Healthcare workers’ knowledge on nosocomial infections preventive measures and its associated factors in Ghana: a cross-sectional study

doi:10.21203/rs.3.rs-2985693/v1

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Healthcare workers’ knowledge on nosocomial infections preventive measures and its associated factors in Ghana: a cross-sectional study

https://doi.org/10.21203/rs.3.rs-2985693/v1

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published 01 Sep, 2023

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Background: Nosocomial infection is a worldwide health concern that affects around 1.4 million individuals and is like an endemic in sub-Saharan Africa. Despite advances in medical technology and surgical management procedures in both developed and developing countries, these infections still continue to be prevalent. The objective of this study was to determine the knowledge in preventive measures and the socio-demographic factors that influence knowledge in preventive measures of nosocomial infection, among healthcare workers in the Hohoe Municipality, Ghana.

Methods: A descriptive cross-sectional study was conducted from July to August 2021. A sample of 237 healthcare workers in the Hohoe Municipality was selected to participate in the study. Data was collected with a questionnaire designed in Google Forms and analyzed using Stata version 16.0.

Results: The majority of the healthcare workers were females 124(52.3%) while males were 113(47.7%). More than two-thirds of them 195(82.7%) were within the age group of (20-40) years. Findings from this study showed that majority (69.2%) of the healthcare workers were not knowledgeable on the preventive measures of nosocomial infections. However, the study revealed that age [aOR=0.25; 95%CI=0.09-0.69), p=0.007] and in-service training or workshop [aOR=9.55; 95%CI=1.23-74.36), p=0.031] were statistically significant to healthcare workers’ knowledge in preventive measures of nosocomial infections.

Conclusion: The study concludes that age and participation in-service training or workshop are significant factors that influence the knowledge of healthcare workers in preventive measures for nosocomial infections. These results highlight the importance of providing ongoing training and professional development opportunities to healthcare workers to enhance their knowledge and improve their ability to prevent and control nosocomial infections. Additionally, the study emphasizes the need for targeted training programs that take into account the age of healthcare workers, in order to ensure that training is tailored to their specific needs and learning styles.

Knowledge

Socio-Demographic

Health Workers

Nosocomial Infection

Prevention Measures

Nosocomial infection is a worldwide health concern that affects around 1.4 million individuals and is like an endemic in sub-Saharan Africa (1). Despite advances in medical technology and surgical management procedures in both developed and developing countries, these infections still continue to be prevalent (2). Nosocomial infections are those infections that patients acquire while receiving health care. They are also called hospital-acquired infections or health care-associated infections (3).

About 5.0–10.0% of all admitted patients develop nosocomial infections and 70.0% of the identified pathogens are resistant to one or more of the antimicrobial medicines presently in use. Transmission of infectious agents within a healthcare setting requires three agents; a reservoir, susceptible host, and a mode of transmission (4). Patients, healthcare workers and visitors however, are susceptible to infectious organisms in a hospital environment. The mode of transmission may vary by the type of organism as some types of organisms may be transmitted through more than one route. The complex interrelationship between a potential host and an infectious agent produces infection. However, compliance on the part of healthcare workers with standard precautions has been recognized as an efficient and effective means to prevent and control healthcare-associated infections among health workers, patients and their visitors (5).

HCAIs remain a major challenge to the health care system constituting over 25.0% of infection rates in the hospital setting and result in significant mortality, morbidity, and economic burden worldwide. One of the major reasons for these high rates of HCAIs is the lack of infection control programs which have been neglected due to limited resources, competing priorities, and other barriers (6). HCAIs occur worldwide and affect both developed and developing countries. About 5.0–10.0% patients acquire one or more infections and 15.0–40.0% of the patient admitted to critical care are thought to be affected. It is also estimated that more than 1.4 million people worldwide are suffering from infections acquired in hospitals (7). One in every ten patients are estimated by the World Health Organization (WHO) to be affected by nosocomial infections globally. 7.0% of patients in developed countries and 15.0% of patients in developing countries acquire infections at the health facility. Likewise, intensive care units (ICUs) account for an increase in cases of nosocomial infections up to 30.0% in high-income countries which triples in number in developing countries (8).

