Factors Affecting Compliance to Infection Prevention Control among Frontline Health Workers at the Kailahun Government Hospital, Sierra Leone: A cross-sectional study

Abstract:

Introduction

Healthcare workers are at increased risk of exposure to infectious agents. 3 million of the 35 million healthcare workers (HCWs) in the world are exposed percutaneously to blood borne pathogens (BBPs) annually. This study aims to determine factors affecting compliance with infection prevention and control (IPC) standards among frontline health workers (FHWs) at the Kailahun Government Hospital in Sierra Leone.

Methods

A cross-sectional study using a mixed-methods approach was employed. The study targeted FHWs at the Kailahun Government Hospital, which included doctors, nurses, community health officers/assistants, lab personnel, pharmacists, etc.  Using the relief application, a sample size of 69 was estimated using parameters such as 83 (total population of the health facility), 95% confidential level, margin error (5), and population proportion of 50%. Participants were selected using a Stratified Random Sampling technique, and the data was analyzed using SPSS software version 26.0.

Results

The results revealed that the majority (78.2%) of the participants were female, and 21.8% were male. 65.5% of the study participants were nurses, followed by 23.6% who were allied health professionals and 3.6% who reported being doctors. The study identified several positive factors influencing IPC compliance, such as adequate training (34.5%), availability of resources (49.1%), clear guidelines and protocols (56.4%), positive reinforcement (83.6%), peer support (65.5%), and management support (61.8%). The study’s identification of barriers, such as fear or discomfort with PPE, cultural or personal beliefs, and lack of understanding or misinformation were also identified by the participants. The regression analysis revealed significant relationships between knowledge of IPC protocols and factors like age (p<0.000), gender (p<0.005), Years of experience in healthcare (p<0.005), and department (p<0.013), suggesting that demographic and professional characteristics play a role in IPC adherence. The study’s findings on attitudes toward IPC compliance, particularly the importance of PPE and cleaning and disinfection products, are corroborated by research emphasizing the role of these resources in promoting adherence to IPC measures. The study explores barriers to accessing IPC resources, such as inadequate storage or distribution systems and high costs.

Conclusion

The findings underscore the need for targeted interventions to address identified barriers and improve compliance with IPC measures. Future research could build on these findings by examining the long-term effectiveness of such interventions and exploring additional factors that may influence IPC compliance.

Keywords: Knowledge, Attitude, Practice, Infection Prevention Control, healthcare worker, Sierra Leone.