Download RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1.Name of the candidate and address
PRAMOD.TC
M.Sc NURSING 1 YEAR
Dr. SYAMALA REDDY
NURSING
#111/1 SGR MAIN ROAD,
MUNNEKOLALA,
MARTHAHALLI,
BANGALORE-560037.
COLLEGE
OF
2.Name of the Institution
Dr. Syamala Reddy College of Nursing
3.Course of study and subject
M.Sc Nursing 1 Year.
4. Date of admission to course
MEDICAL SURGICAL NURSING
JUNE 2010
5. Title of the study
A study on Assessment of level of Knowledge and
Practice regarding Occupational Blood And
Body Fluid Exposure among Staff Nurses in
selected Hospital at Bangalore.
1
BRIEF RESUME OF THE INTENDED WORK
‘PREVENTION IS BETTER THAN CURE’
6.0. INTRODUCTION
Hospital is a health industry where people with various diseases are cared for and major group
of people who provide health care. Health and safety of the workers within the work place is
the major concern of the millennium that has emerged with the rapid technological
advancement in the every field of the practice. Occupational Blood and body fluid exposure
continue to be major worldwide public health problem, despite advances in our understanding
and control of these infections. Nurses are the major health care provider in the hospital and
the nurses are more potential to exposure with blood and body fluid. Occupation exposure to
the blood pathogen plays a significant role in increasing the risk of the workers in the health
care industry.
The blood are the red color, viscous circulating body fluid and body fluid are the fluid such
as the semen, vaginal secretions, cerebrospinal fluid, urine, vomitus, cough, saliva etc which
contain concentrated virus.
Occupational exposure is the exposure to the blood, and body fluids .The mode of exposure
includes percutanouse exposure, and mucocutaneous exposure and non intact skin exposure.
Occupational blood and body fluid (BBF) exposures place healthcare workers (HCW) at risk
for numerous blood-borne infections, most importantly human immunodeficiency virus
(HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).
Transmission of blood borne pathogens such as hepatitis B virus (HBV), hepatitis C virus
(HCV), and human immunodeficiency virus (HIV)) from patient to workers is an important
2
occupational hazard faced by nurses . Risk factors for transmission of blood borne pathogens
after occupational exposure are likely related to the source patient, the type of injury, and
quantity of blood/body fluid transferred to the HCW during the exposure, and the health
status. The greatest risk of infection transmission is through percutaneous exposure to infected
blood. Transmission of HBV, HCV, and HIV after mucous membrane or skin exposure to
blood has also been reported and the risk of transmission of these pathogens through
mucocutaneous exposure is considered lower than the risk associated with a percutaneous
exposure (CDC 2000).1
When intact, the integumentary system serves as an effective physical barrier to the entry of
infectious elements into the body. A special situation exists in terms of mucous membranes.
Across these membranes, lies a layer of mucus secreted by specialized columnar cells that are
closely associated with each other through gap junctions, which are little more than
specialized cell surface projections that allow intercellular communication. The presence of a
moist mucous layer tends to prolong the viability of fragile viruses, such as HIV and HBV,
which cannot survive long in drier environments.
In terms of blood and body fluids, semen and vaginal secretions with visible blood should be
considered potentially infectious vehicles. Similarly, cerebrospinal fluid, amniotic fluid,
pleural fluid, synovial fluid, and peritoneal and pericardial fluids carry a high suspicion of risk
for transmission. In addition, unless blood is present, saliva, sputum, sweat, tears, feces, nasal
secretions, urine, and vomitus carry a low risk of transmission of HBV, HCV, and HIV.
Universal precautions are intended to prevent parenteral, mucous membrane and non-intact
skin exposures of health-care workers to blood borne pathogens. Personal hygiene thus
3
becomes fundamental principle in observing universal precautions. Immunization with HBV
vaccine is recommended as an important adjunct to universal precautions for health care
workers who have exposures to blood. Clinical applications of universal precautions are
important for every health care professional. There should take precautions to prevent injuries
caused by needles, scalpels, and other sharp instruments or devices during procedures.