Furthermore, the burden of HAIs is disproportionately higher in low-and middle-income countries as compared to high-income countries. In sub-Saharan Africa, data available shows that the incidence of nosocomial infections ranges from 2.0–49.0% with patients in intensive care units having the highest rate ranging from 21.2–35.6%. The prevalence of nosocomial infections has been reported to vary between 1.6–28.7% in Burkina Faso, United Republic of Tanzania, Ghana, Mali, Cameroon, Gabon, Uganda, Burundi, Democratic Republic of Congo and Senegal. In Nigeria and Ethiopia, the total accruing occurrence in surgical wards has been reported to vary from 5.7–45.8% with the later having an incidence as high as 45.8% and an incidence density equal to 26.7 infections per 1000 patient days in pediatric surgical patients (9). Also, 3.4–10.9% of hospital-associated infections often result in mortality in most developed countries though these figures are suspected to be higher in developing countries of sub-Saharan Africa including Ghana (1).

Study design

A descriptive cross-sectional study design was employed in this study. This study was carried out in the Hohoe Municipality, in the Volta Region of Ghana. The Hohoe Municipality is one of the eighteen (18) districts in the Volta Region. The city of Hohoe, of which the district was named, serves as the capital and the administrative or local government centre. It shares borders with the Republic of Togo on the east; on the southeast by the Afadzato district and southwest by Kpando Municipality; on the north with Jasikan district; and on the northwest with the Biakoye districts. Its capital, Hohoe, is about 78 kilometers from Ho, the regional capital and 220km from Accra, the national capital. The Municipality consist of one hundred and two (102) communities with a population of 167,016 projected from the 2010 National Population Census.

Sample size and sampling procedure

Using Cochrane’s single proportion formula, a sample size of 215 was estimated as follows;

\(n=\frac{{z}^{2} p(1-p)}{{d}^{2}}\) , considering 5% margin of error, 95% confidence interval = 1.96 and a proportion knowledge of 83.21% from a study conducted by (9). Where;

n = Estimated sample size

p = 0.8321

q= (1-p)

d = margin of error (0.05)

Z = Test Statistic (1.96)

Adding 10% to cater for non-response increased the estimated sample size to 237.

The Hohoe Municipal comprises of four (4) sub-districts and all these sub-districts have health facilities. A simple random sampling was used to select two health facilities from the four (4) sub-districts. This was done by writing the names of all the health facilities from the four (4) sub-districts on pieces of paper, folded for concealment and place into a container. These papers were thoroughly mixed, and two neutral persons were asked to pick one piece of paper each from the container without opening. In each of the two facilities sampled, HCWs who met the inclusion criteria and consented to participate in the study were conveniently selected.

Definition of variables

Outcome variable

Knowledge on preventive measures of nosocomial infections was the study’s outcome variable. This was assessed using eleven (11) items on the questionnaire. These items assessed whether respondents (I) have heard about infection prevention (II) could tell if gloves provide complete protection against acquiring or transmitting infections (III) knows if washing hands with soap or an alcohol-based antiseptic decreases the risk of transmission of nosocomial infections (IV) knows if the use of an alcohol-based antiseptic for hand hygiene is as effective as soap and water if hands are not visibly dirty (V) knows if gloves should be worn if blood or body fluid exposure is anticipated or not (VI) knows if there is a need to wash hands before doing procedures that do not involve bodily fluids or not (VII) knows if there is a need to wear the same pair of gloves for multiple patients as long as there is no visible contamination or not (VIII) knows the specific waste disposal buckets according to the level of their contamination (VIV) knows the written formula for preparing 0.5% chlorine solution (X) knows how long instrument or equipment should be disinfected and (XI) knows disease that are transmitted by needle stick injury.

