KNOWLEDGE OF UNIVERSAL PRECAUTION AMONG HEALTH WORKERS IN HOSPITALS FETHA1



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.

 REFERENCES
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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



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