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KNOWLEDGE, ATTITUDE AND PRACTICE OF STANDARD PRECAUTIONS AMONG HEALTH CARE WORKERS

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KNOWLEDGE, ATTITUDE AND PRACTICE OF STANDARD PRECAUTIONS AMONG HEALTH CARE WORKERS

CHAPTER ONE
1.1 INTRODUCTION
Infection is one of the most important problems in health care services worldwide. It constitutes one of the most important causes of morbidity and mortality associated with clinical, diagnostic and therapeutic procedures.1,2
Health care workers (HCWs) are at a high risk of needle stick injuries and blood-borne pathogens as they perform their clinical activities in a hospital.3 They are exposed to blood borne pathogens, such as human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses, from sharp  injuries and contacts with blood and other body fluids.4,5 According to a WHO estimate, in the year 2002, sharp injuries resulted in 16,000 hepatitis C Virus, 66,000 hepatitis B virus and 10,000 HIV infections in health care workers worldwide.6 There is no immunization for HIV and hepatitis C.7 It becomes important to prevent infection by preventing exposure. Recapping, disassembly, and inappropriate disposal increase the risk of needle stick injury.8,9 The incidence rate of these causative factors is higher in developing countries for the higher rate of injection with previously used syringes.10 Developing countries where the prevalence of HIV-infected patients is very high, record the highest needle stick injuries too.10 Needle stick injuries were also reported as the most common occupational health hazard in a Nigerian teaching hospital.11 The World Health Organization (WHO) estimates that about 2.5% of HIV cases among HCWs and 40% of hepatitis B and C cases among HCWs are the result of these exposures.12 Irrational and unsafe injection practices are rife in developing countries.13 The practice of recapping needles has been identified as a contributor to incidence of needle stick injuries among HCWs.5, 14 It is believed that only one out of three needle stick injuries are reported in the US, while these injuries virtually go undocumented in many developing countries.15 Unsafe injections and the consequent transmission of blood borne pathogens are suspected to occur routinely in the developing world.16 It was estimated that each person in developing countries receives an average of 1.5 infections per annum. 16, 19 About 90-95% of injections are therapeutic, while 5-10% is given for immunization.17 It has been shown that between 70% and 99% of these injections are unnecessary, while at least 50% are unsafe in 14 of 19 countries in five developing world regions with data. 17, 18, 19, 20.

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KNOWLEDGE, ATTITUDE AND PRACTICE OF STANDARD PRECAUTIONS AMONG HEALTH CARE WORKERS

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