Hand hygiene: knowledge and practice by health care workers in a tertiary health care facility in south east Nigeria

Background: The prevalence of health care associated infections can be reduced by hand hygiene (HH). This study is aimed at determining the knowledge and practice of HH among healthcare workers (HCWs).Method: descriptive cross-sectional study using semi-structured questionnaire among HCWs selected by cluster sampling was carried out at University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu.Results: Respondents were 629, mostly females (64.4%), married (62.3% and aged between 19 and 59 years. About 63% received training on HH. Average knowledge score was 80.3%. All respondents knew about the following moments of HH: before exiting patient’s care area and after contact with body fluids. However, 45.6% and 54.2% knew that HH was indicated before touching a patient and after removing hand gloves respectively. Only 12.2% of respondents washed hands before patients. All doctors and nurses washed hands before aseptic procedures. Regular access to HH resources were 17.6%, 7%, 5.5%, and 1.7% among medical laboratory scientists (MLS), doctors, nurses, and health attendants respectively.Conclusion: knowledge of HH was generally high but practice was poor for some moments of HH like before wearing gloves and leaving patients’ care area. Unavailability of HH resources was implicated.Keywords: Hand hygiene, knowledge, practice, healthcare worker

Audit of Referrals to an Ophthalmic Outpatient Clinic of a Tertiary Eye Care Centre in a Developing Country

Objectives: To determine the referral pattern and assess the quality and accuracy of referral letters to the ophthalmic outpatient clinic of University of Nigeria Teaching Hospital, Enugu.Methods: This study is a prospective cross-sectional survey of all new ophthalmic referrals to the ophthalmic outpatient clinic at University of Nigeria Teaching Hospital, Enugu between 1st July 2006 and 31st December 2006. Patients’ referral letters and clinical case notesprovided information on demography, referral source, referral diagnosis, definitive diagnosis and quality of referral letter. The number of ophthalmic outpatient consultations during the study period was obtained fromclinic records. Data were analysed with the Statistical Package for Social Sciences to generate frequency and percentage distributions. The chi-square test was used for inter-group comparison at p 16 years) than children (< 16 years) were referred (

Prevalence and Predictors of Stress among Bankers in Enugu State South-East Nigeria

Background: The work environment is rapidly changing and in recent times, occupational stress poses a threat to the health, morale and productivity of workers and the organization. This study sought to determine the prevalence and predictors of stress among bankers in a south-eastern state of Nigeria. Methods: A descriptive cross-sectional study was carried out among 370 bankers in Enugu State, Nigeria using the Health, Safety, Executive (HSE) management standards indicator tool. Multistage sampling method was used to select participants. Statistical analysis was done using SPSS 22.0. Level of statistical significance was set at p&lt; 0.05.Results: The mean age of the participants was 34.54±6.3 years while the mean years of work was 6.01±4.7years. One hundred and seventy-four (47%) reported high level of stress due to relationship at work while 318 (85.9%) reported low level of stress due to roles. Being 35 years or less was found to a predictor of high (AOR 0.55, CI 0.30-1.02) level of stress due to control.Work experience of 5 years or less was found to be a predictor of both high (AOR 0.74, CI 0.40--1.37) and low (AOR 0.99, CI 0.40-1.37) levels of stress due to control.Conclusion: This study has shown that the prevalence of stress was high among bankers in Enugu State, South-East Nigeria. There is, therefore, the need for routine stress assessment and interventions in the banking industry especially for those at high risk. Keywords: Bankers; HSE Stress Questionnaire; Stress; Workplace; Southeast Nigeri

The role of the employer in workplace violence: The health care workers' perspective

Background: Workplace violence affects millions of people on a yearly basis. It has important consequences both for the harassed and the employer. The aim of the study was to find out the role employers play in controlling workplace violence in a tertiary healthcare institution as perceived by the health care workers.Methods: The study was a descriptive cross-sectional study carried out among nurses and doctors at the University of Nigeria Teaching HospitalItukuOzalla (UNTH), using a pre-tested, self-administered and semi-structured questionnaire that was adapted from the workplace violence in the health sector country case studies research instruments by ILO/ICN/WHO/PSI. A sample size of 412 was obtained using the sample size determination formula for cross-sectional descriptive studies. Data was analysed using Epi Info version 3.5.4. Chi-square test was used to determine association with a significance level of p-value at 0.05.Results: Four hundred and twelve healthcare workers participated in the study, of which 111(26.9%) were doctors while 301 (73.1%) were nurses. One hundred and thirteen (27.4%) respondents felt there were policies on health and safety, 154 (37.4%) reported that there was no policy while 145 (35.2%) did not know if there was any existing policy. For measures in place to mitigate violence at the workplace, 240(58.3%) mentioned existing security measures, 174 (42.0%) improved surroundings, 96 (23.3%) reduced work alone hours, while only 89 (21.6%) mentioned restriction of public access.Conclusion: Very few healthcare workers had correct information about the existence of policies to protect them from violence at the workplace.Most employees only know about existing security measures with little or no knowledge of other measures that can be helpful in curbing violence in their workplace. Drafting, dissemination and implementation of policies to reduce workplace violence in our healthcare facilities is recommended. Keywords: workplace, violence, role of employers, health-worker

