The management of blood and body fluids in a Kenyan university hospital : a nursing perspective

Ngesa, Anna Adhiambo (2008-03)

Thesis (MCur (Nursing Science))--University of Stellenbosch, 2008.


ENGLISH ABSTRACT: The purpose of this study was to determine the knowledge of Universal Precautions Policy by Registered Nurses at Kenyatta National Hospital (Kenya) and their perception of occupational risk of exposure to blood-borne pathogens. The study also assessed management of blood and body fluids of patients and identified the types and frequency of occupational exposure common among these Registered Nurses. A structured 24-item, self-administered questionnaire was distributed to 185 randomly sampled Registered Nurses in selected departments at this hospital. Compliance with Universal Precautions practices was also observed using a checklist. Data analysis was done by use of a computer software package, Statistical Package for Social Sciences (SPSS) version 11.0. The study findings suggest: 1) lack of continuous education demonstrated by a high level of non-response about knowledge of Universal Precautions Policy with only 19% of the respondents having attended an in-service course in Universal Precautions Policy, and 2) inaccurate understanding of transmission modes of blood-borne pathogens. The majority of nurses surveyed were using Universal Precautions; with indications that nurses were not as familiar with Universal Precautions as they think they were. Respondents admitted modifying personal protection habits based on subjective judgment regarding patient’s perceived blood-borne infectious state. Non-compliant behaviours with barrier precautions were identified, which included failure to use gloves, gowns and protective eyewear, failure to wash hands, and recapping used needles. Compliance with barrier precautions was associated with patients’ perceived blood-borne status. The study revealed a high level of occupational exposures, of which the majority went unreported. Although respondents were aware of the risk of occupationally acquired blood-borne infections, their irregular practice of Universal Precautions Policy is likely to perpetuate the risks. The findings suggest a need for more educational interventions, which may result into integration of concepts into practice. Educational programmes should focus on the epidemiology of occupationally acquired blood-borne pathogens and their modes of transmission, risk of occupationally acquired blood-borne infections at work place, and with emphasis on the principle and practice of Universal Precautions Policy and current protocol of reporting mechanisms in Kenya.

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