Knowledge, practice and factors associated with poor compliance with universal precautions among healthcare workers at Bugando Medical Centre, Mwanza, Tanzania

Background: Healthcare workers (HCWs) are exposed to blood-borne infections by pathogens, such as HIV, and Hepatitis B and C viruses, as they perform their clinical activities in hospitals. Compliance with universal precautions has been shown to reduce the risk of exposure to these pathogens. This aimed at assessing the knowledge, practices and factors associated with poor compliance to universal precautions among HCWs at Bugando Medical Centre in Mwanza, Tanzania.
Method: This was a cross sectional study carried out from December 2014 to February 2015.
Results: There were 200 participants including 62 (31.0%) doctors, 74 (37.0%) nurses, laboratory personnel 34 (17.0%) and 29 (14.5%) auxiliary HCWs. More than three quarters (82%) of participants had adequate knowledge of universal precautions. There was statistically significant difference between knowledge of universal precautions and sex, job category, working experience (≥ 5 years) and previous training on universal precautions. Out of 200 HCWs, 154 (77.0%) practiced universal precautions. Working experience (≥ 5 years) and previous training on universal precautions were significantly associated with good practice of universal precautions (P < 0.001). There was a strong correlation between knowledge and compliance (practice) with universal precautions (r=0.76, p<0.001). Factors associated with poor compliance with universal precautions included lack of personal protection equipment (69.5%), lack of knowledge (65.0%), emergency situations (63.0%), presumption that patient is not infected with HIV or HBV (59.0%), time constraints (53.0%), heavy workload (48.0%) and absence of penalties (34.0%).
Conclusions: There was adequate knowledge and a fair level of compliance among HCWs towards universal precautions. These findings suggest that training of health care workers to increase their knowledge about blood-borne pathogens and universal precautions could improve their compliance and thus reduce health care workers’ risk of blood-borne pathogen exposure.

Keywords
universal precautions; knowledge; practice; factors; poor compliance; hospital; Tanzania