Assessment of Knowledge, Attitude, and Practices on Hospital-acquired Infections Among Healthcare Workers at Kamuzu Central Hospital in Malawi

Abstract

Background: Hospital Acquired Infections (HAIs) are of great public health importance and have contributed to substantial morbidity and mortality among patients globally. Health Care Workers (HCWs) are essential in preventing and controlling such adverse outcomes associated with HAIs, however to the best of our knowledge studies assessing knowledge, attitude and, practice (KAP) on HAIs among HCWs are particularly rare in Africa which shoulder a considerable burden of these infections. Objective: The study aimed at assessing the level of knowledge, attitude, prevention and, practices of HAIs among HCWs at Kamuzu Central Hospital (KCH). Methods: This was a mixed methods cross-sectional study. A self-administered questionnaire was given to 295 participants for quantitative data. Analysis was conducted using R version 4.3.3. The results were determined at a 5% significance level. Scores of KAP were computed to find the median score and other quantiles including the 95% CI. Qualitative data was collected through audio-recorded interviews, transcribed verbatim and analysed through thematic analysis. Twelve Key Informant Interviews (KIIs) and two focus group discussions (FGDs) with six participants were conducted for qualitative data. Nvivo version 12 was employed for qualitative data analysis. Results: Of the 295 study participants included in the survey, 201 were nurses and, 94 clinicians. About 76% HCWs were trained on Infection Prevention and control (IPC) measures. 74% of had good knowledge on HAIs at 95% CI (68-79). The level of knowledge increased with higher education with OR 2.85 95% CI: (1.11- 8.84) P=0.002. With 96% revealing having a good practice towards IPC practice. 99% showed a positive attitude towards HAIs prevention. Most participants demonstrated good knowledge and attitude towards HAIs leading to good IPC practices. HCWs trained on HAIs demonstrated to be more knowledgeable as compared to the new intern clinicians who had not received IPC training. Conclusion: The HCWs demonstrated having good knowledge and positive attitude on the HAIs and their prevention. The HCWs also demonstrated good practice on the prevention and control of the HAIs. Recommendations: There is a need for frequent in-service trainings for the HCWs and daily orientations on IPC of HAIs to the patients