After blood and body fluid exposure, decontamination of the blood splash is very important
to avoid transmission of the blood borne pathogens. Avoiding occupational blood and body
fluid exposures is the primary way to prevent transmission of pathogens in health-care
settings. Immunization and post exposure management are integral components of a complete
program to prevent infection following blood borne pathogen exposure and are important
elements of workplace safety (The U.S. Public Health Service (PHS). Post-exposure
prophylaxis refers to the set of services that are provided to manage the specific aspects of
exposure to infection and to help prevent infection in a person exposed to the risk of getting
infected by HIV, HBV, and HCV and also done follow-up(WHO 2007).2
Nurses are an integral component of the health care delivery system .They perform
numerous procedure during which they may exposed to patient s blood or body fluid ,it is
observed that accidental exposure are more frequent when nurses neglect safety practices.
So nurse should be knowledgeable about all the potential problem of which is caused by
occupational blood and body fluid exposure and its preventive measures and management.
4
6.1. NEED FOR THE STUDY
Hospital-associated infections (HAI) are considered as major causes of mortality, emotional
stress and enhanced morbidity in hospitalized patients. These also account for significant
Economic loss and additional burden on health care institutions.
WHO reported that, the highest frequencies of HAI from hospitals in the Eastern
Mediterranean Region (11.8%) followed by South-East Asia, where it was 10%. It has also
been estimated that at any time over 1.4 million people worldwide suffer from infectious.
Complications acquired in hospital. The infections acquired in the hospitals may be due to
resistant organisms that further accentuate the problem (WHO2002).2
Occupational blood and body fluid (BBF) exposures place healthcare workers (HCWs) at risk
for numerous blood-borne infections, most importantly human immunodeficiency virus
(HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Approximately three million
percutaneous exposures to blood-borne pathogens occur annually among 35 million HCWs
worldwide. These injuries are estimated to result in approximately 16,000 HCV, 66,000 HBV,
and 200 HIV infections. Over 90% of these infections occur in low-income countries and
most are preventable.27 An European survey of NSIs, found that nurses are exposed more
commonly (91%) than doctors (6%) or phlebotomists (3%).3
A study revealed that 70% of medical, 74% of dental, and 72%of nursing students reported
have had at least one sharps-related injury since beginning of their clinical education. On
which, 75 – 85% of these students did not report their injuries.4
5
All healthcare workers face a wide range of hazards on the job, including blood and body
fluid exposure. In 2001, U.S. hospitals reported 293,600 nonfatal occupational injuries and
illnesses among their personnel. Annual exposure prevalence rates range from <10% to 44%,
depending on the occupational subgroup. Every year, approximately 600,000–800,000
occupational needle stick injuries occur in the United States.5
A study revealed that, nurses were the most likely to experience a blood or body fluid
exposure. Most exposures involve percutaneous injuries, although mucocutaneous and
direct contact of infected blood with nonintact skin is also routes of exposure. These
potential infections, like healthcare-associated infections, also appear to be tied to nurses'
working conditions. 1
A cross-sectional study was conducted on Occupational exposure to body fluids among
healthcare workers. The study revealed that of 900 HCWs studied, 476 exposures had
occurred (0.53 exposures per person-year). The highest exposure rate (per person-year) was
observed among housekeeping staff nurses (0.78) and nurses (0.63), and occurred most
commonly in the medical wards (23.0 percent). Percutaneous injury was reported in 280
participants. There were 72 exposures to human immunodefiency virus, HBV and hepatitis C,
with exposure to HBV being the most common.6
6
A study conducted on Blood and body fluid exposures place healthcare workers at risk for
blood-borne infections, the result was the overall prevalence of blood and body fluid
exposures was 79% with a rate of exposure to sharps devices of 50%. Hypodermic needles
were involved in most exposures (73%) with the most common source of injury being needle
recapping (35%).7
The literature however in its effort to explore all facets of the current potential problem by
occupational blood and other body fluid exposure has produced a complex construct make it
exceeding difficulty for the researcher to understand the problem.
