ASSESS THE KNOWLEDGE, ATTITUDE AND PRACTICE ON HAND HYGIENE AMONG HEALTH WORKERS IN CALABAR SOUTH LOCAL GOVERNMENT AREA OF CROSS RIVER STATE, NIGERIA.
CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Prevention and management of infection is the responsibility of all staff working in health care services and an integral element of patient safety programmes. Hand washing is one ofthe monumental infection control measures for prevention of healthcare-associated infection. Although the technique involved in hand hygiene is simple, compliance with hand hygiene recommendations is poor worldwide (WHO, 2009).
Effective hand hygiene is the simplest proven method to reduce the prevalence of healthcare associated infections. Unfortunately, the prevalence of these infections continue to rise and it is estimated that annually about hundreds of millions of patients suffer from healthcare associated infection the world over (Gilbert, 2014). Therefore, infection control is necessary to reduce the high level of healthcare associated infections and the importance of hand hygiene in the control of infection cannot be overemphasized.
Hand hygiene is a general term referring to any action of hand cleaning by using water and detergent and or the use of alcohol based hand sanitizers for the removal of transient microorganisms from one’s hands (Pitte, Altegranzi & Boyce, 2009). Although many communities have guideline on hand hygiene for healthcare settings, many researchers have found that measuring adherence to the hand hygiene guidelines is not a simple task. Experts in quality improvement have suggested that a multidisciplinary strategy is necessary to improve hand hygiene including training protocols, routine observation and feedback (Katama, 2011).
Healthcare associated infections are serious problem in the healthcare services as they contribute to the prolonged hospital stays, long-term disability, mortality in most cases and excessive healthcare costs. Most healthcare associated infections can be transmitted from patient to patient through the hands of healthcare workers. In other words, healthcare workers hands due to poor hygiene are most usually the vehicle for the transmission of health care-associated infections (Askarian, Vadollahi & Asjadian, 2012).
According to Mehtar, (2010) reported that adherence rates of hand hygiene is upto 67% at best and most of the studies reveal that health workers do not wash hands routinely. It’s now recognized that hand hygiene does not only reduce the risk of disease transmission of patients and visitors but also protect the healthcare workers including doctors, nurses, laboratory workers, cleaning and housekeeping staff (Friedman & Newson, 2007). A key action within the global challenge is to promote hygiene in healthcare. Poor hand hygiene among healthcare providers is a worldwide problem. Better hand hygiene has the potential to reduce infections in advanced health system (WHO, 2009). The researcher therefore wants to find out the knowledge, attitude and practice of hand hygiene among health workers in Calabar South Local Government Area.
1.2 Statement of the problem
The 2009 WHO guidelines on hand hygiene provide a comprehensive review of scientific data on hand hygiene rationales and practices in healthcare. However, compliance by health workers with recommended hand hygiene procedure, has remained unsatisfactory, with compliance rates generally below 50% (Pittet, 2009).
Improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections resulting in prolonged illnesses, hospital stays, long term disability, unexpected high cost on patients and their families leading to additional functional burden on the healthcare system. The spread of infection in developing countries remain a serious problem especially in health facilities due to lack of awareness in the healthcare workers and compounded by “Omo syndrome” (a belief that they are super clean and sterile) (Saloojee & Steechoff, 2007). Lack of knowledge and lack of recognition of hand hygiene opportunities during patient care are mainly responsible for poor hand hygiene among health workers. Although, many countries have guidelines, regarding hand hygiene for their health system, the overall practice among healthcare workers remain poor (Suchitra & Lakshimderi, 2008).
