The knowledge, attitudes and practices of health care workers regarding the occupational exposure to blood and bodily fluids in a public hospital, KwaZulu-Natal

Abstract

The risk of exposure to BBF amongst health care professionals may be considered a consequential yet vastly unexplored field of study in the medical setting, particularly in the developing world. In South Africa, knowledge and practices to safeguard health care workers (HCWs) from blood borne infections (BBI) proved substandard in necessitous health care facilities. Ideally, hospital management should be provided with data to guide and inform procedures for prevention and control for potential infections arising in the work environment. An extensive review of South African literature showcased finite research data published on blood and bodily fluid (BBF) exposures and factors affecting infection prevention and control (IPC). In the KwaZulu Natal province, knowledge, attitude and practices (KAP) of HCWs, regarding occupational exposure to BBF, as well as the HCWs perceptions on the barriers to IPC, in a public hospital, has yet to be studied, with no recently published research encountered thus far, in South Africa. This study aimed to evaluate the KAP of HCWs regarding occupational exposure to BBF in a public hospital of KwaZulu-Natal. An institutional based, observational-descriptive cross-sectional study with a quantitative approach was conducted, in order to determine the association between the knowledge and attitudes of HCWs and behavioral risks for occupational exposure, as well as the perceptions of HCWs, on the barriers to IPC in a public hospital of KwaZulu Natal. This study utilised a simple-random sampling technique from a total number of 199 HCWs. The minimum sample size was calculated at 166, by a statistician, in which the margin of error is set at 5%. This study found a correlation between profession as well as work department and risk of exposure to BBF. Level of education was found to play a significant role in HCW knowledge of PEP. Work practices were found to greatly influence the likelihood of an NSI. Post exposure prophylaxis amongst a substantial amount of HCWs who did experience an accidental exposure, was distressingly low. Underreporting seemed to have been associated with profession. The age of the respondents did play a significant role in terms of the needle recapping practices of HCWs, with the middle age category between 36 to 40 years most often engaged in needle recapping behaviour. As per the active belief of the HCWs themselves, lack of knowledge, feedback on monitoring and training on IPC, as well as lack of availability of infection prevention and control guidelines were considered to be barriers to IPC in the hospital. Respondnets in this study also displayed a potential lack of awareness on the infrequent or absence of regular infection prevention and control committee meetings. Additionally, more than half of the total sample exhibited complete ignorance in terms of cost requirements for IPC interventions as a likely impedance of IPC. A disquieting amount of HCWs were found to have received training more than 24 months ago which deviated from the recommended annual refresher training as per the Occupational Health and Safety Act (No. 85 of 1993).