CHAPTER
FIVE
5.0 CONCLUSIONS AND RECOMMENDATIONS
This chapter focuses on the summary of
the findings as obtained in the presentation and analysis of data generated in
the previous chapter. Conclusions and recommendations are also made in this
chapter.
5.1 Discussion of Findings
5.1.1 Research
Question 1: On The Level of Knowledge of Universal Precaution
From the analysis on the data generated
on knowledge of universal precautions among health workers in FETHA1, it was
revealed that the workers are adequately knowledgeable about standard
precautions. This finding is in consonance with Adinma, Ezeama, Adinma and
Asuzu (2009), who earlier found that knowledge of up measures was high among
house officers and nurses in tertiary health institutions in South East Nigeria.
This finding also concurs with Val et al.
(2010) who found that there was adequate knowledge and a fair level of
awareness among healthcare workers at the university Hospital of the West Indies,
Jamaica.
However, the result of this study stands
out starkly against the findings of Okaro, Eze Ohagwu (2010) who found that
many radiographers in tertiary hospitals in Enugu do not have knowledge of some
aspects of universal precaution. The findings also deviated form those of Izegbu,
Amole and Ajayi (2006) that knowledge of UP among workers in laboratories in
two colleges of medicine and their teaching hospitals in Lagos state was poor.
Ofili, Asuzu and Obi (2003) also had a result that did not converge on the same
point with this study. They found the level of knowledge and practice of UP
among nurses in central Hospital, Benin city, Edo State to be poor. The
findings of this study are also in stark contrast with those by Hawaid at al (2009), that majority of doctors
in civil Hospital in Karachi, Pakistan, did not know anything about CDC
guidelines for standard precautions.
5.1.2 Research Question 2: On Attitude of Health workers
On the attitude of the health workers in
FETHA1 towards universal precautions, it was found that these health personnel
exhibit a safely conscious attitude while on duty. This finding depicts a huge
deviation from what was obtained in nearly all the available literature
reviewed in this study. Ofili, Asuzu and Obi (2003) found that there was a poor
observance of UP among nurses in central Hospital, Benin City, Edo State. Hesse
et al (2006) obtained a relatively divergent finding that a large proportion of
health workers in a hospital in Ghana admitted reluctance to perform an
invasive procedure on an HIV positive patient. The finding, by Garcia-Zapata et
al (2010) also deviated from the findings obtained in this study when they
revealed that in spite of their impressive knowledge of UP majority of nursing
and medical students in a tertiary teaching hospital in Brazil did not wash
their hands before and after caring for a patient, even though the necessary
materials were there. Gaidhanes et al (2009) also obtained a contrasting
result, stating that majority of residents in Dalta Megha Institute, medical
science in India were following dangerous procedures of either bending It
against table wall or recapping used needles before disposal. The only
available finding that bear little resemblance to the one obtained in this
study was by Sadoh et al (2006), that compliance with non-recapping of used
needles and the screening of transfused blood by health workers in Abeokuta
metropolis was high. It must be stated however that more than half of them had
never worn goggles during deliveries and at surgeries.
5.1.3 Research question 3: On level of Availability
This study also revealed that materials
needed for universal precaution practices are readily available at FETHA1. This
finding concurs with those obtained Sadoh et
al (2009) and garlia-zapata et al (2009). Sadoh et al had earlier
reported that the provision of sharps containers by health institutions in
Abeokuta metropolis was high. In the same vein, Garcia-zapata et al reported that necessary materials
for precautions were made available for nursing and medical students in a
tertiary teaching hospital in Brazil, even though the students failed to make
use of them. However, the findings obtained in this study does not tie in with
Adinma et al (2009) who had earlier reported
a lack of provision of adequate protective equipment for house officers and
nurses in tertiary institutions in southeast Nigeria. The finings on
availability of necessary materials for UP in FETHA1 is also a negation of the
one obtained by Javaid, Igbaz and Shabbaz (2009) that protective tools were not
used by doctors in civil Hospital in Karachi, Pakistan due to non-availability
of protective modalities in the health facility.
5.2. Summary of Findings
* This
study reveals that health workers at FETHA1 have an appreciably high level of
knowledge of universal precautions. They are aware of the concept and it
importance; they understand what constitute universal precautions and practice
the safety measures.
* Health
workers at FETHA1 are favourably disposed towards universal precautions. They
view universal precautions as a good measure for preventing disease
transmission and cross infection; they readily decontaminate and sterilize
surfaces and instruments and hardly recap needless after used.
* The
study also revealed that materials needed for universal precaution practices
are readily available, for health workers’ use at FETHA1. The health
institution provides sufficient gloves, goggles, masks, shields, water-proof
gown, incinerators, puncture-resistant disposal containers and disinfectants at
points of use.
5.3 Conclusions
From the results obtained, the
researcher concludes that;
* Health workers at FETHA1 have adequate
knowledge of universal precautions.
