CHAPTER ONE
1. 1 BACKGROUND OF THE STUDY
Standard precautions are set of fundamental infection prevention and
control (IPC) measures designed to protect both health care workers and
patients from the transmission of infectious agents in all health care settings.
These precautions include proper hand hygiene, use of personal protective
equipment (PPE), safe handling and disposal of sharps, respiratory hygiene,
and environmental cleaning to reduce the risk of exposure to blood and body
fluids from both known and unknown sources of infection. The practice of
standard precautions is rooted in the understanding that all body fluids,
secretions (except sweat), and non-intact skin may contain transmissible
pathogens that could result in healthcare-associated infections (HAIs) if IPC
measures are not consistently applied.
Nurses constitute the largest group of healthcare workers and are directly
involved in patient care activities that expose them to blood, body fluids, and
contaminated materials. As a result, nurses are at increased risk of
occupational hazards such as needlestick injuries and infections including
HIV, hepatitis B, and hepatitis C (Adebimpe et al., 2015). Effective practice of
standard precautions is therefore essential for protecting nurses, preventing
healthcare-associated infections (HAIs), and ensuring patient safety.
Despite the availability of international guidelines, studies have shown that
compliance with standard precautions among nurses is often inadequate,
especially in developing countries. In Nigeria, research conducted in tertiary
hospitals revealed that although healthcare workers had good knowledge
and positive attitudes toward standard precautions, their level of practice
was poor (Iliyasu et al., 2016). Factors such as inadequate supply of PPE, lack
of regular training, heavy workload, and poor institutional support were
identified as major barriers to effective practice.
Similarly, studies from other parts of Nigeria reported gaps between
knowledge and actual practice of standard precautions among nurses,
particularly in areas such as hand hygiene and safe disposal of sharps
(Efstathiou et al., 2011). Poor adherence to these precautions increases the
risk of healthcare-associated infections, leading to prolonged hospital stays,
increased healthcare costs, and preventable morbidity and mortality.
In Northern Nigeria, including Sokoto State, healthcare facilities often face
challenges related to limited resources, inadequate infection control
infrastructure, and insufficient monitoring systems (Iliyasu et al., 2016).
Specialist Hospital Sokoto serves a large population and relies heavily on
nurses for patient care delivery. However, there is limited documented
evidence on the extent to which nurses in this hospital practise standard
precautions. Assessing the practice of standard precautions among nurses at
Specialist Hospital Sokoto is therefore necessary to identify gaps, inform
appropriate interventions, and improve infection prevention and patient
safety within the hospital.
1. 2 Statement of the Problem
Healthcare-associated infections (HAIs) remain a major public health concern
worldwide, particularly in developing countries where infection prevention
and control practices are often inadequately implemented. Nurses, who
provide continuous and direct patient care, are at increased risk of exposure
to infectious agents due to frequent contact with blood, body fluids, and
contaminated materials. Although standard precautions are internationally
recommended as the minimum infection prevention measures for all patient
care activities, evidence suggests that compliance among nurses is often
inconsistent and suboptimal (World Health Organization [WHO], 2016).
Studies conducted in Nigeria have demonstrated a persistent gap between
nurses’ knowledge of standard precautions and their actual practice. For
instance, Iliyasu et al. (2016) reported that despite good awareness of
infection control measures among healthcare workers in tertiary hospitals,
adherence to standard precaution practices was low. Factors such as
inadequate supply of personal protective equipment (PPE), lack of regular
training, heavy workload, and poor institutional monitoring were identified as
major contributors to poor compliance. This inadequate practice increases
the risk of occupational exposure, including needle stick injuries and
transmission of blood-borne infections such as HIV and hepatitis B and C.
Furthermore, poor adherence to standard precautions has been associated
with increased incidence of healthcare-associated infections, prolonged
hospital stays, increased healthcare costs, and preventable morbidity and
mortality (Efstathiou et al., 2011). In resource-limited settings, these
challenges are often exacerbated by weak infection control policies and
insufficient infrastructure, making effective implementation of standard
precautions difficult.
In Northern Nigeria, including Sokoto State, healthcare facilities face similar
challenges related to limited resources and inconsistent infection control
practices (Iliyasu et al., 2016). Specialist Hospital Sokoto serves a large and
diverse patient population, and nurses play a critical role in the delivery of
healthcare services. However, there is limited documented evidence on the
level of practice of standard precautions among nurses in this hospital,
making it difficult to assess compliance, identify existing gaps, and
implement targeted interventions.
