Abstract
BACKGROUND
Compliance with standard precautions for infection control is a major challenge for healthcare workers, especially those in developing countries, and poor compliance may compromise safety and increasing exposure to blood-related pathogens. The increasing number of healthcare workers infected with COVID-19 in Eswatini suggests that there may be suboptimal implementation and compliance with standard precautions in the country.
STUDY OBJECTIVE
To investigate healthcare worker knowledge and compliance with COVID-19 standard precautions at two major regional hospitals in Eswatini.
METHODS
The study used a quantitative descriptive cross-sectional design. Present-day data were gathered from a pool of healthcare workers of varied healthcare cadres and demographics. The study was conducted at two major regional referral hospitals of Eswatini. The target population for this study comprised doctors, nurses, nurse assistants, healthcare lay cadres (HIV testing counsellors, phlebotomists and expert clients), laboratory personnel, and cleaners assigned to clinical services during the study period. A stratified random sampling method was adopted for the study. A structured self-administered questionnaire, based on standard precautions guidelines, was used to gather information anonymously from respondents who voluntarily agreed to participate in the study.
RESULTS
This study evaluated the knowledge and compliance with standard precautions among healthcare workers in Eswatini. A total of 146 study participants were recruited a response rate of 68.9% (146/212). Majority were females 110 (76%), 35 (24%) were between the ages of 30 – 35 years old and 89 (61%) nurses.
Knowledge of COVID-19 standard precautions. Overall knowledge of COVID-19 standard precautions was 81.27%. Nurses were found to be knowledgeable of the standard precautions (82.9%, standard deviation = 10.572). There was no between significant difference between participants who received training on standard precautions (81.65%) and those that did not receive the training (89%). A statistically significant weak negative relationship (r = -2.54 and p = <0.05) was observed between knowledge of standards precautions and years of work
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indicating that with increase in the number of years worked the knowledge of standard precautions decreases.
Compliance with COVID-19 infection prevention and control (IPC) standard precautions. Overall compliance with COVID-19 standard precautions was 72%. Cleaners /Orderlies were found to be more compliant (83.88%) with the standard precautions. Major reasons provided for non-compliance were non-availability of IPC equipment, not practical and time consuming.
Association between knowledge of and compliance COVID-19 standard precautions
There was no significant correlation between knowledge of and compliance with standard precautions (r = 0.003, p = 0.973).
CONCLUSION
Healthcare workers are knowledgeable and compliant with COVID-19 standard precautions. Receiving training on standard precautions does not improve knowledge of or compliance with standard precautions. Knowledge does not improve compliance with standard precautions, there are factors influence compliance beyond knowledge of the standard precautions. Unavailability of essential IPC supplies and equipment, the time-consuming rigours of wearing PPE, and the impracticality of adhering to stipulated frequencies of IPC-related activities were some of the barriers to compliance.