Knowledge, Compliance and Attitude of Nursing Students towards Standard Precautions: A Cross-Sectional Study in a Tertiary Hospital

@#Introduction: Knowledge, compliance, and attitudes toward the standard precaution guidelines are crucial to avoid contamination not only on patients but also on healthcare providers. Little is known regarding Malaysian nursing students’ knowledge, compliance, and attitudes toward standard precaution guidelines. The purpose of this study was to look into Malaysian nursing students’ knowledge, compliance, and attitudes towards standard precaution guidelines. Methods: This cross-sectional study was conducted among 337 Diploma nursing students who were chosen by simple random sampling. A self-invented questionnaire based on the CDC recommendations was administered to the participants and their responses were recorded. With a Cronbach’s alpha coefficient of 0.96, the instrument is reliable. The STROBE cross-sectional design process guideline was used as the study design. Results: Majority of the nursing students have adequate knowledge (n=222, 65.9%), adequate compliance (n=229, 68%) and good attitudes (n=171, 50.7%) with the standard precaution. The findings suggest an association between gender (p=0.005) and year of educational level (p=0.001) with the level of knowledge. There was also an association between the level of knowledge with the level of compliance (p=0.029) and the level of attitude (p=0.002) with standard precautions among the nursing students. Conclusion: Even though nearly two-thirds of the participants appeared to have adequate knowledge and compliance, only half of them have good attitudes with the standard precautions. This study indicates that although the students had adequate knowledge and compliance, measures are needed to foster compatible attitudes towards the standard precautions among the nursing students.

Experience from community based childhood burn prevention programme in Bangladesh: implication for low resource setting.

A comprehensive community-based burn prevention framework was developed for rural Bangladesh taking into consideration the magnitude, consequences of burns, risk factors of childhood burn, health seeking behaviour of parents after a burn injury of a child and the perception of community people. This paper explains the comprehensive framework of the childhood burn prevention programme and describes its acceptability, feasibility and sustainability. A number of methodologies were adopted in developing the framework, such as, (i) building up relevant information on childhood burn and prevention methods, (ii) arranging workshops and consultation meetings with experts and related stakeholders and (iii) piloting components of the framework on a small scale. Lack of supervision of the children, hazardous environment at home and the low level awareness about childhood burn and other injuries were identified as the major attributes of childhood burn in Bangladesh. To address these factors "Triple S" strategies were identified for the prevention framework. These strategies are: Safe environment. Supervision. Skill development. According to these strategies, home safety, community crèche, school safety, formation of community groups and general awareness activities were identified as the different components of the childhood burn prevention framework in rural Bangladesh. The framework was piloted in a small scale to explore its feasibility acceptability and sustainability. The framework was found to be acceptable by the community. It is also expected to be feasible and sustainable as very low cost and locally available technology and resources were utilized in the framework. Large scale piloting is necessary to explore its effectiveness and ability to scale up all over the whole country.

Initial community response to a childhood drowning prevention programme in a rural setting in Bangladesh.

OBJECTIVES: To describe the development, community acceptability, feasibility, and sustainability of a pilot drowning prevention intervention for rural children, 1-4 years old, in Bangladesh. METHODS: A prevention package was formulated and piloted in four rural communities of Bangladesh for 3 months. Focus group discussions and in-depth interviews were organised with stakeholders to elicit community acceptability, feasibility, and sustainability of the proposed interventions. RESULTS: Increased supervision of children, raising awareness on water safety, and educating the community on first response skills were the three core aspects identified through workshops to include in the intervention package. During development of interventions emphasis was given to finding low-cost local resources. To increase child supervision, creation of drowning-safe homes and establishment of community crèches were identified. To create heightened water safety, formation of village committees and conduction of courtyard and social autopsy meetings with communities were considered. The community actively participated and considered that these interventions would be useful for prevention of child drowning. There was also an increasing demand for some of these interventions. CONCLUSION: Use of low-cost local resources, community participation, and increasing demand of the interventions indicated that the package was acceptable, feasible, and sustainable to the community. To determine the effectiveness of the package demands implementation on a larger sample.

Health seeking behaviour of parents of burned children in Bangladesh is related to family socioeconomics.

OBJECTIVE: The study was design to explore the health seeking behaviour of Bangladeshi parents for their children during burn injuries. METHODS: A population-based cross-sectional survey was conducted between January and December 2003 in Bangladesh. Nationally representative data were collected from 171,366 rural and urban households comprising of a total population of 819,429, including 351,651 children of 0-18 years. Mothers or heads of households were interviewed with a structured questionnaire in obtaining the information. RESULTS: About sixty percent parents seek health care from unqualified service providers for their children during a childhood burn injury. Educated and the higher income groups parents choose qualified service provider at significantly higher rate compared to illiterate and poor. Higher proportion of parents of urban residence chooses qualified service provider compared to rural. No significant difference of health seeking behaviour of parent in choosing care provider was found in relation to sex of the children. CONCLUSION: Education, economic condition and place of residence were found as the contributory factors in choosing service provider. Education to the parents can contribute in changes in health seeking behaviour which ultimately contribute in reducing morbidity and mortality from childhood burn injuries. Including parent's education a national burn prevention program needs to be developed to combat the devastating child injury, burn.

