This study focused on evaluation of universal precautions practice in FETHAI. The work was guided by three research questions and objectives. The descriptive survey design was used in generating data through questionnaire, Simple percentage was used to analyze the data generated from 200 health workers in FETHAI. After the analysis, the researcher found that health workers at FETHAI have an appreciably high level of knowledge of universal precautions; they are favourably disposed towards universal precautions practices, and materials needed for universal precautions are readily available at the health institution.
The study recommended that, among other things, there is need for relevant authorities and agencies to carry out further sensitization and awareness programmes on universal precautions; all health workers must be made to adopt the attitude of strict adherence to universal precautions practices whenever they are on duty; there is need to monitor the level of compliance with universal precautions among health workers in FETHAI, and there is need to sustain the level of availability of materials needed for up in FETHAI and insist that these materials are judiciously used. In ocnclusion, the researcher stated that the practice of universal precautions in FETHAI is appreciably high.

1.0                                                INTRODUCTION
1.1       Background of the Study
Health promotion and development have remained at the centre stage of global discussions, especially as it concerns developing countries, where the healthcare situations are usually in a deplorable state. The commitment on the part of the global community to come up with strategies to ensure the promotion and development of global health condition is evident in the Millennium Declaration of September 6th-8th 2000, in New York, captioned the Millennium Development Goals (MDGs) (Mbam, 2006). The MDGs consist of eight (8) goals that were formulated as a structural framework to facilitate development in developing countries, among the 8 goals of the MDGs four (4) were geared towards the improvement of healthcare and healthcare related conditions. These four goals are to reduce child mortality (Goal 4); to improve maternal health (Goal 5); combat HIV/AIDS, malaria and other diseases (Goal 6); and ensure environmental sustainability (Goal 7), (Mbam, 2006; UNDP, 2006 and 2007). Remarkable health improvement can only be attained if the possibilities of transmission from infected to uninfected are reduced or eliminated, and the prevalence of disease conditions contained (Okaro et al, 2010). Thus, health improvement can only be achievable if, in the first place, measures or precautions are taken to protect the uninfected, mostly health care workers from being infected, while the infected are successfully treated of their disease conditions. Again, the emergence of dreaded diseases like HIV/AIDS and other life-threatening infections made it imperative that healthcare worker who comes into contact with those infected are protected (Culter and Jordan, 2004). In this wise, interventional measures have been proposed to minimize exposure of healthcare workers and patients to infections with the implementation of universal precautions as one of the strategies (Garcia-Zapata, et al 2010; Fawiad, et al., 2009, and Sadoh, 2006).

In 1983, in line with the objective of safeguarding the health of healthcare workers while on duty, the U.S. Centre for Disease Control and Prevention (CDC) published a document that recommended blood and body fluid precautions when a patient is know or suspected to be infected with fluid precautions when a patient is known or suspected to be infected with blood born pathogens (Beltrami, et al., 2000).According to Vaz et al., (2010), the CDC recommended, that regardless of status, the precautions must be consistently used. The extension of blood and body fluid precautions of all patients is referred to as “universal blood and body fluid precaution” or simply “universal precautions” (McCarthy, 2010).

In related accounts, it was stated that almost from the moment these guidelines were issued and hospital and clinics began implementing them, it was recognized that this new strategy, while protecting hospital personnel (patient-to-personnel transmission), sacrificed some measure of preventing patient-to-patient and personnel-to-patient transmission. (Jawaid et al 2009) Also, because many people with blood borne infections such as HIV/AIDs do not have symptoms, nor can they be visibly recognized as being infected, universal precautions had to be modified to include all person-patients and clients-attending healthcare facilities regardless of whether or not they are infected (Twitchell, 2003; and Gerberding, 2003). In line with this, compliance on the part of healthcare workers (HCWs,) including nursing and medical students with whom standard precautions have been recognized as efficient means to prevent and control health care-associated infections. Such measures not only protect the patients, but also the healthcare workers and the environment. Here, universal precautions include: hand washing; use of barriers (e.g gloves, gowns, caps, masks, etc); sterilization of devices, equipment and clothing used during care; environmental control (e.g surface processing protocols, health service waste handling); adequate discarding of sharp instruments including needles. Another important measure is adequate professional immunization, as this guarantees anticipated protection against immuned-preventable diseases (Pruss-ustun et al, 2003).

