Amongst the different Health Care Personnel nurses are at a greater risk of being accidentally exposed to HIV and other Blood Borne Pathogens. The present study was conducted among 50 final year nursing students of a Medical College Hospital to assess the knowledge regarding HIV, occupational exposure and Post Exposure Prophylaxis (PEP) among the students and analyses the impact of educational intervention measures on the issues amongst the study subjects. A Pre-designed and Pre-tested semi-structured questionnaire was used to evaluate the level of knowledge before and after educational intervention sessions. Knowledge regarding risk of transmission of HIV by needle-stick injury and body fluids against which universal precautions were mandatory increased by 72% following the intervention sessions (χ2 = 53.202, p <0.001). 72% and 36% respondents correctly knew the duration within which to start PEP and the drugs available for PEP, post educational sessions 98% and 96% students were aware of it: the difference being statistically significant (χ2 = 11.294, p <0.001) and (χ2 = 37.748, p <0.001) respectively. The mean pre-intervention score was 8.32; mean post-intervention score was 14.40: statistical analysis showed the results to be significant (t= 13.857, p< 0.001). The study reflects that there is a dearth of knowledge among the study group. Incorporating the concerned issues in the academic curriculum to provide the students with adequate knowledge and information during their formative years is needed

Baghel, SS

Dixit, S

Jaiswal, S

Khatri, AK

Saroshe, S

Sengar, SS

Soni, S

Taneja, G

English

Cognitive Sciences ePrint Archive

Original Article:
Impact of Educational Intervention Measures on Knowledge regarding HIV/ Occupational Exposure 
and Post Exposure Prophylaxis among Final Year Nursing Students of a Tertiary Care Hospital in 
Central India
Sanjay Dixit, Professor & Head, Dept. of Community Medicine, 
Khatri AK, Assistant Professor, Dept. of Community Medicine, 
Gunjan Taneja, Post-graduate student, Dept. of Community Medicine, 
Satish Saroshe, Post-graduate student, Dept. of Community Medicine, 
Siddharth Singh Baghel Final Year MBBS Student
Shruti Jaiswal, Final Year MBBS Student
Sona Soni, Final Year MBBS Student
Sunil Singh Sengar, Final Year MBBS Student
MGM Medical College, Indore, Madhya Pradesh, India
Address For Correspondence:
Dr. Sanjay Dixit, 
Professor & Head, Dept. of Community Medicine, 
MGM Medical College, Indore,
Madhya Pradesh, India
E-mail: communitymedicineindore@gmail.com
Citation:  Dixit S, Khatri AK, Taneja G, Saroshe S, Baghel SS, Jaiswal S, Soni S, Sengar SS. Impact of Educational Intervention 
Measures on Knowledge regarding HIV/ Occupational Exposure and Post Exposure Prophylaxis among Final Year Nursing Students 
of a Tertiary Care Hospital in Central India. Online J Health Allied Scs. 2009;8(4):6
URL: http://www.ojhas.org/issue32/2009-4-6.htm
Open Access Archives: http://cogprints.org/view/subjects/OJHAS.html and http://openmed.nic.in/view/subjects/ojhas.html
Submitted: Oct 2, 2009; Accepted: Nov 18, 2009; Published: Apr 30, 2010
Abstract:
Amongst the different Health Care Personnel nurses are at a 
greater risk of  being accidentally exposed to HIV and other 
Blood  Borne  Pathogens.  The  present  study  was  conducted 
among 50 final  year  nursing students  of  a  Medical  College 
Hospital to assess the knowledge regarding HIV, occupational 
exposure and Post Exposure Prophylaxis (PEP) among the stu-
dents  and  analyses  the  impact  of  educational  intervention 
measures on the issues amongst the study subjects. A Pre-de-
signed and Pre-tested semi-structured questionnaire was used 
to evaluate the level of knowledge before and after educational 
intervention sessions. Knowledge regarding risk of transmis-
sion  of  HIV by needle-stick injury and body fluids  against 
which  universal  precautions  were  mandatory  increased  by 
72%  following  the  intervention  sessions  (χ2  =  53.202,  p 
<0.001). 72% and 36% respondents correctly knew the dura-
tion within which to start PEP and the drugs available for PEP, 
post educational sessions 98% and 96% students were aware 
of it: the difference being statistically significant (χ2 = 11.294, 
p <0.001) and (χ2 = 37.748, p <0.001) respectively. The mean 
pre-intervention score was 8.32; mean post-intervention score 
was 14.40: statistical analysis showed the results to be signi-
ficant (t= 13.857, p< 0.001). The study reflects that there is a 
dearth of knowledge among the study group. Incorporating the 
concerned issues in the academic  curriculum to provide  the 
students  with  adequate  knowledge  and  information  during 
their formative years is needed.
Key Words:  Nurses,  Occupational  exposure, Post  Exposure 
Prophylaxis
Introduction:
Occupational exposure to Blood or other body fluids presents 
a small but definite risk of transmission of Human Immunode-
ficiency Virus (HIV) and other Blood Borne Pathogens.(1,2) 
Worldwide the first case of documented seroconversion after a 
specific occupational exposure to HIV was reported in 1984 
(3) and an approximate number of one thousand cases occur 