Nurses are important group of health care providers who render support to health care. They
are also expected to impact new ideas to their practice all of which is expected to bring
improvement to the service. It is with this context that this study is conducted with the aim of
knowing the level of knowledge regarding occupational blood and body fluid exposure as
well as their level of practice.
7
6.2. REVIEW OF LITERATURE
Review of the literature is an important step in the development of research project .the
investigator carried out an extensive review of literature on the research topic to gain deeper
insight in to the problem and to collect maximum relevant information for building up the
study in a scientific manner so as to achieve the desire result.
OCCUPATIONAL BLOOD AND BODY FLUID EXPOSURE
A cross-sectional descriptive study conducted on the frequency of occupational blood and
body fluids exposure (OBBFE) among the nursing staff, revealed that of the 186 responses
analyzed, 77.7% were female. Of those surveyed, 91 (48.9%) indicated that at some time they
had an OBBFE, with 33 (17.7%) of these having occurred.8
A study conducted on the epidemiology and time trends of blood and body fluids (BBF)
exposures among hospital doctors shown that 175 cases of BBF exposures in doctors were
reported over the 3-year study period. Eighty-one (46%) occurred in senior doctors and 94
(54%) in junior doctors. 9
A cross-sectional study conducted on Exposure to blood and body fluids among residents,
interns, nurses and technicians. Revealed that overall incidence of occupational exposure to
blood and body fluids during the study period of one year was 32.75%. The incidence of
accidental exposure to potential infectious material was the highest among the staff nurses at
39.63%, followed by interns at 37.34%, technicians at 26.92% and least among the resident
doctors at 21.01%.10
8
A study conducts on Occupational blood and infectious body fluid exposures in a teaching
hospital, shown that needle stick injuries were the most commonly reported BBF exposure,
accounting for 80% of reported cases. The total incidence density of BBF exposures was 1.96
per 100 person-years. Nurses had the highest percentage (60.6%) of BBF exposures and other
job categories including physicians, technicians, cleaning staff, and interns accounted for
around 10% each.11
Prospective studies of HCWs have estimated that the average risk for HIV transmission after
a percutaneous exposure to HIV-infected blood is approximately 0.3% (95% confidence
interval = 0.2 to 0.5%) and that after a mucous membrane exposure it is 0.09% (95%
confidence interval = 0.006 to 0.5%).12
A retrospective study Conducted on the impact of nurse understaffing on the transmission of
hepatitis C virus in a hospital-based hemodialysis unit. The finding that the overall HCV
prevalence and seroconversion rate per year was 43.4 and 8.6%, respectively. 13
A cross sectional study Conducted on Occupational exposure of health workers to blood and
body fluids revealed that a total of 618 health care workers were interviewed about exposure
in the past three months prior this interview. Needle stick injury was reported in 106 health
care workers (17.2%), 348 (56.3%) had contact of blood and body fluid to their skin and 154
(24.9%) reported exposure to their mucus membrane. Working in the delivery room (80.4%)
and gynecological wards (75%) had higher risk of exposure to the skin. 14
A study conduct on use of disposable gloves of every day clinical practice when contact with
blood or body fluids shown that only a small percentage of staff (20%) were wearing vinyl
gloves to deal with blood spillages and for venepuncture (13%) and cannulation (10%).15
9
A study conducted on Universal precautions: a survey of community nurses' experience and
practice shows that the majority of community nurses reported compliance with universal
precautions, although a small number of nurses stated that they re-sheathed needles,
inappropriately stored sharps containers, inadequately wore gloves and experienced
difficulties in hand washing.16
As highlighted in the UK Health Departments’ guidance (1998), chlorine-releasing agents,
including sodium hypochlorite or sodium dichlorisocyanurate tablets or granules are
recommended for general surface disinfection with a concentration of 10,000ppm available
chlorine for dealing with blood/body fluid spillages. This approximately represents a 1:10
dilution of household bleach, although the strength of various brands may differ and may
deteriorate on storage.