For each of the items (I-X), respondents were asked to choose from the two responses “yes” or “no” provided. For question (XI), respondents were provided with a list of diseases (HBV, HCV, TB, HIV) to choose from. Respondents were allowed to choose from the list multiple times. A composite knowledge score was obtained by assigning a score of 1 to all the positive responses to the eleven (11) questions. All negative responses on the other hand were assigned the score of 0. A mean score was generated by adding all these responses and HCWs who scored below the mean were considered “not knowledgeable” on the preventive measures of nosocomial infections, whereas HCWs who scored above the mean were considered “knowledgeable”. The study incorporated the classification of knowledge on the preventive measures of nosocomial infections into “not knowledgeable” and “knowledgeable” from previous studies (13, 14, 17, 18).

Explanatory variable

For the study, five (5) explanatory variables were considered in our estimations. These variables included age, sex, level of education, years of working experience and in-service training or workshop. None of these variables were chosen at random; rather, they were chosen based on the findings of previous studies on knowledge in preventive measures of nosocomial infections among healthcare workers (10–12). In assessing these socio-demographic information of the respondents, age and years of working experience were collected as continuous variables and categorized into (< 20 years, 20–40 years, 41–60 years) and (1–10 years, 11–20 years and > 20 years) respectively. Respondents’ sex (male or female), level of education (certificate, diploma, degree, masters or doctoral), and in-service training or workshop (yes or no) were collected as categorical variables.

Data collection

The study covered a period from July 2021 to August 2021. Healthcare workers working in the Hohoe Municipality and whose consents are been sought during the time of the study were recruited to participate in the study. Data was collected using a well-structured questionnaire comprising of both open and close-ended questions which were pretested. The questionnaire was designed in Google Forms. It comprised of 35 items related to the socio-demographic factors, knowledge in preventive measures and practice of preventive measures of nosocomial infections.

Data analysis

The data was extracted from Google Forms to Excel Sheet for cleaning and then exported into STATA 16.0 for analysis. To ensure the quality of the data extracted, double entry was done to address discrepancies which may have occurred during data extraction. The data was extensively cleaned again in STATA 16.0 before analysis was carried out. Descriptive statistics were performed to interpret the socio-demographic features including age, sex, level of education, work experience, and in-service training or workshop on nosocomial infection prevention. However, inferential statistics were done to test the association between socio-demographic factors and healthcare workers' knowledge in preventive measures of nosocomial infections. Frequencies and percentages related to the study findings were presented using tables and graphs.

Table 1 provides a distribution of the socio-demographic characteristics of the respondents. The majority of the healthcare workers were females 124 (52.3%) while males were 113 (47.7%). More than two-thirds of them 195 (82.7%) were within the age group of (20–40) years. Among the healthcare workers, the majority of them 127 (53.6%) were Diploma holders. Regarding their work experience, almost all of them 204 (86.1%) had work experience ranging between (1–10) years. Out of the total 237 healthcare workers, 218 (92.0%) had ever attended in-service training or workshop on nosocomial infection prevention while 19 (8.0%) had never attended any in-service training or workshop on nosocomial infection prevention.

Table 1

Distribution of the socio-demographic characteristics of the respondents
Variable	Frequency (n = 237)	Percentage (%)
Sex
Female	124	52.3
Male	113	47.7
Age
< 20 years	19	8.0
20–40 years	195	82.3
41–60 years	23	9.7
Level of Education
Certificate	15	6.3
Diploma	127	56
Degree	80	33.8
Masters	14	5.9
Doctoral	1	0.4
Years of Working Experience
1–10 years	204	86.1
11–20 years	23	9.7
> 20 years	10	4.2
In-service training or Workshop
No	19	8.0
Yes	218	92.0

Knowledge of healthcare workers in preventive measures of nosocomial infections

Table 2 above showed the knowledge of healthcare workers in preventive measures of nosocomial infection. Out of the total 237 healthcare workers who participated in the study, more than ninety percent 216 (91.1%) indicated that they had heard about infection prevention. More than half 148 (68.5%) out of the 216 (91.1%) who had heard about infection prevention believed that gloves cannot provide complete protection against acquiring or transmitting infections. Almost all of them 213 (98.6%) believed that washing your hands with soap or using an alcohol-based antiseptic decreases the risk of transmission of nosocomial infections. More than eighty percent of them 187 (86.6%) also indicated that the use of an alcohol-based antiseptic for hand hygiene is as effective as soap and water if hands are not visibly dirty. All of them 216 (100%) agreed that there is a need to wash hands before doing procedures that do not involve bodily fluids. Furthermore, 198 (83.5%) of the healthcare workers know the specific waste disposal buckets according to the level of their contamination. The majority of them 210 (88.6%) indicated that instruments or equipment should be disinfected for 10 minutes.

