INTRODUCTION:

Occupational accidents are common in any area of work, including hospitals or health care settings.¹ Needle pricks injury (NPI) is the most frequent occupational hazard for nurses and other health care workers (HCWs).² it can be defined as the parenteral introduction of blood or other potentially infectious material by a hollow bore needle.^2,3

It is the commonest route by which blood-borne viruses and/or infections such as HIV and hepatitis B and C are transmitted from patients to healthcare workers. Such infections serve as high occupational risks and threats to healthcare workers, especially where basic rules of occupational safety and health are not implemented.³

Globally, NP/SIs are stated to be the most common source of occupational exposures to blood and the primary cause of blood-borne infections for HCWs.² The risk of contracting acute hepatitis C infection due to a needle prick injury is estimated to range from 1% to 5%.³

WHO reports in the world health report 2002 that of 35 million health care workers, 2 million experience and percuteneoos exposure to infectious disease each year. it further notes that 37.6% of hepatitis B, 39% hepatitis C and 4.4% of HIV/AIDS in health care workers around the world are due to needle prick injuries and other percuteneous injury occurs unusually among health care workers.⁴

NEED FOR THE STUDY:

The frequency of needle prick injury has been estimated to be about 600,000–800,000 cases annually in the USA.⁴ Data shows that on average four NSIs per worker per year in the African, Eastern Mediterranean, and Asian populations. In Vietnam, 383 of physicians and 663 of nurses reported sustaining a sharp stick injury in the previous nine months.⁶ According to WHO, globally the annual estimated proportions of HCWs exposed to blood borne pathogens were 6% of HCV, 5.9% HBV and 0.5% for HIV.⁴ It is estimated that needle stick injury cause about 66,000 HBV, 16000 HCV and 200-500 HIV among health workers every year.^7,8

The present study was carried out to assessed knowledge and practice of needle prick injuries amongst the Auxiliary nurse and midwifes, their immunization status; awareness of needle-prick injury hazards/preventive measures, post exposure prophylaxis taken or not. Study on needle prick injury at primary level/sub centre play a significant role because where ANM are not having adequate resource and management skills. So this study is very important to understand the knowledge and practice of ANMs at subcentre level which highlight the need of further preventive strategy.

PROBLEM STATEMENT:

“A study to assess knowledge and preventive practice on needle prick injury among ANMs (Auxiliary nurse and midwifes) working at selected public health facility of Etawah district, Uttar Pradesh”

OBJECTIVE OF THE STUDY:

1. To assess the level of knowledge on needle prick injury among ANM’s.

2. To assess level of preventive practice on needle prick injury among ANM’s.

3. To find out the association between knowledge and preventive practice of needle prick injury with selected demographic variable.

HYPOTHESIS:

H1: there is a significant association between the level of knowledge and practice with selected demographic variables among ANM,s.

RESEARCH METHODOLOGY:

Research methodology refers to controlled investigations related to the ways of obtaining, organizing and analyzing data.¹⁰ Study adopts quantitative approach and Non-experimental descriptive exploratory design was used to assess the knowledge and preventive practice of ANMs regarding needle prick injury. The population for the study was registered ANM’s working at sub center level in Etawah district. Probability simple random (lottery method) sampling technique is adopted. The sample size will be 30 ANM’s. Knowledge and practice are the research variable in the study.

Description of tool:

The tool was divided into 3 parts:

Part A: consisted of question related to demographic data like age, gender, education, religion, caste, experience, socio economic status. It also included question related to previous knowledge about need stick injury and immunization to prevent infection. Part B: consisted of question related to knowledge regarding occupational hazards, needle stick injury, and cause of injury, prevention and management of needle stick injury. Part C: include the observation check list to check the procedure of safe injection practice at sub centre.

Scoring:

The responses were scored for right answer 1 marks and wrong answer 0 marks. Study included total 32 item related to knowledge of ANM. The knowledge score was categories in four categories that is poor (0-25%), average (26-50%), very good (51-75%) and excellent (76%-100%) level. The preventive practice of ANM was observed by check list. Each writ response was marked as 1 marks and wrong responses was marks as 0. Check list included 24 items. The check list was category in four category that is poor (0-25%), average (26-50%), very good (51-75%) and excellent (76%-100%) level.

Study formal approval was obtained from the concern authorizes to conduct study. The purpose of study was explained to participants and obtains their willingness to participate in the study. ANM knowledge was assessed by questionnaire method at subcentre and practice was observed by investigators.

RESULT AND DISCUSSION:

The major finding of the study was that around 40% ANM worker were belonging to 21- 30 years age group and 40% ANM worker were belonging from 51-60 years age group. 96.7% ANM worker is belonging to Hindu religion, 76.7% ANM worker were belong to OBC category and 53.3% ANM worker were belonging to upper class socioeconomic status.

Study result also 60% ANM worker had 2 years diploma course AND 46.7% ANM had below 10 years work experience and another 53.3% ANM worker were is having more than 10 years work experience. Only 73.3% ANM worker taken vaccination against hepatitis B and only 56.7% ANM responded that they had attended training about safe injection practice. Study also assessed that 63.3% ANM worker had an incidence of needle prick injury.

The mean score and standard deviation of knowledge in ANM worker were 15.43 and 4.264 respectively and mean score and standard deviation of practice in ANM worker were 13.63 and 3.528 respectively.