A study conducted on the antiviral activity of sodium hypochlorite (NaOCl) and sodium
dichloroisocyanurate (NaDCC) against human immunodeficiency virus (HIV) by Using a
quantitative suspension test method indicated that satisfactory disinfection can be achieved
using NaDCC and NaOCl at concentrations of 50 ppm and 2500 ppm available chlorine for
clean and soiled conditions respectively. (Bloomfield SF, Smith-Burchnell CA, Dalgleish
AG)
The US Centers for Disease Control and Prevention (CDC) first recommended that
institutions provide post exposure prophylaxis (PEP) for occupational exposure to HIV.1
Many emergency departments (EDs) have developed protocols for the distribution of
medications to health care workers who have sustained high-risk injuries with contaminated
blood and body fluids.
10
NURSES KNOWLEDGE AND PRACTICE REGARDING OCCUPATIONAL BLOOD
AND OTHER BODY FLUID EXPOSURE
A cross-sectional descriptive study on assess the level of knowledge regarding occupational
blood and body fluid exposure among nursing staff revealed that 56.3% nurses had not
received adequate training; and, 94.1% claimed to have been vaccinated against Hepatitis B. 8
A cross-sectional study conducted on Knowledge and practice of universal precautions among
nurses revealed that the nurses had a poor knowledge about universal precautions as only
34.2% of nurses had heard about universal precautions.18
A cross sectional survey conducted to evaluate the Impact of Hospital Infection Control
Training Program on Health Care Workers. Shown that 64% of HCWs had received complete
vaccination against Hepatitis B and 13% were undergoing it. The number of HCWs not
vaccinated for Hepatitis B was 23%, of which 14% had not undergone HIC training. Amongst
the HCWs, who have attended the HIC training program, 60-75% were aware about the use of
gloves, apron and other personal protective devices (mask/ eye shield) for its prevention. 52%
of HCWs were aware of proper hand washing practices and its importance in hospital
infection control. 40-50% of HCWs, who had undergone training, had knowledge about the
care of spillage and the use of Sodium hypochlorite in adequate concentration for its good
efficacy. Also, the awareness about the availability of Post Exposure prophylaxis (PEP) and
immediate measures to be taken following needle stick injury was 40-52% in this group.19
11
A study conducted on knowledge and perception and prevalence of hepatitis B among
Moroccan health care workers (HCWs), study revealed that prevalence of hepatitis B core
antibody (anti-HBc) was 28% and was significantly higher among nursing auxiliaries, nurses,
medical physicians and midwives than among laboratory technicians. 20
A study conduct on knowledge and practice amongst nursing staff toward infection control
measures, revealed that the knowledge of staff nurses regarding infection control measures
was 75.5% and the mean reported infection control practice was 57.5%.21
A cross-sectional survey conducted on knowledge, attitudes and risk perception regarding
HIV amongst nurses, doctors and other healthcare workers showed that general willingness of
HCWs to provide care for patients with HIV, tempered by concerns regarding provision of
such care.22
A survey conducted on nurses knowledge about transmission and precautionary measures
regarding hospital acquired infection revealed the nurses showed misconceptions regarding
disinfection and precautionary measures were present; 33% had overall negative attitudes .23
A study conducted on knowledge, concerns, and practices regarding Healthcare workers and
blood borne pathogens. Findings provide information regarding knowledge level, practices of
staff in applying universal precautions, and availability of supplies and equipment. The
concerns of nurses along with content for educational programs and suggested approaches to
education are outlined.24
12
A study conducted on assesses the knowledge, attitude and practices among health care
workers on needle stick injuries revealed that 4% and 61% of health care workers respectively
were unaware of the fact that hepatitis B and hepatitis C can be transmitted by needle-stick
injuries. 52 subjects (74%) had a history of needle-stick injuries and only 21% reported the
injuries to the hospital authority. 79% were of the impression that needle should be recapped
after use. Only 66% were aware of Universal Precaution Guidelines. And revealed that
knowledge of health care workers about the risk associated with needle-stick injuries and use
of preventive measures was inadequate.25
A study conducted on the level of knowledge of staff nurses regarding post-exposure
prophylaxis of blood-borne infections (HIV, HBV and HCV) revealed that 21.6-29.6% of
nurses had inadequate knowledge in this area of post-exposure prophylaxis.26
13
6.3. STATEMENT OF THE PROBLEM
A study on assessment of knowledge and practice regarding occupational blood and body
fluid exposure among staff nurses in selected hospitals at Bangalore.