Table 2

Knowledge of healthcare workers in preventive measures of nosocomial infections
Variables	Frequency (n = 237)	Percentage (%)
Did you hear about infection prevention?
No	21	8.9
Yes	216	91.1
Can gloves provide complete protection against acquiring or transmitting infections? (n = 216)
No	148	68.5
Yes	68	31.5
Can washing your hands with soap or an alcohol-based antiseptic decreases the risk of transmission of nosocomial infections? (n = 216)
No	3	1.4
Yes	213	98.6
Is the use of an alcohol-based antiseptic for hand hygiene as effective as soap and water if hands are not visibly dirty? (n = 216)
No	29	13.4
Yes	187	86.6
Should gloves be worn if blood or body fluid exposure is anticipated? (n = 216)
No	38	17.6
Yes	178	82.4
Is there a need to wash hands before doing procedures that do not involve bodily fluids? (n = 216)
No	0	0.00
Yes	216	100
Is there a need to wear the same pair of gloves for multiple patients as long as there is no visible contamination? (n = 216)
No	201	93.1
Yes	15	6.9
Do you know specific waste disposal buckets according to the level of their contamination?
No	39	16.5
Yes	198	83.5
Do you know the written formula for preparing 0.5% chlorine solution?
No	51	21.5
Yes	186	78.5
For how long should instrument or equipment be disinfected?
10 minutes	210	88.6
1hr	20	8.4
24hrs	7	3.0
Which of the following disease is transmitted by needle stick injury? (More than one answer is possible)
HBV; HCV	1	0.4
HBV; HCV; HIV	117	49.4
HBV; HCV; TB; HIV	3	1.3
HBV; HIV	52	21.9
HBV; TB; HIV	2	0.8
HIV	58	24.5
TB; HIV	4	1.7
HBV: Hepatitis B Virus;HCV: Hepatitis C Virus;HIV: Human Immunodeficiency Virus;TB: Tuberculosis

Figure 1 below showed the overall level of knowledge of healthcare workers in preventive measures of nosocomial infection. A knowledge mean score was generated using the items used to measure the level of knowledge among the HCWs. HCWs who scored below the mean were considered not knowledgeable on the preventive measures of nosocomial infections, whereas HCWs who scored above the mean were considered knowledgeable.

The findings from this study revealed that 69.2% of the healthcare workers are not knowledgeable on the preventive measures of nosocomial infections.

Table 3

Factors associated with healthcare workers’ knowledge on preventive measures of nosocomial infections

Variable	Not Knowledgeable = 164 n(69.20%)	Very Knowledgeable = 73 n(30.80%)	cOR [95% CI]	P-values	aOR [95%CI]	P-values
Sex
Female	92(56.10)	32(43.84)	0.51 [0.12–0.71]	0.081
Male	72(43.90)	41(56.16)	6.12 [1.01–1.99]	0.132
Age
< 20 years	7(4.27)	12(16.44)	*Ref		*Ref
20–40 years	136(82.93)	59(80.82)	0.25 [0.09–0.67]	0.006	0.25 [0.09–0.69]	0.007
41–60 years	21(12.80)	2(2.74)	0.06 [0.01–0.31]	0.001	0.05 [0.01–0.29]	0.001
Level of Education
Certificate	10(6.10)	5(6.85)	6.43 [2.62–9.67]	0.072
Diploma	84(51.22)	43(58.90)	0.87 [1.08–6.95]	0.111
Degree	56(34.15)	24(32.88)	5.43 [0.03–1.72]	0.065
Masters	13(7.93)	1(1.37)	0.97 [0.07–0.49]	0.232
Doctoral	1(0.60)	0(0.00)	3.25 [1.33–4.11]	0.142
Years of Working Experience
1–10 years	136(82.92)	68(93.15)	5.16 [2.04–6.63]	0.074
11–20 years	18(10.98)	5(6.85)	2.95 [0.19–1.42]	0.081
> 20 years	10(6.10)	0(0.00)	1.66 [0.01–0.31]	0.061
In-service training or Workshop
No	18(10.98)	1(1.37)	*Ref		*Ref
Yes	146(89.02)	72(98.63)	8.88 [1.16–67.81]	0.035	9.55 [1.23–74.36]	0.031
aOR: adjusted odds ratio, CI: confidence interval, cOR: crude odds ratio, Ref: Reference point*