Therefore, the problem this study seeks to address is the uncertain level of
practice of standard precautions among nurses at Specialist Hospital Sokoto,
despite their critical role in patient care and infection prevention. Identifying
the extent of compliance and the factors influencing standard precaution
practices among nurses in this hospital is essential for improving infection
control measures, enhancing patient safety, and protecting nurses from
occupational hazards.
1. 3 Objectives of the study
1. Assess the level of knowledge of standard precautions among nurses
at Specialist Hospital Sokoto.
2. Examine nurses’ attitudes toward standard precaution practices in
patient care.
3. Identify challenges or barriers faced by nurses in implementing
standard precautions during patient care.
4. Determine the extent of practice of standard precautions in the care of
patients among nurses at Specialist Hospital Sokoto.
1. 4 Research question
1. What is the level of knowledge of standard precautions among nurses
at specialist hospital sokoto
2. What is the attitude of nurses towards standard precaution practice in
patient care at specialist hospital sokoto
3. What changes or barriers do nurses face in implementing standard
precaution during patient care at specialist hospital sokoto?
4. To what extent do nurses practice standard precaution in the care of
patients at specialist hospital sokoto
1. 5 Significance of the study
The findings of this study will be of great significance to nurses, patients,
hospital management, healthcare policymakers, and future researchers.
The study will help nurses at Specialist Hospital Sokoto to become more
aware of the importance of standard precautions in patient care. By
identifying gaps in knowledge, attitude, and practice, the study will
encourage improved compliance with infection prevention measures,
thereby reducing occupational exposure to infectious diseases.
The study will benefit patients by promoting safer nursing care practices.
Improved adherence to standard precautions will reduce the risk of
healthcare-associated infections, enhance patient safety, and improve
overall quality of care within the hospital.
The findings will also be useful to hospital management and
administrators. The study will provide evidence-based information on
existing challenges and barriers faced by nurses in implementing
standard precautions. This information can guide management in
planning regular training programs, ensuring adequate supply of personal
protective equipment (PPE), and strengthening infection prevention and
control policies within the hospital.
1. 6 Scope of the study
This study is limited to assessing the practice of standard precautions in the
care of patients among nurses at Specialist Hospital Sokoto, Sokoto State,
Nigeria. The study focuses specifically on registered nurses working in
selected clinical units of the hospital, including wards, outpatient
departments, and other patient-care areas where direct nursing services are
provided.
The scope of the study covers the assessment of nurses’ knowledge,
attitude, and practice of standard precautions, as well as the challenges or
barriers they face in implementing these precautions during patient care.
Standard precautions considered in this study include hand hygiene, use of
personal protective equipment (PPE), safe handling and disposal of sharps,
infection control measures, and environmental cleanliness.
The study does not include other categories of healthcare workers such as
doctors, laboratory scientists, or cleaners, and it does not assess infection
control practices in other healthcare facilities outside Specialist Hospital
Sokoto. Additionally, the study does not measure the incidence of healthcare-
associated infections but is limited to evaluating nurses’ compliance with
standard precaution practices.
1. 7 Operational Definition of Terms
1 Standard Precautions:-In this study, standard precautions refer to the basic
infection prevention and control practices used by nurses at Specialist
Hospital Sokoto, including hand hygiene, use of personal protective
equipment (PPE), safe handling and disposal of sharps, proper waste
management, and environmental cleanliness to prevent the transmission of
infections during patient care.
2 Practice of Standard Precautions:-This refers to the extent to which nurses
at Specialist Hospital Sokoto correctly and consistently apply standard
precaution measures during patient care, as measured by their responses to
the practice section of the research questionnaire.
3 Knowledge of Standard Precautions:-In this study, knowledge refers to the
level of understanding nurses have regarding standard precaution guidelines
4 Attitude toward Standard Precautions:-Attitude refers to the beliefs,
perceptions, and feelings of nurses at Specialist Hospital Sokoto regarding
the importance and usefulness of standard precaution practices in patient
care
5 Nurses:-For the purpose of this study, nurses refer to registered nurses
working in clinical units at Specialist Hospital Sokoto who are directly
involved in patient care activities.
6 Patient Care:-Patient care refers to all nursing activities carried out by
nurses at Specialist Hospital Sokoto that involve direct contact with patients
7 Personal Protective Equipment (PPE):-In this study, PPE refers to protective
items such as gloves, face masks, gowns, and eye protection used by nurses
8 Challenges/Barriers:-Challenges or barriers refer to factors that hinder
nurses at Specialist Hospital Sokoto from effectively practicing standard
precautions, such as lack of PPE, inadequate training, heavy workload