* The health workers exhibit
safety-conscious attitude while on duty, thereby observing the universal
precautions measures.
* Materials that are needed for
universal precautions practices are adequately provided to health workers at
FETHA1, and they make judicious use of these materials.
5.4 Limitations of the Study
The following were the Limitations of
the study:
(i) Finance, time and helping hands,
especially during the distribution, collection and collation of data generated
during the study were limited the researcher had serious time and financial
constraints as she had to combine this research work with her studies.
(ii) This study was limited to evaluation of
universal precautions practice in FETHA1. As such, the findings of this study
could therefore, be generalized to Federal teaching Hospital Abakaliki. The
findings and conclusions are not universal.
(iii) The authenticity of this work solely
depends on the extent to which the respondents reacted to the instruments of
the study.
5.5 Suggestions for Further Studies
(i) There should be a further study to
evaluate universal precaution practice in other health institutions or
facilities in Abakaliki and other areas.
(ii) There should be a study that focuses mainly
on single variables such as knowledge, attitude or compliance with universal
precautions among health workers in various health institutions and facilities.
(iii) Another study should be carried out,
focusing on a comparative analysis to ascertain who between nurses and doctors
at FETHA1 comply with universal precautions practices the more.
5.6 Recommendations
In view of the findings of this study,
the following recommendations were made:
* Given
the fact that there are still some health workers, no matter how small, who are
not aware of the universal precautions concept, there is a need for relevant authorities
and agencies to carry out further sensitization and awareness programmes on
universal precautions to ensure that every health worker has good knowledge and
compliance with these measures.
* The
fact that a handful of the health working FETHA1 still exhibit unfavourable
attitude towards universal precautions still poses some risks to health
practices, and this makes it imperative that relevant authorities come up with
strategies to ensure all workers adhere strictly to universal precautions
practices whenever they are on duty.
* Relevant
authorities and agencies should strive to sustain the perceived high level of
availability of materials needed for universal precautions in FETHA1, and
ensure that those materials are judiciously used by health workers while on
duty.
* There
is a need for relevant authorities to monitor the level of compliance with
universal precautions among health workers in FETHA1, with a view to ensuring
that these precautions are carried out by all the health workers in every
occasion in the health institution.
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APPENDIX
II
QUESTIONNAIRE
PRESENTED TO THE HEALTH WORKERS AT FETHA1 ON THE EVALUATION OF UNIVERSAL
PRECAUTION PRACTICES.
SECTION
A
SOCIO-DEMOGRAPHIC
DATA OF HEALTH WORKERS AT FETHA1
AGE: 21-30 41-50 51 and above
Sex: Female Male
Health
workers status:
Nurses
Medical doctor
Laboratory workers
Ward orderly
SECTION
B
ON LEVEL OF
KNOWLEDGE
1. Have you heard about universal
precaution? Yes No
2. Do you practice universal
precaution? Yes No
3. Do you know what constitute universal
precaution? Yes No
4. How the see the concept of universal of
universal precaution do you think it is necessary. Yes No
ON ATTITUDE OF THE HEALTH WORKERS
5. Universal precaution is a good measure
preventing disease transmission and cross infection.
Strongly disagree (c) neither agree nor
disagree
(b) disagree (d) Strongly agree (e) agree
6. The use of universal precaution reduces
disease transmission and contamination. (a) Strongly
disagree
(b) disagree (c) neither agree nor disagree
(d)
Strongly agree (e)
agree
7. Decontamination and sterilization of
all surfaces and instruments are necessary. (a)
Strongly disagree
(b) disagree (c) neither agree nor disagree
(e)
agree (f)
agree Strongly
8. Recapping of needless after use is
good. (a) Strongly disagree
(b) Disagree (c) neither agree nor disagree
(d)
Strongly agree (e) agree
9. The use of isolation technique in the
treatment of clients with infectious disease is necessary. (a) Strongly
disagree
(b) Disagree (c) neither agree nor disagree
(d)
Strongly agree (e) agree
0. Promptly seeking medical attention and
counseling if exposed to contaminated materials is advisable (a) Strongly
disagree
(b) disagree (c) neither agree nor disagree
(d)
Strongly agree (e)agree
11. How conscious are you with respect to
universal precaution practice.(a) always
(b) Not always (c) Rarely
CHECK LIST
LIST OF
MATERIALS NEEDED FOR UNIVERSAL PRECAUTIONS
|
AVAILABLE
|
NON-AVAILABLE
|
1.
Sufficient gloves
|
||
2. Glass, goggles, masks, shields and water
proof gowns/aprons
|
||
3.
Incinerators for disposing used needles
|
||
4.
Puncture-resistant sharp disposal containers at the point of use.
|
||
5.
Disinfectant for cleaning surfaces and device after use
|