Factors associated with healthcare workers’ knowledge on preventive measures of nosocomial infections (dup: abstract ?)

Having conducted both bivariate and multivariate analyses (logistic regression) to test the association between socio-demographic characteristics of healthcare workers and their knowledge in preventive measures of nosocomial infections, age and in-service training or workshop were factors which are significantly associated with healthcare workers’ knowledge in preventive measures of nosocomial infections. However, there was no significant association between the other socio-demographic characteristics (sex, level of education and years of working experience) and knowledge in preventive measures of nosocomial infections. Healthcare workers who were within the age group of 20–40 years were 75% times less likely to be knowledgeable about the preventive measures of nosocomial infections [aOR = 0.25 (95% CI = 0.09–0.69), p = 0.007]. Health workers who were also within the age group of 41–60 years were 50% less likely to be knowledgeable about the preventive measures of nosocomial infections [aOR = 0.05 (95% CI = 0.01–0.29), p = 0.001]. Nonetheless, healthcare workers who attended in-service training or workshop were 10 times more likely to be knowledgeable about preventive measures of nosocomial infection than healthcare workers who never attended in-service training or workshop [aOR = 9.55 (95% CI = 1.23–74.36), p = 0.031] (Table 3).

Knowledge in preventive measures of nosocomial infection

This study revealed that more than two-thirds (69.2%) of the healthcare workers were not knowledgeable on the preventive measures of nosocomial infections. The finding from this study is consistent with descriptive research conducted among 245 staff nurses working in Meniet El-Nasr Central Hospital, to assess their level of knowledge on the preventive measures of nosocomial infections. The finding from the study revealed that, 71.0% of them had inadequate knowledge regarding infection prevention and control (13). Similarly, the finding from this study agrees with the finding from a study conducted by (14) in Sierra Leone, to assess HCW’s knowledge of preventive measures against occupational exposures. In their study, it was found that, more than half (52.6%) of the HCWs at the hospital had insufficient knowledge on preventive measures regarding infection control.

Another study conducted in Rwanda by (15), to access the level of knowledge on preventive measures of nurses, towards the prevention of catheter-associated urinary tract infection in some selected referral hospitals revealed that out of a total of 53 nurses, (79.9%) had a low level of knowledge on preventive measures of nosocomial infections. This is however in agreement with the finding of this study. Likewise, another descriptive cross-sectional study conducted, to assess the knowledge and practices of nurses regarding nosocomial infection control measures in private hospitals in Sana’a City, Yemen revealed that, most of the nurses (87%) had a fair level of knowledge, while only 4% of them had a good level of knowledge of preventive measures of nosocomial infections (16). This is also consistent with the findings of this study. These variations may be due to insufficient in-service trainings or workshops on nosocomial infection prevention. It may also be due to differences in the composition of respondents who participated in these studies.