Dentalanxiety and pain in clinical practice: asurvey amongurbanadults

Objective: To investigate the relationship between dental anxiety and pain of dental treatment among urban adult patients attending a Nigerian tertiary hospital. In addition, to identify the influence of age and sex on dental anxiety and pain of dental tratment. Methods: Fifty-one patients, aged 18 to 70 yearswho were first time dental attendees were studied for anxiety and pain levels by completing questionnaires on dental anxtiey and visual Analogue Scales. Results: Fifty-one patients aged 18 years and above were surveyed.Majority of the patients (76.5%) were below40 yearsof age. More patients 40 years and above (66.7%) hadmild pain while more patients less than 40 years of age (64.1%) had moderate or severe pain. Mild pain was found more in men (70.0%) than inwomen (25.8%), whilemoderate or severe pain was found more in women (84.2%) than in men (30.0%). Moderate or severe pain (62.1%) was more amongst patients with moderate or high dental anxiety, while mild pain (90.9%) wasmore amongst patientswithmild DentalAnxiety.Mostmen hadmild anxiety level (80.0%) thanwomen (48.4%),whilemore women (51.6%) had moderate or high Dental anxiety than men (20.0%).Conclusion: Pain of dental treatment was severer in younger patients and women.Also, dental anxiety was worse in women, while pain perception was higher in patients who were more dentally anxious. Niger Med J. Vol. 49, No. 2, April – June, 2008: 43 – 46. Keywords: Dental anxiety, visual analogue scale, urban adult, pain level

Evaluation of the implementation of directly observed treatment short course by private medical practitioners in the management of tuberculosis in Enugu, Nigeria

This study was carried out to evaluate the use of directly observed treatment short course by private medical practitioners in the management of tuberculosis (TB) as a step towards achieving public-private mix strategy in Enugu, Nigeria. A self-administered questionnaire was used to collect data from all private practitioners practicing in Enugu North Local Government Area. Three hundred and forty doctors were studied and among these 64 (18.8%) managed more than 5 tuberculosis cases every month. Most of the doctors, 310 (91.2%) based their diagnosis of tuberculosis on sputum acid-fast bacilli result. However, none of the private practitioners used the appropriate drug combination, dosage and duration. Most of the private practitioners (61.5%) did not follow up their tuberculosis patients and a larger percentage (72.1%) did not have facilities for tracing defaulters. Although 321 (94.4%) of private practitioners would like to be provided with information about national tuberculosis control programme (NTP) only 32 (26.2%) of them had ever participated in a continuing medical education (CME) on tuberculosis. In conclusion, although private practitioners manage a reasonable number of tuberculosis patients their management is often inappropriate and not in line with NTP guidelines. As part of the efforts to achieving a successful public-private mix in TB control, private practitioners should undergo CME on national tuberculosis control programme. It is important that the government should routinely monitor and evaluate the management of TB by the private practitioners

The prevalence of occupational asthma and rhinitis among woodworkers in south-eastern Nigeria

Wood dusts are known to cause respiratory disorders like rhinitis and asthma. This study was therefore done to determine the magnitude of the problem among woodworkers in south-eastern Nigeria exposed to high level of wood dust. Five hundred and ninety one woodworkers were selected using a stratified random sampling. The prevalence of woodwork-related rhinitis and asthma were then observed in the study population. Also the peak expiratory flow rate (PEFR) of each woodworker was obtained. The prevalence of occupational rhinitis was 78%, while that of asthma was 6.5%. As period of woodwork increased the prevalence of rhinitis and asthma increased (rhinitis: χ2 trend = 53.015, df = 1, P = 0.000). For asthma, χ2 trend =19.721, df = 1, P = 0.000). Also the PEFR significantly became low with increasing years of exposure to woodwork (χ2 trend = 75.965, df = 1, P= 0.000). In conclusion the prevalence of rhinitis and asthma in woodworkers was high and significantly increased with years of working as a woodworker

