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Effect of Infection Prevention Education on Standard Precaution Practices among Nurses in Nigerian Hospitals

Abstract

Needle-stick injuries remain an important occupational health and public health concern among healthcare workers because accidental exposure to contaminated needles and other sharps may result in the transmission of blood-borne infections and other occupational health consequences. Healthcare workers involved in injections, blood collection, medication administration, surgical procedures, and waste handling may be exposed to needle-stick injuries when injection safety procedures are not properly followed. Needle-stick injury prevention education provides healthcare workers with knowledge and practical skills relating to safe injection techniques, appropriate handling of needles and other sharps, avoidance of unsafe recapping practices, appropriate use of safety devices, immediate disposal of used sharps, appropriate use of personal protective equipment, safe waste management, post-exposure procedures, and reporting of occupational exposures. Safe injection practices refer to procedures undertaken by healthcare workers to administer injections safely while protecting patients, healthcare workers, and the surrounding environment from preventable infection and injury. These practices include appropriate hand hygiene, use of sterile equipment, safe preparation and administration of injections, appropriate sharps handling, immediate disposal of used needles, avoidance of unsafe needle recapping, proper sharps-container use, and adherence to infection prevention and control procedures. In Nigeria, inadequate injection-safety knowledge, heavy workloads, limited availability of safety devices and sharps containers, insufficient training, inadequate staffing, and inconsistent supervision may affect safe injection practices among healthcare workers. Effective needle-stick injury prevention education may improve healthcare workers' knowledge, practical skills, risk perception, and adherence to recommended safe injection procedures. Against this background, this study investigates the influence of needle-stick injury prevention education on safe injection practices among healthcare workers in Nigeria. The study is anchored on Social Cognitive Theory, the Health Belief Model, and the Knowledge-Attitude-Practice framework. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping infection prevention and occupational safety behaviour. The Health Belief Model explains preventive occupational health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding healthcare workers' adoption of safe injection practices. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from needle-stick injury prevention education may influence safe injection practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how needle-stick injury prevention education may influence safe injection practices among healthcare workers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from healthcare workers involved in injection-related procedures in selected public and private healthcare facilities in Nigeria using a structured self-administered questionnaire, needle-stick injury prevention knowledge assessment, and an observational safe injection practice checklist. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, departments, and eligible healthcare workers. Where feasible, selected healthcare facilities or healthcare worker groups will be assigned to intervention and comparison groups. Healthcare workers in the intervention group will receive structured needle-stick injury prevention education covering injection safety principles, hand hygiene, safe injection preparation and administration, appropriate handling of needles and other sharps, avoidance of unsafe needle recapping, immediate disposal of used sharps, appropriate use of safety devices and sharps containers, personal protective equipment, sharps waste management, post-exposure procedures, and reporting of needle-stick injuries. Safe injection practices will be assessed using indicators such as appropriate hand hygiene, use of sterile equipment, safe preparation and administration of injections, correct handling of needles, avoidance of unsafe recapping, immediate disposal of used sharps, appropriate use of sharps containers, and compliance with infection prevention and control procedures. Descriptive statistics will be used to summarize healthcare workers' sociodemographic and professional characteristics, needle-stick injury prevention knowledge, exposure to education, and safe injection practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the influence of needle-stick injury prevention education on safe injection practices. Where appropriate, pre-intervention and post-intervention practice scores will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that needle-stick injury prevention education has a significant positive influence on safe injection practices among healthcare workers in Nigeria. Healthcare workers exposed to structured prevention education are expected to demonstrate improved knowledge of needle-stick injury risks and greater compliance with recommended safe injection procedures. Education may improve workers' hand hygiene practices, safe injection preparation and administration, appropriate handling and disposal of sharps, avoidance of unsafe needle recapping, appropriate use of sharps containers, and compliance with infection prevention and control procedures. It may also improve workers' awareness of post-exposure procedures and encourage timely reporting of needle-stick injuries. However, education alone may not guarantee sustained safe injection practices because healthcare workers may continue to face barriers such as inadequate supplies, insufficient sharps containers, limited availability of safety devices, heavy workloads, staff shortages, overcrowding, and inadequate supervision. Consequently, needle-stick injury prevention education is expected to be most effective when supported by adequate injection-safety supplies, accessible sharps containers, appropriate safety devices, regular supervision, infection prevention and control programmes, and effective occupational exposure reporting systems. The study is expected to contribute to the literature on injection safety, needle-stick injury prevention, occupational health, infection prevention and control, healthcare worker safety, health education, and public health in Nigeria by providing empirical evidence on the influence of needle-stick injury prevention education on safe injection practices among healthcare workers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, National Primary Health Care Development Agency, state ministries of health, healthcare facility managers, infection prevention and control committees, professional healthcare associations, occupational health professionals, public health practitioners, development partners, and policymakers regarding strategies for preventing needle-stick injuries and unsafe injection practices. The study will also provide evidence-based recommendations for strengthening injection-safety education, ensuring adequate availability of sharps containers and safety devices, improving healthcare worker training and supervision, strengthening infection prevention and control programmes, enhancing occupational exposure reporting systems, and promoting safer injection practices across healthcare facilities in Nigeria.

Keywords: Needle-stick injury prevention education, safe injection practices, healthcare workers, injection safety, needle-stick injuries, sharps safety, infection prevention and control, occupational health, healthcare safety, health education, occupational exposure prevention, public health, Nigeria.