Perceptions of rural people about childhood burns and their prevention: a basis for developing a childhood burn prevention programme in Bangladesh.

OBJECTIVES: This study was conducted to gain an in-depth understanding of people's perceptions of childhood burns and their prevention in rural areas of Bangladesh. STUDY DESIGN: Qualitative study. METHODS: Five focus group discussions were conducted in this study. Eight to twelve members were present in each group. Groups were composed of mothers of children under 5 years of age, adolescent male and female students in Grades IX and X, fathers and local leaders such as school teachers and religious leaders. The study was conducted in a rural community of Bangladesh in 2003. RESULTS: Focus group participants were aware of the devastating consequences of childhood burn injuries. They reported that younger boys and older girls are at higher risk of burn injuries. They identified home as the most common place for childhood burn injuries, and stated that occurrence was more common in winter. They held the household members or caregivers responsible because of their lack of supervision and carelessness. The focus group participants suggested that people should supervise their children more carefully, and should take initiatives to modify their homes and premises as necessary so that children would not have access to fires and heat sources. Regarding first aid, the focus group participants reported prevailing harmful practices which are likely to make injuries worse. CONCLUSIONS: A safety education programme could be an effective intervention to improve knowledge and practices of rural people in Bangladesh with regard to prevention of burns injuries in children.

Analysis of the childhood fatal drowning situation in Bangladesh: exploring prevention measures for low-income countries.

OBJECTIVE: To determine the epidemiology of child drowning in order to propose possible interventions for Bangladesh and other similar low-income countries. DESIGN: Population-based cross-sectional study. SETTING: Rural and urban communities in Bangladesh. SUBJECTS: About 352,000 children 0-17 years were selected from over 171,000 households, using multistage cluster sampling. MAIN OUTCOME MEASURES: Incidence of fatal drowning. RESULTS: Drowning was the leading cause of death (28.6 per 100,000 child-years) in children aged 1-17 years. The highest incidence (86.3 per 100,000 child-years) was in children aged 1-4 years. More than two-thirds of drownings occurred in ponds and ditches. Most drownings (85%) happened in daylight. In more than one-third of cases of drowning, the child was alone. In the two-thirds of cases in which the child was accompanied, almost half were with children who were 10 years or below. Only 7% of drowned children over 4 years of age knew how to swim. CONCLUSIONS: Drowning is a major cause of childhood mortality in Bangladesh. Creating drowning-safe homes, improving supervision of children, modifying the environment, and developing water safety skills for children and the community may be effective interventions for drowning prevention.

Consequences of childhood burn: findings from the largest community-based injury survey in Bangladesh.

In terms of morbidity and disability, burn is a major public health problem throughout the world, especially in low-income countries. It causes long-term disability and remains as a health, social and economic burden. A population-based survey was conducted in Bangladesh between January and December 2003. Nationally representative data were collected from 171,366 rural and urban households comprising of a total 819,429 population, which included 351,651 children under 18 years of age. Mothers/head of households were interviewed with a structured instrument. The objective of this paper is to determine the consequences of childhood burn at social and economic levels in Bangladesh. In the survey, 1013 children were found with different degrees of burn in the preceding 1 year. Among them 20 children were permanently disabled. The rate of permanent disability was found to be 5.7 per 100,000. The average loss of school days was found to be about 21 days. More than two-thirds of the burn victims required assistance in their daily activities for different durations of time. More than 7% of the children required hospitalisation for their burns. The rate of hospitalisation was 21.9 per 100,000; the average duration of hospital stay was 13.4 days. The highest duration (40 days) of hospital stay was found among girls 10-14 years old. The highest expenditure for the treatment was also found in this age group. The average direct expenditure incurred by a family for treatment of severe burn was determined to be $462. In this study it was found that more than 61% of the families earn less than $50 a month. Burn is a devastating injury among all childhood injuries with significant additional economic consequences beyond the medical, pain, and suffering issues. Developing a national prevention program should be an immediate public health priority.

Epidemiology of childhood burn: yield of largest community based injury survey in Bangladesh.

In terms of mortality, morbidity and disability, burns are emerging as a major child health problem in Bangladesh. This trend is similar to many other developing countries. To develop effective burn prevention programmes, information on its magnitude and determinants is necessary. The purpose of this study was to document the magnitude and determinant of childhood burns in Bangladesh, based on a population-based survey which was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429. To facilitate data collection, face-to-face interviews were conducted. The rate of non-fatal burn among children under 18 years of age was calculated as 288.1 per 100,000 children-year. The highest incidence (782.1/100,000 children-year) was found among the 1-4 years age group. About 46% of non-fatal burn injuries occurred between 9 a.m. and 3 p.m. The incidence of childhood burn was found to be more than four times higher in rural children than urban children. Ninety percent (90%) of the childhood burns occurred at homes and the kitchen was the most common place. The rate of disability due to burn was 5.7 per 100,000 children per year. The rate of fatal burn was 0.6 per 100,000 per year among all children. The study findings confirmed that childhood burn was a major childhood illness in Bangladesh. An urgent and appropriate prevention programme is required to prevent these unwanted morbidities, disabilities and deaths due to burn.