Assessment of Infection Prevention and Control Knowledge, Practices, Implementation and Barriers Among Healthcare Workers and Support Staff at Pumwani Maternity Hospital, Nairobi Kenya

Abstract

Background: Healthcare-associated infections (HAIs) represent significant threats to the safety of patients and lead to cases of increased morbidity, mortality and treatment costs in both public and private hospitals. While HAIs remain a public health concern globally, Sub-Saharan countries are the most affected, with Centers for Disease Control and Prevention (CDC) estimating the prevalence to be higher than 40%. Infection prevention control (IPC) knowledge and practices can play a central role in reducing the rate of HAIs. Objective: To assess IPC knowledge and practices among healthcare workers and support staff, establish the level of implementation of IPC guidelines and identify barriers to IPC implementation at Pumwani Maternity Hospital, Nairobi Kenya. Methodology: A cross-sectional survey design was adopted for the study using the employee population in Pumwani Maternity Hospital. A random sampling formula was utilized to compute the sample size of 171 healthcare workers including medical officers, nursing officers, clinical officers and hospital housekeeping support staff. Self-administered questionnaires were used to collect the data. Data were analysed using descriptive and inferential statistical techniques. Results: The majority of the respondents, 102 (64.6%), were female. The median age was 33 (IQR: 29 – 37.5) years; 82 (51.9%) of the respondents were nursing officers, 32(20.3%) were housekeeping staff, while 23 (14.6%) were medical doctors. The median years of experience was 7 (IQR: 3 – 12) years. The overall knowledge of IPC guidelines was good (73%) with knowledge on different components assessed being waste segregation (92%), protective gloves (91%), housekeeping (85%), reusable equipment (84%), hand hygiene (80%), personal protection (75%) and injection and blood samples (68%). Respondents aged between 30 and 49 years OR =5.83, (95%CI: 1.43 – 23.88), p = 0.014, working experience of between 5 -10 years OR = 6.0, (95%CI: 1.84 – 19.57), p=0.003 and >10 years OR =4.34, (95%CI: 1.37 – 13.79), p =0.013 were more likely to have good knowledge on IPC guidelines. Compliance with IPC guidelines and practices was 36%. Clinical officers OR = 11.11, (95%CI: 2.72 – 45.46), p =0.001, support staff OR = 3.78, (95%CI: 1.61 – 8.86), p = 0.002 and good knowledge on IPC OR = 3.79, (95%CI: 1.55 – 9.23), p = 0.002 were associated with increased likelihood of compliance. The common limits to compliance with IPC practices were staff shortage and high hospital patient flow. Conclusion and recommendation: The findings showed a good level of knowledge, although compliance with national IPC guidelines was low. Thus, there is a need for the hospital administration to provide copies of IPPC policy guidelines in all wards/units and ensure effective implementation through constant supervision as well as recruit more IPC team members.