participants were final year MBBS undergraduate students who regularly attended the in-patient and out-patient clinics along with operation theatres as a part of their clinical teaching curriculum. In the present study, participants had good knowledge and attitude but poor practices towards different aspects of hospital acquired infections and its control measures.

75% (60 participants) of the study population had correct knowledge about the most common HAIs being infection of venous access, urinary tract infection, respiratory infections and surgical site infections, based on their current knowledge on hospital acquired infections as shown in Table 1. Also about 94% of the participants correctly knew that the inappropriate application of disinfection procedures increases the risk for a health care worker of either acquiring or transmitting a HAI from/to a patient.

The percentage of the respondents who had appropriate knowledge on the questions of most common HAIs and inappropriate disinfection causing HAI is shown in Table 1.

Attitudes towards the utility of guidelines/protocols for disinfection procedures, measured on a ten-point Likert scale ranging from 1 to 10 with higher scores indicating more positive attitudes as shown in Table 2. Responses from the study participants showed a mean score of 7 with the highest score being 9 and the lowest being 4. >90% participants had a good attitude towards risk of getting or transmitting any infectious disease by a HCW while working and the utility of the application of disinfection procedures during work would reduce the rates of HAI.

Practices of the students towards disinfection during performance of certain medical procedures ranged from 10% to 88% of the times (Table 3). >80% of the participants practiced disinfection procedures during certain medical procedures like insertion venous catheter, urethral catheter and intramuscular or intravenous injections. <50% answered that they followed disinfection procedures

Table 1. Table showing the percentage of the respondents who had appropriate knowledge on the questions of most common HAIs and inappropriate disinfection causing HAI.

Table 2. Table showing the attitude of the study population towards risk of the HCW in getting/transmitting an infectious disease while working and that application of disinfection procedures can reduce the HAI rates.

Table 3. Table showing the percentage frequency of disinfection practices followed during certain medical procedures.

during certain medical procedures like while taking a biopsy, blood culture collection or during an intra-arterial injection. However the significant difference in the answers might be due to the fact that the study population in majority had final year MBBS undergraduate students who might not have performed/attended such above mentioned procedures. Analysis of Knowledge, Attitudes and practices are shown in Figure 1 & Figure 2 of hospital acquired infections and infection control practices as answered by final year MBBS undergraduate students.

Figure 1 & Figure 2 shows that KAP analysis of students revels that attitude towards infection control practices found well but because lack of knowledge, people are not able to perform right practices. Regular trainings and efforts to increase knowledge may work for control of health care associated infections.

4. Discussion

Health care-associated infections have long been recognized as crucial factors undermining the quality and outcomes of health care delivery. Developing

Figure 1. Average percentage of knowledge, attitude and practice in certain aspects of hospital acquired infections and infection control practices as answered by final year MBBS undergraduate students.

Figure 2. Average percentage of favorable and unfavorable responses in knowledge, attitude and practice towards certain aspects of hospital acquired infections and infection control practices as answered by final year MBBS undergraduate students.

countries were reported to have up to 20 times the risk of contracting a nosocomial infection compared to developed countries. Thus, spread of infection serves as a major source of worry for managers in health care practice, particularly in developing countries where the health care system is already overstretched [4] .

Although infection is most prevalent in patients upon admission, health care workers also act as potential vectors for pathogenic agents. Hospitals provide a favorable transmission pathway for the spread of nosocomial infections, owing partly to poor infection control practices among health workers on one hand and overcrowding of patients in most clinical settings on the other.

In the present study, participants had good knowledge and attitude but poor practices towards different aspects of hospital acquired infections and its control measures. 75% of the participants stated that the infection of venous access, urinary & respiratory tract infections and infection of surgical site as the most common HAIs based on their current knowledge. Attitude towards the utility of guidelines/protocols for disinfection procedures was measured on a ten-point Likert scale ranging from 1 to 10 with higher scores indicating more positive attitudes. The overall attitude of the students was satisfactory as >90% agreed for risk of getting or transmitting any infectious disease by a HCW while working and the utility of the application of disinfection procedures during work would reduce the rates of HAI. The practices of the students for the application of disinfection during performance of certain medical procedures were unsatisfactory. The practice of disinfection was inadequately followed during certain procedures like intra-arterial injections, biopsy, blood culture collection, etc. The reason behind this might be that the students were undergraduate final year medical students so they might not have attended or been able to do such procedures more frequently.

Information regarding to the newer/changing guidelines for infection control practices was given to the medical students by either their colleagues or other medical journals. <50% participants had attended any educational course for disinfection during the past one year. So it would be better if there are regular workshops/seminars for the learning of newer guidelines as these undergraduate students are the future of clinical practice that need to be kept updated for their infection control practices.

Few studies have reported on medical student’s knowledge of standard precautions or sharp injuries [9] [10] [11] and noted a lack of adequate knowledge of standard precautions [11] . In one survey, 27% of participating health care students reported insufficient emphasis on teaching about infection control in their training program, whilst 50% expressed a desire for more emphasis on isolation procedures during their training [12] . Certain other studies [13] [14] have detected poor adherence to universal precautions among multiple health care providers. In a study by, it was found the general medical practitioners and medical college students had sufficient knowledge and attitude towards nosocomial infections. Also both these groups practice approach towards nosocomial infection was not sufficient and it needs improvement [15] .

