Knowledge and Practice of Infection Control Among Midwives

1.1 Introduction

Infection control refers to practices and procedures intended to prevent the spread of infections within healthcare settings. These practices include hand hygiene, use of personal protective equipment (PPE), sterilization of medical instruments, and environmental cleaning. Effective infection control measures are crucial for minimizing the risk of healthcare-associated infections. Proper infection control protocols can significantly reduce the risk of healthcare-associated infections, which contribute to increased morbidity and mortality rates in mothers and infants worldwide (World Health Organization, 2020). Infection control in healthcare settings, particularly in maternity wards, is essential to ensuring the safety of both mothers and newborns. Midwives, who are pivotal in providing care during childbirth, play a critical role in implementing infection control measures. Their knowledge and practices directly influence the outcomes of maternal and neonatal health.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Limitation of the study and Definition of technical terms.

1.2 Background of Study

In recent years, there has been a concerted effort to standardize infection control practices through guidelines and continuous education. The World Health Organization and other health bodies have developed comprehensive infection control guidelines that are specifically tailored to various healthcare settings, including maternity wards (WHO, 2020). Infection control in the healthcare setting is a fundamental component of patient safety, particularly in maternal and neonatal care. Midwives, who are essential in providing care during childbirth, must adhere to rigorous infection control practices to prevent the transmission of pathogens and protect both mothers and newborns. The significance of infection control in midwifery is underscored by its potential impact on health outcomes, including the prevention of maternal and neonatal infections which can lead to serious complications or death (Nicolini et al., 2018).

Infection-related diseases are still the main cause of death in Nigeria, according to the 2013 health profile acquired by the World Health Organisation (WHO, 2013) statistics. The burden of disease in Nigeria includes HIV, TB, Malaria, other infectious diseases and respiratory infections. Expansion of the infection prevention and control movements occur due to the increase in infection occurrences in the country. This increase in infection-related disease’s impact the increase health financing in Nigeria with a government contribution to health care of 57.5% above the figures budgeted for (WHO, 2014). Despite established infection control guidelines and protocols, various studies have indicated that the knowledge and practice of infection control among midwives often fall short of ideal standards.

The World Health Organization (WHO) emphasizes that effective infection control is contingent on not only theoretical knowledge but also the practical application of these principles in everyday clinical settings. According to WHO guidelines, midwives should routinely engage in hand hygiene, use appropriate PPE, and ensure the sterilization of medical instruments to minimize infection risks (WHO, 2020).

Research has demonstrated that continuous education and training are vital for maintaining high standards of infection control. Studies such as those by Tan et al. (2019) highlight that midwives who receive regular and updated training are more likely to implement effective infection control practices. However, disparities in training opportunities and the availability of resources can hinder the ability of midwives to adhere to these practices consistently.

Despite the availability of guidelines and protocols for infection control, gaps still exist in the knowledge and practice of healthcare workers, including midwives. Studies have shown that midwives' understanding of infection control principles, such as hand hygiene, sterilization of equipment, and the use of personal protective equipment (PPE), is crucial for minimizing infection risks (Kramer et al., 2019). However, the implementation of these practices often varies due to factors such as inadequate training, resource limitations, and lack of adherence to protocols.

Effective infection control is not solely dependent on individual knowledge but also on institutional support, which includes the availability of resources, continuous professional training, and strict enforcement of guidelines. A study by Smith et al. (2021) highlights that midwives who receive regular infection control training are more likely to adhere to proper practices, thereby improving the quality of care provided to patients. Therefore, in Nibo, Awka South in Anambra State where the research was carried out, the activities that was conducted is to know the Knowledge and Practice of Infection Control among Midwives.

1.3 Statement of the Problem

Investigation revealed the research problem which is an area of concern in the gap of knowledge base needed for midwives practice (Burns & Grove 2011:146). The researcher has observed that nurses do not apply infection prevention and control measures in the hospital setting which is required to ensure patient safety.

Lack of knowledge among nurses can increase the rate of hospital-acquired infections, and lack of knowledge, attitude and practices in infection prevention and control contribute to high rates of hospital-acquired infections (Jain, Dogra, Mishra, Thaku and loomba, 2012 & Hayeh and Esena, 2013). Uncontrollable nosocomial infection contributes to prolonged stay, morbidity and mortality which put stress on health care economics of the country (Mishta, Banerjee & Gosain, 2014).