In contrast to the finding of this study, the finding from a study conducted by (17), among Healthcare Workers in two selected tertiary hospitals in Ogun State, Nigeria showed that, almost all (95.9%) the HCWs had high knowledge on preventive measures against nosocomial infection. Similarly, a hospital-based cross-sectional study conducted by (18) to determine the knowledge, attitude and practice on HAIs prevention, and associated factors among HCWs at the University of Gondar Comprehensive specialized hospital, Northwest Ethiopia revealed that, 90.2% of the participants had good knowledge towards HAI prevention. This is however inconsistent with the finding of this study. Moreover, another study conducted by (19) in a tertiary hospital in South-South Nigeria, revealed that, most of the doctors (93.5%) who participated in the study, had excellent knowledge on infection prevention. Finally, the findings from a study conducted by (20) in La General Hospital in Ghana also indicated a good knowledge on IPC among health workers to be (97.0%) which is inconsistent with this study’ finding. Sufficient in-service trainings or workshops on nosocomial infection prevention could greatly account for the variations in these findings. These discrepancies could also be attributed to the variation in academic background of the study participants as well as the sample size variation in these studies.

Factors associated with healthcare workers’ knowledge on preventive measures of nosocomial infections

Findings from both bivariate and multivariate analyses (logistic regression) of this study revealed that there was an association between socio-demographic characteristics (age and in-service training or workshop) of healthcare workers and their knowledge in preventive measures of nosocomial infections.

Age

According to this study, the findings revealed that, healthcare workers who were within the age group of 20–40 years were 75% times less likely to be knowledgeable about the preventive measures of nosocomial infections [aOR = 0.25 (95% CI = 0.09–0.69), p = 0.007]. Health workers who were also within the age group of 41–60 years were 50% less likely to be knowledgeable about the preventive measures of nosocomial infections [aOR = 0.05 (95% CI = 0.01–0.29), p = 0.001]. The finding in the current study is in support with a cross-sectional, correlational study conducted (21), among nurses in Jeddah, Saudi Arabia. The findings from the study revealed that there was a significant relationship between nurses' knowledge in the preventive measures of nosocomial infection and age (p = 0.005). Similarly, this study is consistent with another study conducted among healthcare workers in Debre Markos referral hospital, Northwest Ethiopia. It was found that, healthcare workers with advanced age were significantly associated with higher knowledge in the preventive measures of nosocomial infections (aOR = 3.15, 95%, CI = [2.467–5.025]) (22). This consistency might be attributed to the fact that as the health care workers age they are more likely to update their knowledge through work experience and exposure.

In contrast, a study conducted by (23) among nurses revealed that, there was no significance relationship at p > 0.05 between nurse's age and their knowledge toward nosocomial infection prevention. Similarly, another study conducted among nurses by (24) to assess the nurses' knowledge about nosocomial infection at burns' centers and units in the middle Euphrates teaching hospitals revealed that, there was no significant relationship between the nurse's knowledge about NIs prevention and their ages at p-value (> 0.05).

In-service training or workshop on nosocomial infection prevention

The finding from this study revealed that healthcare workers who attended in-service training or workshop were 10 times more likely to be knowledgeable about preventive measures of nosocomial infection than healthcare workers who never attended in-service training or workshop. [aOR = 9.55 (95% CI = 1.23–74.36), p = 0.031]. This is consistent with a study conducted by (12) to assess the knowledge, practice, and associated factors towards prevention of surgical site infection, among nurses working in Amhara Regional State Referral Hospitals, Northwest Ethiopia. It was revealed in their study that nurses who had ever taken training on infection prevention methods were about 2 times more likely to be knowledgeable about the prevention of surgical site infection than those who had not (aOR = 1.95, 95% CI = 1.27, 2.99). Similarly, this finding is also consistent with a study conducted by (25). He revealed in his finding that, there was a significant association between the degree of previous in-service training in nosocomial infection control measures and nurses’ knowledge (p ≤ 0.05).

Furthermore, a hospital-based cross-sectional study conducted among healthcare workers in Debre Markos referral hospital, Northwest Ethiopia showed that, ever taking training on infection prevention was found to be significantly associated with knowledge on infection prevention. In the study, healthcare professionals who had not taken infection prevention training were 75% times less likely to be knowledgeable on infection prevention (aOR = 0.25, 95%, CI = [1.689–3.95) about infection prevention than those had taken training in infection prevention (22). This is however in agreement with the finding of this study. On the other hand, the finding from this study is inconsistent with a cross-sectional study conducted by (26). The findings from their study revealed that no significant statistical differences were found between training courses (p = 0.647) and infection control knowledge scores.