6.4. OBJECTIVES
1. To assess the level of knowledge regarding occupational blood and body fluid
exposure among staff nurses.
2. To identify the practice of staff nurses regarding occupational blood and body fluid
exposure among staff nurses.
3. To determine the correlation between the level of knowledge and practice of staff
nurses regarding occupational blood and body fluid exposure among staff nurses.
4. To find out the association between the levels of knowledge regarding occupational
blood and body fluid exposure and selected socio demographic variable among staff
nurses.
5. To determine the association between the practice regarding occupational blood and
body fluid exposure and selected socio demographic variable among staff nurses.
14
6.5. HYPOTHESIS
H0 1: There is a significant correlation between the level of knowledge and practice of staff
nurses regarding occupational blood and body fluid exposure.
H0 2: There is a significant association between the level of knowledge and selected
socio demographic variables among staff nurses.
H0 3: There is significant relationship
between the level of practice and selected
socio demographic variables among staff nurses.
6.6. OPERATIONAL DEFINITIONS
Assessment: It is the process of measuring the level of knowledge of staff nurses
regarding occupational blood and body fluid exposure using structured self
administered questionnaire.
Knowledge: It is the information possessed by staff nurses regarding occupational
blood and body fluid exposure such as meaning, infections caused by the exposure ,
mode of transmission of infections, prevalence of infections, preventive measures ,
management of spillage and post exposure prophylaxis and follow up of infections
measured using structured self administered questionnaire.
15
Practice: It is the procedure carried out by staff nurses regarding the prevention of
occupational blood and body fluid exposure measured using structured self
administered questionnaire as elicited by verbal response.
Blood: It is the red color, viscid, circulating body fluid which is concentrated with
pathogens and exposed to the nurses.
Body fluid: It is the body fluid such as semen, vaginal secretion, urine, cerebrospinal
fluid, vomits, sputum, and pus which is concentrated with pathogens.
Occupational: It is the possession of a person which is connected with health care.
Exposure: It is vulnerability or chance of nurses towards blood and body fluid
pathogenic infection
6.7. ASSUMPTIONS
1. Knowledge and practice of staff nurses differ from the person to person.
2. Knowledge and practice of staff nurses is influenced by selected socio demographic
variables.
3. Mass media influences the level of knowledge and practice of staff nurses.
4. Knowledge of staff nurses influences their practices.
16
7.0. MATERIALS AND METHODS
7.1. SOURCES OF DATA; The staff nurses at selected hospitals, Bangalore.
7.2. METHOD OF DATA COLLECTION PROCEDURE

RESEARCH APPROACH
Non experimental approach

RESEARCH DESIGN
It is descriptive co relational design using structured self administered questionnaire to
determine the level of knowledge and practice regarding occupational blood and body
fluid exposure among staff nurses.
SAMPLING TECHNIQUE
The sample of 100 staff nurses at selected hospitals will be selected using non probability
convenience sampling technique.
SAMPLE AND SAMPLE SIZE
The sample of 100 staff nurses at selected hospitals will be selected for the study.
17
SETTING OF THE STUDY
A descriptive correlation study will be conducted in selected hospital at Bangalore.
7.2.1. CRITERIA FOR SAMPLE SELECTION
1. Staff nurses who are willing to participate in the study.
2. Staff nurses who are present at the time of data collection.
7.2.2. DATA COLLECTION TOOL
Structured self administered questionnaire will be prepared to assess knowledge and
practice regarding blood and body fluid exposure among staff nurses in selected hospitals at
Bangalore.
