The Knowledge of infection prevention among healthcare workers
This study assessed the general level regarding knowledge of infection prevention showing that 81.4% of healthcare staff had good knowledge, which was higher than a study conducted in Ethiopia which showed 50.55% ]7[. This difference may be due to a much larger sample size in the current study. However, this result was lower than a study by Tasfai et al. (2020) ]8[, which reported 91.9%. This difference may be due to the previous research excluded staff working less than two months. However, in this regard observing the level of knowledge in infection prevention could help control infection.
When each of the exact factors of measures was analyzed, better results have been observed in some of the items. For instance, A relatively high proportion of around 95% of respondents knew that the hand was the most common vehicle to transmit infection in healthcare facilities, which was higher than the result from a study conducted in Nigeria, which reported 86.3% ]9[. This variation might be attributable to the difference in sample size and setting, as the present study was conducted in all departments. In contrast, the previous study was conducted in an intensive care unit. Based on the results from the focused group discussion, there was adequate awareness to prevent the chances of infection within hospital facilities.
Most healthcare workers in the present study lacked sufficient knowledge regarding disinfection, with only 31% aware that disinfection does not eliminate bacterial spores. This finding is supported by a previous study that assessed staff knowledge, attitudes, and practices regarding the sterilization of instruments in India, which reported that the staff had insufficient knowledge about sterilization; thus, recommended providing hands-on training via programs and workshops ]10[.
The study revealed no significant correlation between age, gender, duration of work, and training with knowledge of infection prevention among healthcare workers. These results are supported by previous studies ]4[,]11[ and ]12[. There was a statistically significant correlation between profession and availability of guidelines. The doctors had a significantly better rate of excellent knowledge toward infection control, possibly because they had a higher level of education. Those healthcare workers who had infection prevention guidelines in the hospital were more likely to be knowledgeable than those who did not.
The attitude of infection prevention among healthcare workers
This study assessed the general level regarding the attitude of infection prevention among healthcare staff, showing that 82% had a positive attitude, which was higher than that reported 69.32% by a study conducted in Ethiopia ]7[. This difference may be due to a much larger sample size in the current study. However, this result was lower than a previous study in 2019 which showed 100% ]11[, possibly because healthcare workers try to be model subjects in filling questionnaire items. However, Folgori et al., ]13[, explains that the associated burden of disease related to hospital-acquired infections can be effectively controlled if the practitioners are well trained to have a positive attitude toward managing infectious symptoms. Encouraging a positive attitude has also been identified as a common way to reduce the risk associated with healthcare ]14[.
About 89% of the respondents interviewed agreed that hospital-acquired infections can pose serious outcomes, similar to a study conducted in 2019, which indicated 83.6%. ]8[, this agreement may be due to the participants of both studies had a similar background. A publication by Geberemariyam et al., (2018) ]15[, reported that positive activity by health service practitioners towards the management of infectious diseases has increased as majorities are seeing the benefits of such activities.
Some participants agree that they do not have to wash their hand after removing gloves, which reflect a negative attitude toward infection prevention. However, a study assessed the site of skin contamination after removing personal protective equipment and reported that the skin of healthcare workers was frequently contaminated during gloves removal ]16[.
The present study revealed no significant association between gender, duration of work, and training with the attitude of infection prevention among healthcare workers. However, there was a statistically significant association between age, profession, and guidelines. Healthcare workers aged 41–50 had a more positive attitude than other age groups, with nurses having a high rate of a positive attitude toward infection control, possibly due to the sample size. Also, those healthcare workers who had infection prevention guidelines in the hospital were more likely to have a positive attitude than those who did not.
The practice of infection prevention among healthcare workers
The general level regarding infection prevention practices in this study showed that 59.6% had good practices, 34.0% moderate practices, and 6.3% had poor practices. These results were low compared to a previous study in Ethiopia which showed 70.8% displayed good practices ]17[. This difference may be due to the sampling technique. In this regard, this should have improved poor practices targeted to prevent infectious diseases that have propagated prevalence to outbreaks of hospital-acquired infections within hospital settings.
Healthcare workers should practice good hand hygiene before and after treating patients, and in the current study, 98% of participants applied hand hygiene between each patient contact. This is satisfactory evidence that healthcare workers are actively engaged in managing infectious diseases within the hospital environment. A similar study by Wong et al., (2019) ]18[, further noted that teaching hospitals have shown that participants often possess good hand hygiene practices as one of the most efficient ways of managing infection.
The current study demonstrated that about 73% did not use a wet N95 mask. Moreover, most participants had poor practices in wearing an N95 mask to prevent Tuberculosis infection, which may be due to the lack of clear guidelines on precaution with TB patients. It could also be that staff do not perceive the risks of this practice; therefore, healthcare systems and policy should emphasize improving healthcare quality concerning infection prevention.
The study revealed no significant association between gender, taking training on infection control via infection prevention practices. However, age, occupation, education, working experience, and availability of guidelines were found to be significantly associated with infection prevention practices. These results are supported by a previous study (Desta et al., 2018) ]19[.
Age is a significant factor of practices toward infection prevention, with healthcare workers over 50 years more likely to practice infection prevention activities properly, possibly because years of experience reflect improved practices.
In the present study, nurses had a higher rate of good practices than others toward infection control, possibly due to the fact that nurses spent most of their time with patients, more than other hospital staff. Thus, they will comply with infection control measures regularly. Healthcare workers with a diploma had the lowest level of infection prevention practices; the highest rate was staff with bachelor’s degrees. This might be because they have acquired essential information and infection prevention courses.
Staff who worked more than 10 years in the hospital were positively associated with better infection prevention practices than those who had worked less than 10 years. This could be because as the years of service increased, the staff was repeatedly exposed and gained information during their work.
The study indicated that those healthcare workers who adhere to the guidelines were more likely to practice infection prevention measures than those who did not adhere to the guidelines. This is in line with other studies in Ethiopia ]19[ and may be due to that those who adhered to the measures of infection control guidelines are aware of the updated information, which improves their practice.
However, there was no difference in knowledge, attitudes, and practices among trained and untrained staff, indicating the need for improvement in the content and quality of training.