Infection prevention and control: knowledge and practices among environmental support staff at Mulago National Referral Hospital

Abstract

Introduction: Infection Prevention and Control (IPC) is everyone’s responsibility within the hospital facility. Studies in IPC have been done among Health workers, leaving out the Environmental Support Staff (ESS) who are responsible for housekeeping, environmental cleaning, and waste management including transportation of the potential reservoir of pathogenic micro-organisms, hence the paucity of information. This study, therefore, assessed the IPC knowledge and practices of ESS, as well as establishing a relationship between their knowledge and practices at Mulago National Referral Hospital (MNRH). Methods: A cross-sectional study was conducted among the Cleaning staff of MNRH in October and November 2021. Cleaners were enrolled by purposive sampling, a pre-tested, interviewer-administered, web-based tool designed using KoBo Toolbox, developed from the Uganda National IPC guidelines 2013, and expert advice from the Department of Nursing was used to assess knowledge and practices, defined by Bloom’s criteria. Microsoft Excel 2016 and Stata 16 were used for data analysis. Results: A total of 120 (100%) cleaners were recruited in the study, of which 70(58.3%) had good IPC knowledge, and only 37(30.8%) had good IPC practices. Female participants had higher knowledge and practice scores than males. Working experience and Monthly supervision had a positive correlation with good IPC knowledge where participants with more than 5 years’ experience were 10 times more likely to have good knowledge compared to those with less than 1year experience (aOR: 10.3, p=0.006, 95% CI: 2-54). Those closely supervised had less IPC knowledge compared to those that are not supervised (aOR: 0.1, p=0.047, 95%CI: 0-1). Proper waste disposal among participants was as below: sharps 109(90.8%), Body parts 86(71.7%) and paper and food materials 89(74.2%), with few having knowledge about the proper disposal of chemicals 58(48.3%), radioactive contaminated body fluids 62(51.7%), and blood-contaminated materials 50(41.7%). 38.3% of the study participants practiced recommended hand hygiene and each of them uses at least personal protective equipment. A positive correlation between knowledge scores and practices (p<0.001) was found. Respondents who worked between 2-4 days were more likely to have good IPC practices (Aor: 0.2, P= 0.028, 95%CI: 0-0.8) compared to their counterparts who worked for more than 5 days.Conclusion: Hospital Cleaning staff frontline infection control, thus plays a pivotal role in preventing nosocomial infections. Identifying existing IPC knowledge and practices among them is a key step in developing a successful infection control program.