Indeed, threats from infections and disease–related complications, especially among healthcare workers handling healthcare facilities and attending to patients, have remained a source of nightmare to global population and relevant agencies: According to a World Health Organization (WHO) estimate, as contained in 16,000 hepatitis C virus, 66,000 hepatitis B virus and 1,000 HIV infections in health care workers worldwide. Recapping disassembly and inappropriate disposal increased the risk of needle stick injury (Wang, et al, 2008). Here, the incidence rate of these causative factors, according to Wang, et al (2008), is higher in developing countries with higher rate of injections with previously used syringes (Orji, 2002).

In Nigeria, According to Orji et al (2000) needle stick injuries were reported as the most common occupational health hazards in teaching hospitals. This heart-aching revelation is not unconnected with the typical Nigeria factor’ which stems from either a deliberate refusal to provide needed facilities even when the means to do so are not lacking or the non-adherence to recommended guidelines on the part of practitioners (Aniebue et al 2010). In the Federal Teaching Hospital, Abakaliki (FETHA 1), where our study is carried out, the same factors responsible for the situations in other parts of Nigeria could very well be obtainable there, but there is need for a verifiable evidence. This study, therefore arose from the researcher’s deep interest in carrying out an evaluation of universal precautions practice in healthcare facilities with particular emphasis on Federal Teaching Hospital, Abakaliki (FETHA1).

1.2       Statement of the Problem
Infection has remained one of the most important problems in healthcare services worldwide. It constitutes one of the most important causes of morbidity and mortality with clinical, diagnostic and therapeutic procedures (Papstairou et al 2011) Healthcare workers at Federal Teaching Hospital, Abakaliki, like every other healthcare workers anywhere, are at high risks of needle stick injuries and blood borne pathogens as they perform their clinical activities.
  They are exposed to blood borne pathogens, such as human immunodeficiency virus (HIV), hepatitis B and hepatitis C viruses, from sharp injuries and contacts with blood and other body fluids.

It is disturbing that, sometimes, healthcare workers may not even be provided with sufficient facilities to facilitate the practice of universal precautions as is commonly found in some of our hospitals. Here, factors beyond the control of these healthcare workers and even their management may be responsible for this retrogressive situation (Okaro et al 2010). In some cases, negligence, carelessness and ignorance could make healthcare workers to engage in health care practices without recourse to standard precautions. Situations like this, invariably, expose these healthcare personnel to avoidable hazards with their attendant threats on the continued fight to improve healthcare situations and the achievements already recorded. 

The problem of this study, arises from the fact that:
(i)        Adherence to the standard universal precautions practice could be constrained by factors that are entirely beyond the control of healthcare workers, its attendant consequences not withstanding.
(ii)       Sheer negligence, ignorance and lack of low level of control could make healthcare workers refrain from adhering to universal precautions practice as they discharge their duty.
(iii)     The non-compliance, on the part of healthcare workers, with universal precautions practice exposes them to grave danger of contracting the same disease condition they strive to take care of, thereby eroding the frame work for healthcare improvement and sustainability.
(iv)           Given the complicated nature of infections, the non-compliance with universal precautions practice will worsen the health  situations of the patients in FETHA 1.

1.3       Objectives of the Study
Generally, this study strives to carry out an evaluation of universal precautions practice in the Federal Teaching Hospital, Abakaliki (FETHA1). Specifically, the study will seek.