each  year  due  to  accidental  exposure.(4)  Among  various 
groups of Health Care Personnel (HCP), nurses have a greater 
risk of being exposed to needle stick and other occupational 
injuries. Drexler, H et al in a study reported that approxim-
ately half of nursing students have experienced an exposure to 
Blood and Body fluids during the final two years of study.(5) 
The present study assesses the knowledge regarding HIV, oc-
cupational  exposure  and  Post  Exposure  Prophylaxis  (PEP) 
among nursing students and analyses the impact of education-
al intervention measures on the issues amongst the study sub-
jects.
Methodology:
The study was conducted among final year BSc. nursing stu-
dents of Maharaja Yaswantrao Hospital,  Indore which is the 
biggest public health care setting in the state of Madhya Pra-
desh, India and is attached to MGM Medical College Indore. 
Permission was obtained from the Superintendant of the Hos-
pital and the Principal of the Nursing College before initiation 
of the study. The entire class of 50 students provided consent 
to participate in the study; which was conducted over a period 
of three months (October – December 2008). Pre-designed and 
Pre-tested Semi-structured questionnaire was used to evaluate 
the existing level of knowledge on HIV, Occupational Expos-
ure and PEP among the study participants. Following the ini-
tial  assessment  an Educational  Intervention  Programme was 
conducted among the students using posters, pamphlets, Au-
dio-visual aids and group discussions by four Undergraduate 
students  of the Department  of Community Medicine, MGM 
Medical College, Indore. The intervention sessions focused on 
HIV  epidemiology,  risk  factors,  routes  of  transmission, 
chances of occupational exposure, factors associated with ex-
posure, the exposure codes, the protocol for PEP and adequate 
1
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Volume 8, Issue 4; Oct - Dec 2009
and timely use of  PEP .  Post-interventional  assessment  was 
performed among the study participants using the same ques-
tionnaire one month after the educational session. A total of 19 
questions  were  included in  the  questionnaire:  each question 
carried one mark with no negative marking. Pre and post inter-
vention scores were analyzed using SPSS version 17 and ap-
propriate statistical tests applied to detect improvement in the 
level of knowledge (if any).
Results:
All the participants were female, in the age group of 19-20 
years. Everyone in the study group was aware that HIV is a 
virus. The participants were asked to expand some commonly 
used abbreviations  like  HIV,  AIDS (Acquired  Immunodefi-
ciency Syndrome),  ART (Anti  Retroviral  Therapy),  Preven-
tion of Parent to Child Transmission (PPTCT), O.I (Opportun-
istic Infection) and PEP. The increase in awareness for HIV 
following educational intervention was 24%, which was stat-
istically significant (χ2  = 6.25, p = 0.012), for O.I the aware-
ness level increased by 64% (χ2 = 44.71, p <0.001) and a 28% 
increase was observed for PEP (χ2 = 9.265, p = 0.003). 90% of 
the participants  knew of  the routes of transmission of  HIV, 
56% about the most common route of transmission while 14% 
(7) were aware of the route with the maximum risk of trans-
mission, post intervention this increased to 70% (35 students 
became aware)  (χ2 = 32.184, p <0.001). 12% participants had 
information of at least three O.I occurring in AIDS patients 
during  the  pre-intervention  assessment,  post  intervention  a 
64% increased awareness was noted (χ2  = 41.558, p <0.001). 
60% of  the study subjects became aware about  the window 
period  for  HIV  post  educational  sessions  (χ2  =  36.232,  p 
<0.001). 32 (64%) respondents knew that occupational injury 
with damage to skin carried the greatest risk of transmission of 
the virus; following the intervention 42 (84%) were aware of 
the fact (χ2  = 4.21, p = 0.04). In the pre intervention analysis 
23 students reported that amount of blood loss following ex-
posure, viral load of the patient and use of PEP affected the 
chances of getting infected following exposure, post interven-
tion  27  responded  correctly.  Knowledge  regarding  risk  of 
transmission  of  HIV by needle-stick injury and body fluids 
against which universal precautions were mandatory increased 
by 72% following  the  intervention  sessions  (χ2  = 53.202,  p 
<0.001).  17  (34%)  and  32  (64%)  students  had  information 
about  body  fluids  against  which  universal  precautions  were 
not necessary prior to and following the intervention sessions 
(χ2 = 9.004, p = 0.003). Pre intervention 36 (72%) respondents 
correctly knew the duration within which to start PEP and 18 
(36%) knew about  the drugs available for PEP, post  educa-
tional sessions 49 (98%) and 48 (96%) students had correct in-
formation on the two issues. The difference was statistically 
significant (χ2 = 11.294, p <0.001) and (χ2 = 37.748, p <0.001) 
respectively.(Table1) 
Table 1: Analysis of study results before and after educational intervention (n=50)
Study variable Pre-intervention correct response
Post – intervention 