Study observed that knowledge regarding needle prick injury among ANM’s had a wide range. 40% ANM had good knowledge, 50% ANM had average knowledge, 7% ANM had poor knowledge and only 3% had excellent knowledge.

Practice skills observed by researcher find out that majority (40%) ANM were belonging to good practice and 46.66% were belonging to average practice and (13.33%) ANM worker were belonging to excellent practice skills.

Study find out that that association of knowledge level in ANM worker is significant with age and work experience (p<0.05). other selected socio-demographical variables and immunization against hepatitis-B, any training on safe injection procedure since last 3 year, any experience regarding needle prick injury were not found non-significant (p<0.05). Association of preventive practice level in ANM worker was significant with duration of course (p<0.05). other selected socio-demographical variables and immunization against hepatitis-B, attend any training on safe injection procedure since last 3 year, experience regarding needle prick injury were not found non-significant ( p<0.05).

DISCUSSION:

The present study finding shows that that around 40% ANM worker were belonging to 21- 30 years age group and another 40% ANM were belonging 51-60 years age group. In relation to experience 46.7% ANM had below 10 years work experience and another 53.3% ANM were had more than 10 years work experience. The association of knowledge level in ANM worker were significant with age and work experience (p<0.05).

A Cross sectional Quantitative study was conducted by Yatin Talwar, Ashok Kumar et al (2017) on Needle Stick Injury among the Nursing Staff at Chandigarh, India. Majority of respondents were females (68.3%) and their mean age was 32 (SD= 8.0) years old, also the difference in mean-ages was significant statistically (P< 0.05). Frequency of nursing staff as per their years of work in the institution was also compiled. The majority of them, 187 out of 250 respondents, had work experience less than ten years (75%).¹²

In this study we find that in total selected sample 63% ANM worker had an incidence of needle prick injury while 38% ANM didn’t had any experience of needle prick injuring during injecting a medication in community settings.

In similar type of finding was also found in a study conducted by Rais N. and Jamil H.S. (2012) on prevalence of needle stick injuries (NSI) among health care provider (HCW) at civil hospital Karachi. Result shows that a large percentage (77%) of HCWs reported having had one or more NSIs in their career and (40.3%) NSIs occurred during use of the needle. Study concluded that the occurrence of NSI was found to be very frequent among HCWs in clinical settings.¹⁴

IMPLICATION OF THE STUDY:

As a result of knowledge and practice of ANM regarding needle prick injury.

· All the Public health nurses should be immunized and Administrator must ensure all the nurses or health workers working in field should be immunized timely.

· Administer must ensure all the nurses working in field should routinely trained for these infections.

· All the nurses practical skill and competence routinely monitored by senior nursing supervisors.

LIMITATION OF THE STUDY:

The sample size was small and limited to Etawah district therefore generlisation could not be made.

RECOMMENDATION:

Since the present study was conducted on a small group, a more extensive study on a wider sample is recommended.

CONCLUSION:

Public health nurses (ANM’s) are working as front line workers of health care system. They are playing an important role in providing health care services at gross root level. Study concludes that ANM’s must have a good knowledge regarding occupational hazards especially like needle prick injury. Nurses must have adequate competence of safe injection practice to prevent needle prick injury during immunization. The nurses should be immunized before placing in the field to hazardeous infection. Their knowledge and practical skill should be update timely to prevent infection to nurses and patients.

CONFLICT OF INTEREST:

None.

REFERENCE:

1. Potter and Perry. “Fundamentals of nursing”, 6^th edition, Mosby Publications, pp. 797-799.

2. Jamanesh L (2014). Assessment of knowledge attitude and practice among health care workers regarding stick and sharp object injuries in army force referral and teaching hospital, addias abada, Ethiopia abada university. Available at:etd.aau.edu.et> Lemessa Jemaneh

3. Zungu LI, Sengane ML, Setswe KG (2008). Knowledge and experiences of needle prick injuries (NPI) among nursing students at a university in Gauteng, South Africa. SA Fam Pract 2008; 50(5): 48

4. WHO. Needle stick injuries. Occupational health. Available at: www.who.int>topics>needleinjuries

5. Rishi Buli, Parveen Sharma. Needle stick injuries in health care providers. The nursing journal of India, Nov-2008; pp. 251-254.

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7. Samir A. Singru, Amitav Banerjee. Occupational exposure to blood and body fluids among health care workers. Indian Journal of community medicine, 2008; 33(01)

8. Kermode M, Jolley D, Langkham B, Thomas M, Crofts N. American journal of infection control, 2005; 33(01): 34-41.

9. Seham A. Abd El-Hay . IOSR Journal of Nursing and Health Science (IOSR-JNHS) .Volume 4, Issue 4 Ver. VII (Jul. - Aug. 2015), PP 19-32 www.iosrjournals.org

10. Sharma SK. Nursing research and statistics.2^nd edition. new Delhi: Elsevier; 2015.102,138,206,211,286,288

11. Rais N. and Jamil HM. International journal of endorsing health science research. 2013; 1(2). www.aeirc-edu.com

12. Yatin T . A Study of Needle Stick Injury among the Nursing Staff in a 300 Bedded Pediatric Specialized Centre of a 2000 Bedded Teaching Hospital Services. SM Journal of Health and Medical Informatics Published date: Jul 21, 2017.

Received on 17.08.2021 Modified on 23.09.2021

Int. J. Nur. Edu. and Research. 2022; 10(1):67-70.

DOI: 10.52711/2454-2660.2022.00015