knowledge, attitude and awareness of SPs with little emphasis on factors predicting such compliance. This study was therefore, designed to examine demographic (age and work experience), intrapersonal (knowledge and attitude) and institutional (availability of Personal Protective Equipment (PPE), training and workload) factors as predictors of compliance with SPs among nurses in teaching hospitals in Oyo State, Nigeria.

Health Belief Model was used, while the descriptive survey design was adopted. The three tertiary teaching hospitals (University College Hospital (UCH), Ibadan, Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Ogbomoso and Bowen Teaching Hospital Ogbomoso) in Oyo State were enumerated. One thousand, one hundred and fifty-six clinical and public health nurses were enumerated from UCH, while 270 and 92 nurses were enumerated from LAUTECH and Bowen, respectively. Instruments used were SPs Knowledge (r=0.91), Attitude to SPs (r=0.89), Availability of PPE (r=0.81), Training by Hospital (r= 0.80), Workload (r=0.84) and SPs Compliance (r=0.86) scales. One focus group discussion session was held with selected nurses from each facility. Data were analysed using descriptive statistics, Pearson product moment correlation and Multiple regression at 0.05 level of significance, while the qualitative data were content analysed.

Respondents mean age was 38.7±3.2 years with 89.3% females, while 87.9% had previously contacted flu, smallpox and measles. Compliance rates across the selected facilities were UCH (65.5%), Bowen (51.1%) and LAUTECH (42.6%). Compliance rates based on nurses years of work experience were: short years of work experience (65.1%) and long years of work experience (60%). Age (r=0.67), work experience (r=0.53), knowledge (r=0.64), attitude (r=0.51), availability of PPE (r=0.58), training by hospital (r= 0.55) and workload (r=0.52) had positive relationships with SPs. There was a significant joint prediction of demographic, intrapersonal and institutional factors on SPs (F(3,1495)=1547.73; Adj.R2=0.87); accounting for 76.0% of its variance. Work experience (β=0.76), Knowledge (β= 0.70), availability of PPE (β=0.56), training (β=0.31), age (β=0.25), attitude (β=0.22) and workload (β=0.20) contributed to compliance with SPs. While hospitals were not adequately equipped with facilities for optimal compliance with SPs, the minimal required resources were not readily available. Besides, personnel who were put in charge of distribution of PPE are not knowledgeable on infection control.

Work experience, knowledge, availability of personal protective equipment, training, age, positive attitude and high workload enhanced compliance with standard precautions among nurses in tertiary teaching hospitals in Oyo State. Therefore, there is the need to ensure adequate equipment of hospitals with facilities and resources for optimal compliance with standard precautions and periodic in-service training for nurses and personnel in charge of personal protective equipment distributions.