1.4 Aim and Objectives of Study

The aim of the study is to examine the knowledge, attitudes and practices of midwives regarding infection prevention and control in Nibo, Awka South in Anambra State. In achieving this aim, the following specific objectives were laid out as follows:

1. To determine the knowledge of midwifes in infection prevention and control in Nibo.
2. To examine the attitude of midwife in infection prevention and control in Nibo.
3. To assess the practices of midwife in infection prevention and control in Nibo
4. To make recommendations to the risk programme and policies in Nibo

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Do midwives in Nibo have knowledge of infection control?
• Do midwives in Nibo practice of infection control precautionary measure for health safety?
• What is the level of knowledge, attitudes and practices of health care workers in infection prevention and control in Nibo?
• What are the precautionary measures of infection control practiced by midwives?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant association between knowledge of infection control and precautionary practice among midwives.
• H1: There is a significant association between knowledge of infection control and precautionary practice among midwives.

1.7 Significance of Study

The outcome realized from the research findings will be significant to the following stakeholders:

1. For midwives, this study will offer insights into the gaps in their current infection control practices, helping them to identify areas where additional training or resources are needed. By understanding these gaps, midwives will be better equipped to implement effective infection control measures, thereby improving their own practice and enhancing patient safety.
2. For healthcare institutions, the findings will provide a clear assessment of the effectiveness of current infection control training programs and protocols. This will enable institutions to make informed decisions about updating and improving their training programs and resource allocation to ensure better adherence to infection control practices among midwives.
3. For patients, particularly mothers and newborns, the study will contribute to a safer healthcare environment by highlighting practices that need improvement. Enhanced infection control practices will reduce the risk of healthcare-associated infections, leading to better health outcomes and increased safety during childbirth.
4. For policy-makers, the research will offer evidence-based recommendations for developing and enforcing infection control policies and guidelines. This will support the creation of standardized practices across healthcare settings, ensuring consistency and high standards of infection control.
5. For the broader healthcare community, the study will add to the existing body of knowledge on infection control practices, serving as a reference for future research and helping to advance the field. The results will inform best practices and contribute to ongoing efforts to improve infection control across various healthcare disciplines.

1.8 Scope of Study

The scope of this research is focused on the knowledge, attitudes and practices of midwives regarding infection prevention and control in Nibo, Awka South in Anambra State.

1.9 Limitations of the Study

The study was subject to several limitations that impacted its overall execution and findings.

1. One significant limitation was insufficient data, which arose from challenges in obtaining a comprehensive and representative sample of midwives. This limitation affected the robustness of the conclusions drawn from the study.
2. Frequent power failures also posed a challenge, particularly in regions with unreliable electricity supply. These disruptions impacted the timely collection and analysis of data, leading to delays and potential issues with data accuracy and completeness.
3. The study experienced delays from respondents, which hindered the ability to collect data within the planned timeframe. This delay was exacerbated by the busy schedules of midwives and their varying availability, affecting the study's overall efficiency.
4. Financial constraints were another significant limitation, impacting the resources available for data collection, analysis, and dissemination of findings. Limited funding restricted the ability to conduct a more extensive and detailed study, which may have provided a broader understanding of infection control practices.
5. Time constraints also affected the study's scope and depth. The limited timeframe for conducting the research restricted the ability to explore certain aspects of infection control practices in greater detail, potentially limiting the comprehensiveness of the study's findings.

1.10 Definition of Terms

Infection Control:

Infection control refers to practices and procedures intended to prevent the spread of infections within healthcare settings. These practices include hand hygiene, use of personal protective equipment (PPE), sterilization of medical instruments, and environmental cleaning. Effective infection control measures are crucial for minimizing the risk of healthcare-associated infections (World Health Organization, 2020).

Midwives:

Midwives are trained healthcare professionals who specialize in providing care to pregnant women before, during, and after childbirth. Their role includes monitoring the progress of labor, assisting with delivery, and providing postnatal care to both mother and newborn. Midwives are key players in implementing infection control practices in maternity care settings (American College of Nurse-Midwives, 2019).

Knowledge of Infection Control:

Knowledge of infection control encompasses the understanding of principles, guidelines, and practices designed to prevent infections. This includes awareness of protocols related to hand hygiene, the use of PPE, and the sterilization of equipment. Knowledge in this context refers to the theoretical understanding that midwives have about infection control measures (Kramer et al., 2019).

Practice of Infection Control:

Practice of infection control refers to the application of infection control principles and procedures in everyday clinical settings. This includes the actual implementation of hand hygiene, use of PPE, and adherence to sterilization protocols as per established guidelines. The practice is assessed based on how well midwives adhere to these procedures in their routine care (Al-Momani et al., 2020).

Healthcare-Associated Infections (HAIs):

Healthcare-associated infections are infections that patients acquire while receiving treatment for other conditions within a healthcare setting. These infections are often preventable through effective infection control practices. Examples include surgical site infections, catheter-associated urinary tract infections, and bloodstream infections (Smith et al., 2021).