Factors Associated With Infection Prevention And Control Knowledge And Practice Among Healthcare Workers, Kenema Government Hospital, Sierra Leone.

Abstract

Introduction: Infection prevention and control (IPC) is a hands-on discipline aimed at preventing the transmission of infections in healthcare settings. It is a critical component of the healthcare system. The main objectives of IPC include; the prevention of the incidence of infections in healthcare workers (HCW) and their patients, and other persons related with healthcare facilities; getting healthcare facilities in readiness for early detection, and response to disease outbreaks, and to ensure timely coordination and response to control community-acquired infectious diseases; it also gears to prevent and control antimicrobial resistance and the spread of resistant microorganisms. It is estimated that about 5% - 10% of patients are infected by one or more healthcare associated infection (HAI), and 15% - 40% of patients admitted to critical care are believed to be affected. This study assessed the factors associated with IPC knowledge and practice among healthcare workers, and the availability of IPC materials for practice at Kenema government hospital (KGH) in Sierra Leone. Methods: This was a facility-based cross sectional study that recruited 219 HCWs at KGH. Selection of HCWs to participate into the study was done through simple random sampling using a lottery method. Face-to-face structured questionnaires, and observational checklists were used for data collection. We used logistic regression analysis to assess the associations between knowledge, and practice, and the independent variables such as age, sex, profession, current working unit/ward, working shift, availability of IPC supplies in working area, level of education, training on IPC, work experience, awareness of IPC committee, and access to IPC guidelines. The level of significance was set at 0.05. Results: There was generally good knowledge (77.2%), and poor practice (53.3%) on IPC among the HCWs. Almost all the clinical areas had IPC supplies, although some basic PPEs such as gloves

were lacking in some. After conducting multiple logistic regression, tertiary level of education, (OR: 9.6, 95%CI: 2.8, 33.2, P= <0.001), five or more years work experience, (OR: 2.8, 95%CI: 1.2, 6.2, P= 0.013) were found to be significantly associated with knowledge on IPC, while working in the afternoon shift was significantly associated with good practice on hand hygiene (OR: 9.6, 95%CI: 1.2, 74.9, P=0.031), and reusable equipment (OR: 21, 95%CI: 1.2, 391, P=0.040).