Knowledge and self-reported practice of universal precautions among Kuwait University medical students in their clinical years

First year medical students' and standard precautions: The need for change

BACKGROUND

Standard Precaution (SPs) practices protect health-care workers prevent hospital-acquired infections. With Competency Based Medical Education (CBME) and early clinical exposure (ECE) implemented in the new curriculum, the first year medical students need to be aware of SPs, so as to protect themselves and the patients from these hazards.

AIMS & OBJECTIVE

To assess the knowledge of standard precautions among the medical students and find out association of knowledge with selected demographic variables.

METHODS AND MATERIAL

This cross-sectional study was done among first year medical undergraduate students of a medical college.Data was collected through google form with researcher-made questionnaire including questions on knowledge about SPs and socio-demographic variables of the study participant and their parents.

RESULTS

Response rate was 97.9%. Mean age of the participants was 19.13 ± 0.858 years; 57.7% were girls.Although 80.3% had heard of SPs but as high as 83.1% were of the opinion that "SPs were only for protection of the health-care team", 23.2% felt that it should "only be used in patients diagnosed with infection". 96.5% knew that "hand hygiene should be performed while providing care to patients", 97.2% had knowledge about respiratory and cough hygiene practices, 14.1% of them felt that "PPE can be shared". 57% of the respondents answered that "needle should be recapped after giving injections".

CONCLUSIONS

Students in early clinical years were found to have a varied level of knowledge of SPs and a lot of gaps in correct understanding of required facts. Continued medical education and skill-assessment to test their knowledge, must be incorporated into their teaching curriculum before ECE, so as to minimize the risk of preventable infections.

Incidence of sharp and needle-stick injuries and mucocutaneous blood exposure among healthcare workers

Healthcare workers (HCWs) are exposed to biological hazards on a daily basis. The aim of the present study was to evaluate the risks of infection after occupational exposure to blood or body fluids among HCWs operating in the period 2013-2014, in a university hospital of Southern Italy. The frequency of accidents during the 2-year period was always lower than 5%. In 2013, 103 cases occurred; in 2014, the number of injuries had significantly decreased (n = 60). In 2013, an anti-hepatitis B surface antigen protective titer was only found in 70% of cases; in 2014, the subjects with a positive titer rose to 82%. No HCWs showed seroconversion to the main blood-borne pathogens. The implementation of strict prevention measures after the accidents reported in 2013 allowed the significant reduction of the number of injuries in 2014.

Stethoscope Hygiene: Practice and Attitude of Medical Students

OBJECTIVE

The purpose of this study was to evaluate the frequency and attitude of medical students towards cleaning their stethoscopes.

SUBJECTS AND METHODS

A cross-sectional study was carried out in the first week of December 2013. The study included 771 students (397 in their fourth and 374 in their sixth year) from the Faculty of Medicine, University of Belgrade, Serbia. An anonymous questionnaire was distributed to students before the start of compulsory lessons in classrooms.

RESULTS

317 of the 397 fourth-year students (79.8%) and 306 of the 374 sixth-year students (81.9%) cleaned their stethoscope. The stethoscope diaphragm was most commonly cleaned, while the flexible tubing was the least commonly cleaned area, mainly using ethyl alcohol-based agents. The strongest positive attitude was observed for the statement 'It is important that my stethoscope is clean' (4.3 out of 5.0). A positive correlation (Spearman's x03C1; = 0.105) was observed between a higher frequency of cleaning and the stronger positive notion that a stethoscope should be cleaned.

CONCLUSION

A considerably high proportion of the students studied had ever cleaned their stethoscopes. Based on the students' responses, it would be useful to implement instructions on stethoscope hygiene in the regular practical curriculum with the aim of applying stethoscope disinfection in daily work.

Occupational exposure to blood and body fluids among health-care workers in Serbia

OBJECTIVES

The aim of this study was to examine the epidemiology of occupational accidents and self-reported attitude of health-care workers (HCWs) in Serbia.

SUBJECTS AND METHODS

A cross-sectional study was conducted among HCWs in selected departments of five tertiary care hospitals and in one secondary care hospital in February 2012. A previously developed self-administered questionnaire was provided to HCWs who had direct daily contact with patients. χ(2) test and Student's t test were used for statistical analysis of the data.