(i)        To ascertain the level of knowledge of universal precautions guidelines among healthcare workers in FETHA1.
(ii)       To determine the attitude of Healthcare workers in FETHA1  to the practice of universal precautions.

(iii)     To assess the level of availability of universal precaution facilities at FETHA1.

1.4       Research Question
This study seeks to provide answer to the following research questions.
(1)       What is the level of knowledge on universal precautions practice/guidelines among healthcare workers in FETHA1?
(2)       What is the attitude of healthcare workers in FETHA1 with respect to the practice of universal precautions?
(3)       What is the level of availability  of universal precautions facilities at FETHA1?

1.5       Significance of the Study
The findings of this study would be of tremendous benefit to various stakeholders in the healthcare sector, and the general public. The central position of health and healthcare-related issues in human lives makes this study very imperative or very germane. The various healthcare workers, patients and clients attending healthcare facilities would benefit immensely from this study, policy makers, Ministry of Health and relevant Agencies would find this study of great importance.
In the first place, healthcare workers, through this study, would be able to understand the importance of universal precautions practice and the danger that looms if it is flouted in the course of duty. The study would serve as a reinforcement of universal precautions practice among healthcare workers.

Again, this study would reveal to the various relevant agencies, the level of compliance with universal precautions, as practiced by healthcare worker in FETHA and provide a basis for policy actions. The study would also serve as a clarion call for the relevant agencies, government and management of healthcare facilities, to be pro-active to healthcare-related complications by not only emphasizing on the compliance with universal precautions guidelines, but also providing the facilities needed for this all-important and life-preserving strategy.

Moreover, the study would be of help to patients and clients attending healthcare facilities as they would be able to appreciate the importance of universal precautions accept the practice when it is suggested to them by health care workers, and even go ahead to demand for it if the staff on duty failed to comply with it. The general public would also be aware of this precaution and caution their loved ones visiting healthcare facilities to ensure a strict adherence to universal precautions. This would lay a veritable foundation for the prevention of the transmission of infections, and a great step towards, reducing the deteriorating healthcare situations in developing countries like Nigeria in general and Ebonyi State in particular.
Furthermore, the study being a research work, would add to the stock of knowledge in this field, and serve as a basis of reference in future studies in this or related fields.

1.6       Scope of the Study
This study focuses on carrying out an evaluation of universal precautions practice as adopted in healthcare facilities, with particular emphasis on Federal Teaching Hospital, Abakaliki (FETHA1). The study will only consider the practice by healthcare workers in FETHA1 exclusively. It must be made clear, this juncture that, other healthcare facilities also operate in Abakaliki, but they do not form part of the study. Also, healthcare personnel from other healthcare facilities will not be part of the study. Hence the study does not extend beyond FETHA, and the healthcare personnel therein.

1.7       Definition of Terms
In medical practice, this refers to a will to follow or observe a prescribed course of treatment or actions to prevent the likelihood of being exposed to disease to disease causing micro-organisms, such as bacteria, fungi, viruses, etc
Is a systematic, rigorous and meticulous application of scientific methods to assess the design, implementation, improvement, or outcomes of a program
The tendency of an individual to be infected by a disease, that ,the capacity to be affected by a particular form of disease or
Being predisposed or sensitive to a particular disease.
Otherwise called an infectious agent pathogen is a biological agent i.e. microorganism in the widest sense, such as a virus, bacteria, or fungus that causes disease in its host, and this host may be an animal(including humans),a plant, or even another microorganism.

Universal Precaution
An action taken in advance to protect an individual against possible danger, failure, injury or exposure in the face of a particular disease.
The invasion of a host organism bodily tissues by disease causing organism ,their multiplication, and the  reaction of host tissues to these organisms and the toxins they produce.
A term referring to any process that eliminates(removes)or kills all forms of microbial life, including transmission agents(such as fungi, bacteria, viruses, etc)present on a surface, contained in a fluid, in medication, or in a compound such
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