correct response
Increased 
awareness p value
Full form of HIV 12 24 24% 0.012
Full form of AIDS 44 48 08% 0.269
Full form of ART 15 23 16% 0.099
Full form of PPTCT 00 03 06% 0.241
Full form of O.I. 02 34 64% <0.001
Full form of PEP 31 45 28% 0.002
Routes of transmission 45 48 06% 0.433
Most common route of transmission 28 36 16% 0.145
Route of transmission with maximum possible risk 07 35 56% <0.001
O.I occurring in AIDS (at least three) 06 38 64% <0.001
Window period in HIV 12 42 60% <0.001
Maximum risk of HIV transmission following occupational exposure 32 42 10% 0.04
Factors determining risk of HIV transmission following occupational ex-
posure 23 27 08% 0.549
Risk of HIV transmission following needle stick injury 03 39 72% <0.001
Body fluids against which Universal Precaution is mandatory 03 39 72% <0.001
Body fluids against which Universal Precaution is not  mandatory 17 32 50% 0.003
Duration within which PEP is to be started 36 49 26% <0.001
Drugs available for PEP 18 48 60% <0.001
The mean pre-intervention score was 8.32 (S.D= 2.65, Range= 
12) while the mean post intervention score was 14.40 (S.D= 
2.52, Range= 10), a 73% increase in the mean scoring. Paired t 
test was applied to the mean scores pre and post intervention 
and the difference was found to be statistically significant (t= 
13.857, p< 0.001).
Discussion:
The study results  clearly show a lack of  proper information 
and knowledge on the concerned issues among the study parti-
cipants. A study by Avachat S et al (6) conducted among nurs-
ing students reported that only 44% of the students were aware 
of  infectious  body  fluids,  37%  had  no  information  on  the 
factors affecting the chances of getting infected and just 2% of 
the third year students correctly knew the duration of PEP. A 
study at AIIMS conducted among doctors of private hospitals 
stated that  62.8% of  the  participants  were  unaware  of  PEP 
measures to be undertaken following occupational  exposure.
(7) Imran Ahmed et al in their study among pharmacy students 
revealed that  almost  80% of  the participating students were 
unaware of the use of PEP following accidental occupational 
exposure and only 18.5% had awareness regarding O.I.(8) The 
above findings from across the health care fraternity imply im-
mediate formulation of policies wherein HCP are imparted ad-
equate  training  regarding  PEP  and  occupational  exposure, 
with special emphasis on hands on training to the health work-
ers. Incorporating these particular issues in the academic cur-
riculum of the medical, nursing and pharmacy students is im-
portant  so that they imbibe  adequate and proper knowledge 
during their formative  years.  To ensure easy accessibility to 
proper  information  charts  and  posters  depicting  the  PEP 
guidelines should be hung in every ward, Out Patient Depart-
ments, Operation Theatres and nursing stations in both public 
and  private  hospitals;  also  guidelines  should  be  framed 
wherein early and essential reporting of accidental occupation-
2
al  exposures  amongst  staff  in  health  care  settings  is  made 
mandatory so that appropriate measures can be undertaken at 
the earliest.
Acknowledgements:
The authors would like to thank the Superintendant Maharaja 
Yashwantrao Hospital, Principal Nursing College for granting 
permission for the study and all the nursing students for parti-
cipating in the study.
References:
1. Updated U.S. Public Health Service Guidelines for 
the  Management  of  Occupational  Exposures  to 
HBV, HCV, and HIV and Recommendations  for 
Post  exposure  Prophylaxis MMWR Recomm Rep. 
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2. Sagoe-Moses  C,  Pearson  RD,  Perry  J,  Jagger  J. 
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3


An Assessment of the Knowledge, Attitudes, and Risk Perceptions of Pharmacy Students Regarding HIV/AIDS. Am J Pharm Educ.

Awareness regarding pre- and postexposure prophylaxis for human immunodeficiency virus/acquired immunodeficiency syndrome among nursing students.

Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers.

HIV: awareness of management of occupational exposure in health care workers.

Needlestick injuries and other occupations exposures to body fluids amongst employees and medical students of a German university: Incidence and follow-up.

Needlestick transmission of HTLV III from a patient infected in Africa. Lancet

Public Health Service Guidelines for the Management of

Risks to health care workers in developing countries.

Impact of Educational Intervention Measures on Knowledge regarding HIV/ Occupational Exposure and Post Exposure Prophylaxis among Final Year Nursing Students of a Tertiary Care Hospital in Central India

Shruti Jaiswal

Sona Soni

Siddharth Singh Baghel

Satish Saroshe

Khatri AK

Sanjay Dixit

Sunil Singh Sengar

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Impact of Educational Intervention Measures on Knowledge regarding HIV/ Occupational Exposure and Post Exposure Prophylaxis among Final Year Nursing Students of a Tertiary Care Hospital in Central India

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