RESULTS

Of the 1,441 potential participants, 983 (68.2%) completed the questionnaire: 655 (66.7%) were nurses/medical technicians, 243 (24.7%) were physicians and 85 (8.6%) were other personnel. Of the 983 participants, 291 (29.6%) HCWs had had at least one accident during the previous year and 106 (40.2%) of them reported it to the responsible person. The highest prevalence (68.6%) of accidents was among nurses/technicians (p = 0.001). Accidents occurred more often in large clinical centers (81.1%; p < 0.001) and in the clinical ward, intensive care unit and operating theater (p = 0.003) than in other departments. Seventy-six (13.1%) nurses/medical technicians had an accident during needle recapping (p < 0.001). Of all the HCWs, 550 (55.9%) were fully vaccinated, including significantly more doctors (154, 63.4%) than participants from other job categories (p < 0.001).

CONCLUSION

There was a relatively high rate of accidents among HCWs in our hospitals, most commonly amongst nurses and staff working in clinical wards, intensive care units and operating theaters. The most common types of accidents were needlestick injuries and accidents due to improper handling of contaminated sharp devices or occuring while cleaning instruments or by coming into contact with blood through damaged skin or through the conjunctiva/mucous membranes.

Occupational exposures to body fluids and behaviors regarding their prevention and post-exposure among medical and nursing students at a Brazilian public university

A cross-sectional study was conducted to assess the frequencies and characteristics of occupational exposures among medical and nursing students at a Brazilian public university, in addition to their prevention and post-exposure behavior. During the second semester of 2010, a self-administered semi-structured questionnaire was completed by 253/320 (79.1%) medical students of the clinical course and 149/200 (74.5%) nursing students who were already performing practical activities. Among medical students, 53 (20.9%) suffered 73 injuries, which mainly occurred while performing extra-curricular activities (32.9%), with cutting and piercing objects (56.2%), in the emergency room (39.7%), and as a result of lack of technical preparation or distraction (54.8%). Among nursing students, 27 (18.1%) suffered 37 injuries, which mainly occurred with hollow needles (67.6%) in the operating room or wards (72.2%), and as a result of lack of technical preparation or distraction (62.1%). Among medical and nursing students, respectively, 96.4% and 48% were dissatisfied with the instructions on previously received exposure prevention; 48% and 18% did not always use personal protective equipment; 67.6% and 16.8% recapped used needles; 49.3% and 35.1% did not bother to find out the source patient's serological results post-exposure; and 1.4% and 18.9% officially reported injuries. In conclusion, this study found high frequencies of exposures among the assessed students, inadequate practices in prevention and post-exposure, and, consequently, the need for training in “standard precautions” to prevent such exposures.

Prevention of healthcare associated infections: medical and nursing students' knowledge in Italy

BACKGROUND

The training of health workers is a key issue for the prevention of healthcare associated infections.

OBJECTIVES

To evaluate knowledge of nursing and medical students concerning the prevention of healthcare associated infections.

DESIGN

A cross-sectional study.

SETTING

University hospitals in nine Italian cities.

PARTICIPANTS

One thousand four hundred sixty one healthcare students (607 medical students and 854 nursing students).

METHODS

The study was performed using a questionnaire investigating 3 areas, each having different possible points: standard precautions=12; hand hygiene=8; healthcare associated infections=5, for an overall perfect score of 25. Scores that met a cutoff ≥17.5 were considered to be indicative of an acceptable level of knowledge. Factors associated with an acceptable level of knowledge were analyzed using a logistic regression model.

RESULTS

Mean overall score (±SD) was 18.1 ± 3.2. Nursing students (18.6 ± 2.9) obtained a higher overall score than medical students (17.4 ± 3.5) (p<0.001). Weighed scores (±SD) by area were: 10.3 (±2.0) for standard precautions, 5.0 (±1.3) for hand hygiene and 2.8 (±1.1) for healthcare associated infections. Knowledge level concerning the three areas was different between medical and nursing students (p<0.001). The probability of finding acceptable knowledge was smaller for medical students (OR: 0.54 p<0.0001) and for students aged ≥24 years (OR: 0.39 p<0.0001).

CONCLUSION

The overall score showed an acceptable level of knowledge for the whole sample; but, considering separately the two curricula, only nursing students reached the minimum acceptable score. It seems important to investigate what is working better in nursing than in medical education in order to implement and validate new teaching approaches.

Blood and body fluid exposures in health-care settings: risk reduction practices and postexposure prophylaxis for health-care workers

This review of last year's literature on blood-borne pathogens (= pathogenic microorganisms that are found in human blood) focuses on hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) as the most common pathogens, despite the fact that other microorganisms may cause blood-borne diseases as well. Since the prevention of blood-borne diseases is something that, in the past, has gotten a lot of attention and by now is fully integrated in all safety structures in the U.S., the recent literatures mainly have been come from resource-limited/developing countries and Europe (which, in the definition of the financial word at the present time, in some parts overlap).