CHAPTER ONE
INTRODUCTION
1.0 Introduction
This chapter presents the background to the study, the research problem,
justification, aim, objectives, research questions, and the significance of
examining infection prevention and control (IPC) compliance among Year 2
nursing students.
1.1 Background Information
Infection prevention and control (IPC) policies and procedures are designed
to reduce the risk of healthcare-associated infections (HAIs), thereby
protecting both patients and healthcare workers in clinical settings (WHO,
2024). IPC is particularly critical because HAIs remain a major cause of
morbidity and mortality in hospitals worldwide. According to the World
Health Organization, approximately 7 out of every 100 patients in
high-income countries and 15 out of every 100 patients in low- and
middle-income countries acquire at least one HAI during hospitalization
(WHO, 2024).
Healthcare workers, especially nursing students, play a vital role in both the
transmission and prevention of infections. Consequently, all healthcare
personnel must receive rigorous IPC training to ensure patient safety, reduce
healthcare costs, and combat antimicrobial resistance (WHO, 2024; Darboe
et al., 2025). Despite these measures, gaps in IPC compliance persist,
particularly among nursing students transitioning from theoretical learning to
clinical practice. This underscores the need for continuous education,
effective supervision, and reinforcement of IPC principles.
Infection prevention and control is essential for reducing HAIs and
safeguarding both patients and healthcare personnel (WHO, 2022).
Adherence to IPC principles ensures safe clinical practices by minimizing the
risk of infection transmission (Smith & Jones, 2021). Second-year nursing
students, who are relatively new to clinical environments, are expected to
comply with IPC guidelines to protect themselves and their patients.
However, compliance levels vary due to factors such as inadequate
supervision, limited clinical experience, and insufficient understanding of IPC
guidelines (Brown et al., 2023).
Although IPC training is incorporated into nursing curricula, gaps remain in
understanding how effectively students apply these guidelines in clinical
practice. This represents a critical area of concern in nursing education and
patient safety (WHO, 2023). Addressing these gaps forms the foundation of
the present study.
1.2 Research Problem
Despite the inclusion of IPC guidelines in nursing education, many Year 2
nursing students experience difficulty consistently applying these principles
during clinical placements. This inconsistency exposes both patients and
healthcare providers to increased infection risks, thereby compromising
healthcare safety (Kim & Lee, 2024).
Globally, HAIs significantly threaten patient safety, affecting approximately
7% of hospitalized patients in high-income countries and up to 15% in low-
and middle-income countries (WHO, 2024). In Europe, over 4.8 million HAI
cases occur annually in acute care hospitals, while Sub-Saharan Africa
reports even higher prevalence rates, with some studies indicating rates
between 15% and 19% (WHO, 2024). In intensive care units, HAI incidence
can reach 30%, and in low-income countries, the risk may be up to 20 times
higher than in high-income settings (WHO, 2024).
Across Africa, including The Gambia, IPC compliance remains suboptimal
despite adequate knowledge among healthcare workers and students.
Studies conducted in The Gambia reveal that although over 86% of
healthcare personnel demonstrate sufficient IPC knowledge, only about
49.5% consistently comply with IPC practices (Darboe et al., 2025). Key
barriers include shortages of personal protective equipment (PPE),
inadequate supervision, and gaps in practical training. These findings
highlight the need for targeted instructional and supervisory interventions for
nursing students at various clinical levels.
The level of compliance and the factors influencing IPC adherence among
Year 2 nursing students at the School of Medicine and Allied Health Sciences,
Department of Nursing, have not been sufficiently explored. A clearer
understanding of students’ knowledge, compliance levels, and barriers to
adherence is therefore necessary to inform effective educational and
supervisory strategies.
1.3 Aim of the Study
The aim of this study is to assess the knowledge, level of compliance, and
factors influencing compliance with infection prevention and control
standards among Year 2 nursing students at the School of Medicine and
Allied Health Sciences.
1.4 Objectives of the Study
The specific objectives of the study are to: - Assess the level of knowledge of
Year 2 nursing students regarding infection prevention and control
guidelines. - Determine the level of compliance with IPC guidelines among
Year 2 nursing students in clinical settings. - Identify factors influencing
compliance or non-compliance with IPC guidelines among Year 2 nursing
students.
1.5 Research Questions
The study seeks to answer the following research questions: - What is the
level of knowledge of Year 2 nursing students regarding infection prevention
and control guidelines? - What is the level of compliance with IPC protocols
among Year 2 nursing students in clinical settings? - What factors influence
compliance or non-compliance with IPC guidelines among Year 2 nursing
students?
1.6 Significance of the Study
This study is significant at both global and regional levels.
Healthcare-associated infections remain a major public health concern, and
nursing students play a critical role in the effectiveness of IPC measures
(Elhadi et al., 2021). Findings from this study will provide evidence to
support improvements in nursing education, clinical supervision, and
institutional IPC policies. The results may assist educators, healthcare
administrators, and policymakers in strengthening IPC training, supervision,
and resource allocation, ultimately enhancing patient safety and quality of
care (Oruonye et al., 2025).