Questionnaire will consist of 3 sections
Section A:
Section A consists of socio –demographic variables such as age, sex occupation, income,
experience, etc.
18
Section B:
Section B consist questionnaire on knowledge regarding occupational blood and body fluid
exposure among staff nurses in selected hospitals at Bangalore.
Section C:
Section C consist questionnaire on practice regarding occupational blood and body fluid
exposure among staff nurses in selected hospitals at Bangalore.
VALIDITY: The validity of the tool will be ascertained in consultation with guide and other
experts from various fields like nursing, physician and biostatistician. Reliability of tool will
be established by split half method.
7.2.3. DATA ANALYSIS METHODS;
Data analysis will be done using descriptive and inferential statistics .The descriptive statistics
used will be frequency distribution, percentage, mean and standard deviation. The inferential
statistics used will be Chi-square and correlation coefficient.
7.3. DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS
TO BE CONDUCTED ON PATIENTS OR OTHER HUMAN OR ANIMALS?
No, only a structured questionnaire will be used for data collection .No other invasive
Physical or laboratory procedures will be conducted on the samples.
19
7.4.. HAS ETHICAL CLEARENCE BEEN OBTAIN
Yes. Confidentiality and anonymity of the subjects will be maintained. Prior to the study
consent will be taken from the staff nurses regarding their willingness to participate in the
study.
8.0. REFERENCES
1] CDC Guidelines for Prevention of Intravascular Infections 1995. Department of Health
And Human Services, Center for Disease Control and Prevention, National Centre for
Infectious Diseases, Hospital Infections Program.
2] World Health Organization. Guidelines on Prevention and Control of Hospital Associated
Infections. Vol. 1, W H O Regional Office for South-East Asia, New Delhi, 2002.
3]Ayranci U, Kosgeroglu N. Needlestick and sharps injuries among nurses in the healthcare
sector in a city of western Turkey. J Hosp Infect. 2004; 58: 216 – 223.
4] Askarian M, Malekmakan L. The prevalence of needlestick injuries in medical, dental,
nursing, and midwifery students at the university teaching hospitals of Shiraz,Iran. Indian J
Med Sci. 2006; 60: 227 – 232.
5]Patricia W. Stone, Sean P. Clarke,Jeannie Cimiotti,and Rosaly Correa-de-Araujo.Nurses'
Work and Occupational Exposure to Infectious Disease , Columbia University School of
Nursing, New York, New York, USA.
6]Hadadi A, Afhami S, Karbakhsh M, Esmailpour N, Occupational exposure to body fluids
among healthcare workers, Iran, Singapore Med J 2008; 49(6): 492-496.
20
7] Mehrdad Askarian MD MPH, Soheila Shaghaghian MD, Marion Gillen MD,
Ojan Assadian MD Body Fluid Exposure in Nurses of Fars Province, Southern Iran
Archives of Iranian Medicine, Volume 11, Number 5, 2008: 515 – 521.
8]Warley E, Pereyra N, Desse J, Cetani S, de Luca A, Tamayo Antabak N, Szyld E .A study
of occupational blood and body fluid exposure among nursing staff at a reference hospital in
Buenos Aires, Argentina
9]Seyed Hamid Reza Naghavi1 and Kaveh A. Sanati , Accidental blood and body fluid
exposure among doctors, Department of Occupational Health, Hammersmith Hospital, Du
Cane Road, London W12 0HS, UK.
10]Singru SA, Banerjee A. Occupational exposure to blood and body fluids among health
care workers in a teaching hospital in Mumbai, India. Indian J Community Med 2008;33:2630.
11]Hsieh WB; Chiu NC; Lee CM; Huang FY ,Occupational blood and infectious body fluid
exposures in a teaching hospital, J Microbiol Immunol Infect. 2006; 39(4):321-7 (ISSN:
1684-1182)
12]Ramchandani SR; Mehta SH; Saple DG; Vaidya SB; Pandey VP; Vadrevu R; Rajasekaran
S; Bhatia V; Chowdhary A; Bollinger RC; Gupta A,Knowledge, attitudes, and practices of
antiretroviral therapy among HIV-infected adults attending private and public clinics in
India,AIDS Patient Care STDS. 2007; 21(2):129-42 (ISSN: 1087-2914)
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13]Saxena AK; Panhotra BR, The impact of nurse understaffing on the transmission of
hepatitis C virus in a hospital-based hemodialysis unit, Med Princ Pract. 2004; 13(3):129-35
(ISSN: 1011-7571)
14]Gessessew A; Kahsu A ,Occupational exposure of health workers to blood and body fluids
in six hospitals of Tigray region: magnitude and management, in Mekele Hospital, Tigray
(2006), Ethiop Med J. 2009; 47(3):213-9 (ISSN: 0014-1755)
15]Raybould LM ,Disposable non-sterile gloves: a policy for appropriate usage, Dudley
Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, West Midlands.,Br J Nurs.
2001; 10(17):1135-41 (ISSN: 0966-0461)
16]Bennett G; Mansell I,Universal precautions: a survey of community nurses' experience and
practice,J Clin Nurs. 2004; 13(4):413-21 (ISSN: 0962-1067)
18]Ofili AN; Asuzu MC; Okojie OH, Knowledge and practice of universal precautions among
nurses in central hospital, Benin-City, Edo State, Nigeria, Niger Postgrad Med J. 2003;
10(1):26-31 (ISSN: 1117-1936)
19]M Mathur, T Shripad*, Sachee Tainwala, Vaibhav Misra ,A Study to Evaluate The Impact
of Hospital Infection Control Training Programme on Health Care Workers,Mumbai,2000.
20]Djeriri K; Laurichesse , knowledge and perception and prevalence of hepatitis B among
Moroccan health care workers (HCWs), Occup Med (Lond). 2008; 58(6):419-24 (ISSN:
1471-8405)
22
21]Taneja J; BibhaBati M ,Evaluation of knowledge and practice amongst nursing staff
toward infection control measures in a tertiary care hospital in India, Department of
Microbiology, GB Pant Hospital, New Delhi, India., Can J Infect Control. 2009; 24(2):104-7
(ISSN: 1183-5702).
22]Kermode M; Holmes W ,HIV-related knowledge, attitudes and risk perception amongst
nurses, doctors and other healthcare workers in rural India, Indian J Med Res. 2005;
122(3):258-64 (ISSN: 0971-5916)
23]Datta C; Bandyopadhyay D, Knowledge and attitude in relation to HIV/AIDS among inservice nurses of Medical College, Calcutta. J Indian Med Assoc. 1997; 95(3):75-7 (ISSN:
0019-5847)
24] Ryan ME; Jones L; Miller D, Healthcare workers and blood borne pathogens: knowledge,
concerns, and practices, Gastroenterol Nurs. 1996; 19(3):96-101 (ISSN: 1042-895X).
25]Gurubacharya DL; Mathura KC; Karki DB, Knowledge, attitude and practices among
health care workers on needle-stick injuries,Kathmandu Univ Med J (KUMJ). 2003; 1(2):914 (ISSN: 1812-2027).
26]Bilski B; Wysocki J, The level of knowledge of post-exposure prohylaxis of blood-borne
infections at the workplace observed in nurses, Med Pr. 2005; 56(5):375-8 (ISSN: 04655893).
27]Kermode M, Jolley D, Langkham B, Thomas MS, Croft N. Occupational exposure to
blood and risk of blood-borne virus infection among health care workers in rural north Indian
healthcare settings. Am J Infect Control. 2005; 33: 34 –
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9.
Signature of Candidate
10.
Remarks of the Guide
11.
Name and Designation
12
11.1
Guide
11.2
Signature
11.3
Co-guide
11.4
Signature
11.5
Head of the
Department
11.6
Signature
12.1
Remarks of the
Chairman and
Principal
12.2
Signature
24