Implications for policy and practice

Based on the findings from this study. It is imperative that healthcare institutions implement proper training programs to educate healthcare workers on the prevention of nosocomial infections. It is also recommended that healthcare institutions provide regular training and workshops to update the knowledge of healthcare workers on the prevention of nosocomial infections in the healthcare setting. Additionally, there is the need for regular assessment of healthcare workers' knowledge on preventive measures of nosocomial infections. The assessment should be conducted periodically, and the results should be used to identify areas of deficiency and to implement appropriate interventions.

Strengths and limitations

The strength of this study lies in the use of appropriate methodology to estimate the sample and analyze the data. Nevertheless, there are some limitations that must be taken into consideration. As the study relied on a cross-sectional design, it is not possible to establish a causal pathway between the age and in-service training as determinants of healthcare workers’ knowledge on preventive measure for nosocomial infections. The quantitative approach to this study does not provide an in-depth insight into other underlying factors that might influence the observed associations. Therefore, there is a need for qualitative research to gain a more comprehensive and nuanced understanding of healthcare workers’ knowledge on preventive measure for nosocomial infections.

The study concludes that age and participation in-service training or workshop are significant factors that influence the knowledge of healthcare workers on preventive measures for nosocomial infections. These results highlight the importance of providing ongoing training and professional development opportunities to healthcare workers to enhance their knowledge and improve their ability to prevent and control nosocomial infections. Additionally, the study emphasizes the need for targeted training programs that take into account the age of healthcare workers, in order to ensure that training is tailored to their specific needs and learning styles.

aOR: Adjusted odds ratio

cOR: Crude odds ratio

HCAIs: Healthcare Associated Infections

HAIs: Hospital Acquired Infections

HCWs: Health Care Workers

HIV: Human Immunodeficiency virus

HBV: Hepatitis B Virus

HCV: Hepatitis C Virus

IPC: Infection prevention and Control

ICU: Intensive Care Unit

WHO: World Health Organization

Ethics approval and consent to participate

All methods were in accordance with the Declaration of Helsinki. The University of Health and Allied Sciences Research Ethics Committee (UHAS-REC) reviewed the study and approved it with a reference [ID: UHAS-REC A.11 {79} 20-21]. Permission was also obtained from the Hohoe Municipal Health Directorate before the commencement of the study. During data collection, permission was also sought from all the in-charges of the facilities before the administration of the questionnaire. Written informed consent was obtained from all of the participants.

Consent for publication

Not applicable.

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Competing interests

The authors declare that they have no competing interests.

Funding

This research was self-funded by the corresponding author.

Authors' contributions

SS, VOC and MKA conceived and designed the study. VOC and MKA supervised the research work in the field. SS conducted the whole research work and wrote the drafts and revised manuscript. JO thoroughly reviewed and revised the manuscript and checked the references. SS and JO finalized the manuscript. All authors read and approved the final manuscript.

Acknowledgements

We would like to acknowledge all our study participants for their cooperation and voluntary participation during the data collection. We also thank the Hohoe Municipal Health Directorate for its support in the study.

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No competing interests reported.

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published 01 Sep, 2023

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Editorial decision: Major revision
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Healthcare workers’ knowledge on nosocomial infections preventive measures and its associated factors in Ghana: a cross-sectional study

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Abstract

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Background

Methods

Study design

Sample size and sampling procedure

Definition of variables

Explanatory variable

Data collection

Data analysis

Results

Knowledge of healthcare workers in preventive measures of nosocomial infections

Factors associated with healthcare workers’ knowledge on preventive measures of nosocomial infections (dup: abstract ?)

Discussion

Factors associated with healthcare workers’ knowledge on preventive measures of nosocomial infections

Implications for policy and practice

Strengths and limitations

Conclusion

Abbreviations

Declarations

References

Additional Declarations

Supplementary Files

Status:

Journal Publication

Version 1