Methods: A descriptive design that involved description of the conditions as they existed without influencing opinions was used. The target population and study sample were a total of eighty-six (86) nurses working in the teaching hospital surgical and labour wards. The University of Nigeria Teaching Hospital is well patronized and caters for the health issues of majority of Enugu residents and about four (4) other nearby States of Abia, Anambra, Ebonyi and Imo, all in South Eastern Nigeria. Data was collected using a questionnaire and observation check list developed by the researchers. Content and face validity of the instruments were established while the reliability index was established using nurses in surgical wards of the nearby National Orthopaedic Hospital, also in Enugu and which was not the institution of the study. The reliability index yielded a Cronbach’s Alpha of 0.89. Ethical clearance was obtained from the Ethics Committee of the Teaching Hospital, while verbal consent of the nurses was obtained before administration of the questionnaires and observation. Seventy – nine (92%) of the eighty six (86) questionnaires administered were returned. Data was analyzed using descriptive statistics of frequencies and percentages.
Results:: The results revealed that the respondents comprised fourteen (14) males (17.7%, and sixty five (65) females (82.3%). Almost all the nurses (91.9%) had knowledge of personal protective equipment. The most commonly used of all PPE by these nurses as revealed by their responses were gloves (89.9%), followed by face masks (74.7%); gowns (51.9%), goggles (19%). From the observation using check lists, thirty one (31) of the nurses (39.2%) washed their hands before putting on gloves; while 48 (60.8%) did not wash their hands before putting on the gloves. Forty one (41) of them (51.9%) washed their hands after removing the gloves, while 38 (48.1%) did not. Sixty (60) of the nurses (75.9%) followed standard guidelines to remove used gloves, while 42 (53.2%) did not follow the standard guidelines. For the face masks, 16 (20.3%) of the nurses observed washed their hands before wearing face masks while 63 (79.9%) did not wash their hands; 43 nurses (54.4%) used the face mask for more than one patient. Thirty seven nurses (46.8%) followed standard guidelines for removing face masks while 42 (53.2%) did not follow the standard guidelines. The results revealed that knowledge of PPE did not translate to adequate use of PPE though 63 (79.7%) of the nurses indicated that training received on PPE made it easy to use PPE. Few nurses do not use PPE adequately. The most reported factor hindering the use of PPE was non availability and non accessibility of the equipment. Surprisingly, 68 (86.1%) of the nurses indicated lack of knowledge of the implications of not using PPE as factors that make it difficult for them to use protective equipment. The findings reveal that a lot of efforts are still required to ensure that nurses comply with the use of PPE to protect themselves and their patients, and to guard against litigations for the health institution.
Conclusion: The findings of this study reveal that infection prevention measures are yet to be fully embraced by nurses in surgical and labour wards of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Many health workers in recent times have been exposed to infections that include HIV, HBV, HCV among many others, nurses in surgical wards stand greater exposure to pathogens. This study could serve as a basis for further studies in the same hospital after reorientation and training of the nurses on PPE, and other hospitals in Africa as a baseline to ascertain the use of PPE by nurses among other hospital workers. This study could open avenues for further research opportunities or links within Nigeria, West Africa and Africa on PPE and IPC practices. The study further recommended that the hospital authorities and occupational health nurses should take the lead roles to ensure adequate use of PPE in patient care.