Cardiac risk indices of staff of Federal University of Technology Owerri, Imo State, Nigeria

Non-communicable diseases are the major health burden in the industrialized countries and are increasing rapidly in the developing countries owing to demographic transitions and changing lifestyles among the people. Cardiovascular diseases (CVD) are increasingly becoming a great cause of morbidity and mortality. A total of 100 senior and 141 junior staff in Federal University of Technology, Owerri (FUTO), Imo State, Nigeria was randomly selected for a study on cardiac risk factors. A questionnaire was used to record cardiac risk indices like age, heredity, body mass index (BMI), tobacco smoking, exercise, serum cholesterol estimation, systolic blood pressure and sex. There was no significant difference between the senior and junior staff in sex distribution (P=0.71), family history of CVD (P=0.34), smoking habit (P=0.85) and serum cholesterol (P=0.89). Senior staff had significantly higher values in age distribution (P<0.001), presence of systolic hypertension (P<0.001) and overweight (P<0.001). Senior staff workers, were however, significantly less involved in moderate exercise than junior staff (P<0.001). The senior staff had a significantly higher total score in CVD risk scoring than junior staff (χ2=7.25; P=0.01). In conclusion, the risk of CVD among staff of FUTO is high especially among the senior staff. Health education campaign targeted at improving life style is strongly recommended

Health education: Effect on knowledge and practice of workplace personal hygiene and protective measures among woodworkers in Enugu, Nigeria

Background: There has been increasing incidence of occupational diseases among woodworkers due to exposure to preventable hazards in the workplace. The objective of this study was to determine the effects of health education on the knowledge and practice of workplace hygiene and protective measures among woodworkers in Enugu timber market.Materials and Methods: This was a before and after study conducted among 290 woodworkers using interviewer administered semi-structured questionnaire and manual on workplace hazards prevention. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 17 and P-value of 0.05 was set as the significance level.Results: Two hundred and ninety respondents participated in the study; 282 (97.2%) were males, most completed secondary education and had worked for less than 10 years (71% and 58.3%, respectively). The mean knowledge score of participants pre- and postintervention were 89.5% ± 9.03 and 98.5% ± 1.84, respectively (P &lt; 0.001). Educational status had effect on knowledge of participants (P &lt; 0.001), whereas work experience had no effect (P = 0.285). Preintervention, 37.9% of the participants used protective materials regularly, which increased to 65.8% post intervention (P &lt; 0.001). Personal hygiene practices showed mixed responses most of which improved post intervention. The most common reason for eating in workplace was excessive workload (60.3%), while lack of PPEs (29.3%) and lack of training (23.8%) were the most common reasons for nonuse of PPEs.Conclusion: Majority of the participants had good knowledge of workplace hygiene but had poor use of PPEs. Health education intervention improved the use of PPEs and should be recommended.Keywords: Health education, Nigeria, personal protective equipment, woodworke

Knowledge and practice of standard precautions by health‑care workers in a tertiary health institution in Enugu, Nigeria

Background: Standard precautions (SPs) are crucial in protecting both health‑care workers (HCWs) and patients from nosocomial infections. This study assessed the knowledge and practices of SP among HCWs in tertiary health‑care facilities.Methods: This descriptive study was done in October 2014 among 629 HCWs at the University of Nigeria Teaching Hospital, Ituku‑Ozalla, Enugu State. A pretested questionnaire was used and analysis done using SPSS version 13.Results: The HCWs studied were 629, mostly females (64.4%), married (62.3%), Christians (94%), and within 20–59 years. Majority were nurses (46.1%) working in the wards. Over 90% of respondents had heard of SP, mainly from formal training (62%). Over 70% could define SP, 74.6% had knowledge of when SP is needed and &gt;70% identified most components of SP. Over 90% agreed that SPs are useful and that employers should provide SP training. Most respondents washed hands after removal of gloves (73.6%) and before leaving patient’s care area (33.1%). More than 70% had been exposed to patient’s body fluids and washed the exposed part with water, soap, and disinfectant (52.1%). Gloves were the most commonly used personal protective equipment (PPE) (53.4%) and the major reason for inconsistent use was irregular access (57.7%). Over 50% recap needles before discarding. Exposure to patients’ serum was significantly higher among doctors and nurses P &lt; 0.05, while the use of PPEs was highest among the laboratory scientists (82.4%). Those who were trained on SP (70.8%) and PPE (69.7) were significantly more likely to use PPEs, P &lt; 0.05.Conclusions: SP training and regular provision of PPEs are vital in compliance to SP.Keywords: Enugu, health‑care workers, nosocomial infections, standard precaution