5. Limitation

As the study population contained majority of under graduate final year medical students, they lacked the practice of performing certain procedures like intra arterial injection, biopsy, blood culture collection, etc. Also if other health care workers like resident doctors or nursing staff would have been included in the study, it would have given more informative results as these HCWs are the ones who are in constant contact with the patients.

Cite this paper

Chauhan, K. (2017) Knowledge Attitude and Practice towards Infection Control Measures amongst Medical Students in a Medical Teaching Tertiary Care Hospital. International Journal of Clinical Medicine, 8, 534-542. https://doi.org/10.4236/ijcm.2017.89050

References

  1. 1. WHO (2002) Prevention of Hospital Acquired Infections. A practical Guide. 2nd Edition, WHO, Geneva.http://www.who.int/csr/resources/publications/whocdscsreph200212.pdf

  2. 2. Patel, D.A., Patel, K.B., Bhatt, S.K. and Shah, H.S. (2011) Surveillance of Hospital Acquired Infection in Surgical Wards in Tertiary Care Centre Ahmedabad, Gujarat. Nat J Commun Med, 2, 340-345.

  3. 3. Chugh, T.D. (2012) Hospital Infection Control—Are We Serious? http://www.apiindia.org/pdf/medicine_update_2012/infectious_disease_14.pdf

  4. 4. The Hospital Infection Society of India (HISI) (2007) Newsletter, Volume 3(2). http://hisindia.org/data/HISI-Aug07.pdf

  5. 5. Saleem, M., et al. (2012) Prevalence of Nosocomial Infections in Surgical Wards of Tertiary Care Hospital at Lucknow. Indian Journal of Scientific Research, 3, 79-84.

  6. 6. Allegranzi, B., Bagheri Nejad, S., Combescure, C., Graafmans, W., Attar, H., Donaldson, L., et al. (2011) Burden of Endemic Health-Care-Associated Infection in Developing Countries: Systematic Review and Meta-Analysis. Lancet, 377, 228-241.https://doi.org/10.1016/S0140-6736(10)61458-4

  7. 7. Mehta, A., Rosenthal, V.D., Mehta, Y., Chakravarthy, M., Todi, S.K., Sen, N., et al. (2007) De-vice-Associated Nosocomial Infection Rates in Intensive Care Units of Seven Indian Cities. Findings of the International Nosocomial Infection Control Consortium (INICC). Journal of Hospital Infection, 67, 168-174. https://doi.org/10.1016/j.jhin.2007.07.008

  8. 8. Ganguly, N.K., Arora, N.K., Chandy, S.J., Fairoze, M.N., Gill, J.P., Gupta, U., et al. (2011) Global Antibiotic Resistance Partnership (GARP)—India Working Group. Rationalizing Antibiotic Use to Limit Antibiotic Resistance in India. Indian Journal of Medical Research, 134, 281-294.

  9. 9. Askarian, M., Honarvr, B., Tabatabaee, H.R. and Assadian, O. (2004) Knowledge, Practice and Attitude towards Standard Isolation Precaution in Iranian Medical Students. Journal of Hospital Infection, 58, 292-296. https://doi.org/10.1016/j.jhin.2004.07.004

  10. 10. Mann, C.M. and Wood, A. (2006) How Much Do Medical Students Know about Infection Control? Journal of Hospital Infection, 64, 366-370.https://doi.org/10.1016/j.jhin.2006.06.030

  11. 11. Koenig, S. and Chu, J. (1993) Senior Medical Students Knowledge of Universal Precautions. Academic Medicine, 68, 372-374. https://doi.org/10.1097/00001888-199305000-00021

  12. 12. Suchitra, J.B. and Lakshmidevi, N. (2007) Impact of Education on Knowledge, Attitudes and Practices among Various Categories of Health Care Workers on Nosocomial Infections. Indian Journal of Medical Microbiology, 25, 181-187.https://doi.org/10.4103/0255-0857.34757

  13. 13. Angtuaco, T.L., Oprescu, F.G., Lal, S.K., Pennington, J.H., Russell, B.D., Co, J.M., et al. (2003) Universal Precautions Guideline: Self-Reported Compliance by Gastroenterologists and Gastrointestinal Endoscopy Nurses—A Decade’s Lack of Progress. The American Journal of Gastroenterology, 98, 2420-2423.https://doi.org/10.1007/s100960100509

  14. 14. Huang, J.J., Lee, W.C., Ruaan, M.K., Wang, M.C., Chang, T.T. and Young, K.C. (2001) Incidence, Transmission, and Clinical Significance of Hepatitis G Virus Infection in Hemodialysis Patients. European Journal of Clinical Microbiology and Infectious Diseases, 20, 374-379.

  15. 15. Masavkar, S.P. and Naikwadi, A.M. (2016) Knowledge, Attitude and Practice Regarding Nosocomial Infections among General Health Practitioners and Medical College Students. Scholars Journal of Applied Medical Sciences, 4, 1852-1856.

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