KNOWLEDGE, ATTITUDE AND PRACTICE OF UNIVERSAL PRECAUTIONS AMONG HEALTHCARE WORKERS IN A TERTIARY HOSPITAL IN NORTHWEST NIGERIA: A CROSS-SECTIONAL STUDY

Umar Abdullahi; Abdullahi Shehu; Bello Alhaji Mohammed; Musa Yakubu; Aminu Abubakar Bala; Akibu Umar Aliyu; Abubakar Sanusi Mayana; Mujtaba Bala

doi:10.5455/EJMID.20250928064439

Abstract
Background: Universal precautions (UPs) are essential infection prevention and control (IPC) measures that reduce occupational exposure to blood-borne pathogens among healthcare workers (HCWs). Despite global guidelines, compliance remains suboptimal in many low-resource settings. This study assessed the knowledge, attitude, and practice (KAP) of UPs among HCWs at a tertiary facility in Northwest Nigeria.
Methods: A descriptive cross-sectional study was conducted among 358 HCWs at the Federal Medical Center, Gusau, from March to July 2025. Data were collected using a structured, self-administered questionnaire covering knowledge (12 items) and combined attitude/practice (12 items) domains. Responses were scored and categorized as low (≤50%), fair (51-69%), and good (≥70%). Data were analyzed using SPSS version 25.0 in August 2025, with p<0.05 considered significant.
Results: Among 358 respondents (mean age 35.1 ± 8.5 years; 64.2% male), awareness of UPs was universal. The overall knowledge score was 82.1% (95% CI: 80.9–83.3%), graded as good. The overall attitude/practice score was 55.6% (95% CI: 54.0–57.2%), graded as fair. Critical practice deficits were noted in consistent face mask use (9.5%; 95% CI: 6.7–13.0%), utilization of post-exposure prophylaxis (5.0%; 95% CI: 3.0–7.8%), and regular hand washing before (52.5%; 95% CI: 47.2–57.8%) and after (58.1%; 95% CI: 52.8–63.3%) procedures. Only 9.5% (95% CI: 6.7–13.0%) of respondents had received IPC training in the preceding two years. Training attendance was the only factor significantly associated with good practice (aOR: 3.1, 95% CI: 1.4–6.9, p=0.006).
Conclusion: A significant gap exists between knowledge and practice of UPs, exacerbated by an extreme training deficit and systemic barriers. