Factors Affecting Compliance to Infection Prevention and Control Standard Precautions among Healthcare Workers in Songwe Region, Tanzania

Abstract

Background: Compliance to infection prevention and control standards precautions (IPCSPs) remains a major challenge in Tanzania. This exposes health care workers (HCWs) and patients to high risk of developing healthcare associated infections (HAIs) and increasing of antimicrobial resistance (AMR). The study investigated compliance to IPCSPs and associated factors among HCWs in Songwe Region Tanzania from January to March 2021. Methodology: A cross-sectional study was conducted in all districts of Songwe Region, Tanzania which involved 400 HCWs from all levels of public health facilities. Semi structured questionnaire and compliance with standard precautions scale (CSPS) tool was used. Descriptive and modified Poisson regression analysis were done. A p-value of less than 0.05 was used to compute statistical significance. Results: Only 22.5% (90/400) of HCWs had high compliance (above 80%) to IPCSPS. Majority HCWs reported highest compliance on discarding used needles/sharp items into sharp containers (94%), the lowest IPCSP compliance was on spills management, taking shower after extensive splashing and re-use of disposable masks at 8%, 28.5% and 34% respectively. However, Clinician (ARR=0.61 [0.37-0.99] p=0.049), IPC training or seminar in the previous one year (ARR=2.97 [1.87-4.72] p<0.001), working experiences (ARR=2.08 [1.22-3.54] p=0.007), and experiences to needle stick injury (ARR=0.62 [0.40-0.95] p=0.028), were identified as predictors of the HCWs compliance to IPCSPs. Reported barriers for IPCSPs compliance were: inconvenient location of personal protective equipment (PPEs) (65.5%), inadequate knowledge (56.8%), overcrowding and patient demand (40.3%), time consuming (27.8%), reduce ability to work (21%), and no need of IPCSPS when infections are not anticipated (13.5%). Conclusion: Majority of HCWs in Songwe region had low compliance to IPCSPs. The following factors were predictors of high compliance: IPC trainings, length of years of working, and IPC supportive supervision. Unavailability of PPEs in working units and inadequate knowledge were reported barriers for high compliance. Hence, capacity building initiatives targeting HCWs should be emphasized and PPEs should regularly be supplied at health facilities.