Factors affecting compliance to infection prevention and control measures among frontline health workers: a case study of the Kitale County Referral Hospital
Kisaka, Yvette Nafula
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The quality of services provided at a healthcare facility is greatly influenced by compliance to infection prevention and control (IPC) standards. Low adherence increases the risk of transmitting pathogens like Covid-19 and exposure to occupational hazards. This study sought to assess factors that affect compliance to the IPC standards by frontline healthcare workers at the Kitale County Referral Hospital in Trans-Nzoia County. For purpose of the study, frontline healthcare workers include nurses and doctors only. The study objectives were to (i) examine the implementation of infection prevention and control (IPC) measures relating to hand hygiene, personal protective equipment (PPE) usage, and safe injection practices at the Kitale County Referral Hospital (ii) describe the patterns of association between selected health worker socio-demographic characteristics and compliance to the IPC standards and (iii) examine health facility factors that affect compliance to the IPC standards. A mixed-methods study design was employed. Actual data was collected from healthcare workers, who were stratified into two groups: nurses and doctors. For quantitative data, participants were selected using the stratified random sampling method, and data collected using a semi-structured questionnaire, followed by analysis using the Statistical Package for Social Sciences (SPSS). For the qualitative component, purposive sampling was employed to select participants, data collected through in-depth interviews guided by a topic guide and analyzed using the by NVivo Pro software. A total of 111 participants were involved in the survey, with eight being included in the in-depth interviews. Of the 111, 81% were nurses, and 65% female. Nearly two-thirds said they had had IPC training. The survey found the level of full compliance to be 53.2% for hand hygiene, 52.3% for PPE use, and 59.5% for injection safety which was lower than expected considering the global efforts towards improving IPC practices in the covid-19 era. Additionally, it showed a significant correlation between health worker cadre and compliance to hand hygiene. Existence of an IPC committee, provision of adequate PPE and injection safety boxes, management support, availability of policies and guidelines, and their ease of accessibility were also linked to level of compliance to hand hygiene, PPE use and injection safety. The findings add to ongoing research aimed at understanding how IPC policy and practice can be improved to eliminate transmission of nosocomial infections, especially in the Covid-19 pandemic.