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EunGyeong, Ihnsook, and Shakuntala: Knowledge, Attitude, and Compliance of Healthcare-associated Infection Control among Nurses in the Western Development Region, Nepal
Original Article

J Nosocomial Infect Control 2013;21(1):9-17.

Published online: 3 May 2013

DOI: https://doi.org/10.14192/kjnic.2016.21.1.9

Knowledge, Attitude, and Compliance of Healthcare-associated Infection Control among Nurses in the Western Development Region, Nepal

Kim EunGyeong, Jeong Ihnsook, Thanju Shakuntala

1College of Nursing, Pusan National University, Yangsan, Korea

2Tansen Nursing School, Palpa, Nepal

Address reprint requests to Ihnsook Jeong, College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea Tel: 051-510-8342, Fax: 051-510-8308 E-mail: jeongis@pusan.ac.kr

Received 11 February 2016       Accepted 20 June 2016

Copyright © 2013, the Korean Thyroid Association. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Healthcare-associated infection (HAI) affects the morbidity and mortality of inpatients worldwide. Nepal is a developing country in which HAIs pose a major problem in terms of patient safety. Therefore, this study was designed to assess the level of knowledge and attitude toward HAIs and compliance for infection control among nurses.

Methods

A cross-sectional survey was conducted using a self-administered questionnaire including general characteristics, and knowledge of, attitude toward, and compliance with HAI control practices, on a sample of 259 nurses from 11 hospitals in 3 cities in Nepal, from July 17 to August 5, 2014.

Results

The average score on knowledge of HAI was 6.56, on a 13-point scale. In total, 59 nurses had undergone HAI control training and 211 nurses reported that they were governed by some guidelines, but there were no significant differences. The overall level of compliance with HAI control guidelines was 79.2 points based on a 100-point scale, which did not differ in terms of age, exposure to infection control training, and the presence of any guidelines.

Conclusion

The level of knowledge of HAI control among nurses was very low and a majority had never undergone any HAI control training. Evidently, there is an urgent need to provide HAI control training to nurses, and to develop infrastructure to provide training for them.

Keywords: Attitude, Compliance, Healthcare-associated infection, Knowledge, Nepalese nurses

References

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Table 1.
Differences in knowledge according to the general characteristics of participants (N=259)
Characteristics Category No. of correct answer (maximum score=13) meanSD 100 based score of the mean t P
Total knowledge score Age (years) <25
≥25		 6.561.76
6.601.73
6.36190		 50.5
50.8
48.9		 0.85 0.395
Ever undergone infection control training Yes
No		 6.161.89
6.671.70		 47.4
51.3		 –1.94 0.053
Had any guidelines Yes
No		 6.591.75
6.431.83		 50.7
49.5		 0.53 0.595
Table 2.
Knowledge about healthcare-associated infection control (N=259)
Contents Correct answer (%)
1. The most important vehicle in pathogen transmission 67.2
2. The main purpose of glove use 52.9
3. The main benefit of hand hygiene 65.3
4. The adequate preventive measures in a complex care situation 52.5
5. The adequate preventive measures in a regular care situation 48.3
6. The indication for mask use in a regular care situation 83.8
7. The anticipated timing of isolation precaution 41.3
8. The adequate procedures in contact precaution 15.8
9. The basic concept of standard precautions 27.4
10. The risk-guided application of a preventive strategy 66.0
11. The ubiquitous risk of coming in contact with body fluids 38.2
12. The bidirectional risk of pathogen transmission 71.8
13. Being aware of environment-associated risks for immunosuppressed patients 25.5
Total 50.5
Table 3.
Attitude towards healthcare-associated infection control (N=259)
Contents Answer, n (%)
A B C D E
1. Preferred means of prevention “Mask”
17 (6.6)		 “Gloves”
36 (13.9)		 “Hand hygiene”
206 (79.5)		 “Apron” NA
2. Self-assessment of knowledge on isolation precaution “No idea” 2 (0.8) “Heard about”
68 (26.2)		 “Know vaguely”
8 (3.1)		 “Know well”
181 (69.9)		 NA
3. Peer action “Inform the peer immediately”
184 (71.0)		 “Say nothing”
2 (0.8)		 “Inform the peer
later” 54 (20.9)		 “Inform a superior”
19 (7.3)		 NA
4. Information source “Infection control team” 15 (5.8) “Hospital information”
76 (29.4)		 “Colleague” 63 (24.3) “Book” 19 (7.3) “Local
guidelines”
86 (33.2)
Most common reasons for noncompliance with guidelines
5a. Obstacle to compliance: lack of knowledge “Not important”
23 (8.9)		 “Important”
82 (31.6)		 “Very important”
154 (59.5)		 NA NA
5b. Obstacle to compliance: forgetting “Not important”
77 (29.7)		 “Important”
111 (42.9)		 “Very important”
71 (27.4)		 NA NA
5c. Obstacle to compliance: lack of means “Not important”
43 (16.6)		 “Important”
120 (46.3)		 “Very important”
96 (37.1)		 NA NA
5d. Obstacle to compliance: lack of time “Not important” 27 (10.4) “Important”
107 (41.3)		 “Very important”
125 (48.3)		 NA NA
Table 4.
Compliance with Healthcare-associated Infection Control (N=259)
Contents Always n (%) Sometimes n (%) Never n (%)
1. Washing hands before and after examining a patient 243 (93.8) 16 (6.2)
2. Drying hands after washing them 214 (82.6) 42 (16.2) 3 (1.2)
3. Wearing gloves whenever there is a possibility of exposure to blood or other body fluids 234 (90.3) 25 (9.7)
4. Washing hands after removing disposable gloves 246 (95.0) 13 (5.0)
5. Wearing a waterproof apron whenever there is a possibility of exposure to blood or other body fluid splashing 132 (51.0) 88 (34.0) 39 (15.0)
6. Wearing a face mask whenever there is a possibility of exposure to blood or other body fluid splashing 170 (65.6) 80 (30.9) 9 (3.5)
7. Wearing a clean washed uniform everyday 234 (90.3) 24 (9.3) 1 (0.4)
8. Putting all the contaminated items in a disposal bag 251 (96.9) 8 (3.1)
9. Immediately wiping up all spills of blood or any other body fluids 250 (96.5) 9 (3.5)
10. Covering broken skin before coming to work 198 (76.4) 58 (22.4) 3 (1.2)
11. Changing usual care methods if the patient has an infectious disease 154 (59.5) 59 (22.8) 46 (17.8)
12. Consuming food and beverages in patient/resident care areas* 167 (64.5) 40 (15.4) 52 (20.1)
13. Protecting oneself against the blood and body fluids of all patients, regardless of their diagnosis 237 (91.5) 22 (8.5)
14. Putting used needles and other sharp objects into the designated sharp containers 255 (98.4) 3 (1.2) 1 (0.4)
15. Recapping used needles* 92 (35.5) 20 (7.7) 147 (56.8)

*Reverse coding.

Table 5.
Compliance for infection control according to the general characteristics of participants (N=259)
Characteristics Category Compliance (maximum score=15) meanSD 100 based score of mean t P
Total compliance 11.881.87 79.2
Age (years) <25 11.521.81 76.8 1.412 0.799
≥25 11.211.85 74.7
Ever undergone infection Yes 11.491.66 76.6 –0.106 0.169
control training No 11.521.85 76.8
Had any guidelines Yes 11.611.73 77.4 1.847 0.067
No 11.082.08 73.9
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