الفهرس 
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Abstract
Hospital Acquired infection is one of the leading cause of death and increased morbidity for hospitalized patients. As health care
increasingly expands beyond hospitals into outpatient settings, nursing
homes, long-term care facilities, and even home care settings, the more
appropriate term has become healthcare-acquired infection.Healthcare
workers, including support staff (e.g., housekeeping and maintenance and
laboratory personnel), who work in these settings also are at risk of
exposure to serious, potentially life threatening infections.
This study was cross-sectional survey conducted to assess the level
of knowledge, practice and attitude of infection control standards
practiced by health care providers employed in family health settings in
ShebinElom medical sector. The study was conducted from 12th of March
to 10th of April 2012. In four different family health settings of
ShebinElkom. These settings included tow urban settings (The general
medical center and MitKhakan center) and two rural settings (Shenewan
family health unit and Shobrakhalafon family health unit) .
A pilot study was conducted in 8th and 9th of March 2012 in
another family health center (rather than included in the study) to test the
reliability and validity of the questionnaire . Experts opinion was
obtained from two leaders in infection control team in The general
medical center of ShebinElkom city to confirm the validity of the
questionnaire.
Data were collected via a self -administered, anonymous
questionnaire that assessed knowledge, attitude and practice of health
care providers toward infection control measures related to the following
Summary & conclusion
86
items: basic principles and facts about HAIs, hand hygiene and the use of
personal protective equipment, environmental cleaning, waste disposal,
sterilization of instruments.
Also an observation checklist of standard practice was done 2-3
days prior introducing the questionnaire to the participants, which
assessed the basic infection control measures in health care settings
concerned with waste disposal, sharp handling and disposal, handling &
disposal of linen, isolation of precautions, the surrounding environment.
The data and answers were collected and analyzed using the
statistical package for the social science (SPSS software version 20).
Qualitative data were expressed as number and percent. Quantitative data
were expressed as mean, standard deviations. Chi square test was used to
compare between qualitative data and T-test was used to compare
between normally distributed quantitative variables between two groups.
Results of this study revealed that The total number of respondents
were 412 which included 164 physicians ( 39.8%), 141 nurses (34.2%)
and 107 paramedical personnel (26%).The studied health care providers
were mostly from urban centers (68.2%). About (74%) of studied group
were medical personnel (physicians and nurses). the majority of health
care providers in primary health care centers were females, with more
than 5 years of experience 65.5%.
There was significant difference between medical and paramedical
groups regarding age, sex, experience years being more in medical group
(P value <0.005). only 23.4% of paramedical group who attended
previous training, 8.4% of paramedical personnel received HBV vaccine
and the availability of policies of infection control precautions was more
Summary & conclusion
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in medical group 74.4% (P value <0.001), the need for more training was
100% at paramedical group.
The study found that there was significant difference between
physicians and nurses regarding all parameters of knowledge and total
knowledge score was better in physicians than in nurses. About 59.8% of
physicians had good knowledge score compared to 44.7% of nurses.
Regarding knowledge of paramedical personnel, the total score of
knowledge was low to moderate level. 70.1% of paramedical personnel
had low level of knowledge. There was significant difference in all
parameters of knowledge between medical stuff and paramedical
personnel .(P <0.001), the weakest point in knowledge about using
antibiotics were necessary in infection control where 100% of
paramedical personnel agreed this wrong phrase compared to 63% of
medical stuff disagreed. While there were non-significant difference
between urban and rural family health settings regarding knowledge
about infection control measures. (P value >0.05)
The majority of participants reported positive attitude toward
measures of infection control. Also there was non-significant difference
between medical and paramedical groups regarding attitude.
Accordance self-reported questionnaire, There was significant
difference between nurses and physicians in practice of infection control
measures, There were points of strength in nurses’ practice comparing
tophysicians, as hand washing before dealing with patients was 96.5% for
nurses, while was 65.2% forphysicians, regarding of disposable of
medical and dangerous waste was 97.2% for nurses can practice (even
imperfect), comparing to 57.9% of physicians can’t practice at all, and
wearing protective gloves during dealing with patients was 94.3% for nurses, while was 90.9% forphysicians. As practice of paramedical
personnel was low to moderate level. where 60.7% of them couldn’t
practice disposal of medical and dangerous wastes, only 17.8% of them
reported washing hands before dealing with patients, while no one could
remove blood drops on the floor correctly.
Regarding place of work, The majority of participants were from
urban centers (68.2%). Also there were non-significant difference
between urban and rural family health centers regarding knowledge about
infection control (P value >0.05), while there was significant difference
between them regarding practice of infection control measures, for
example 48.4% of urban staff could practice disposal of medical and
dangerous wastes sanitary, while 28.2% of rural settings’ staff could do..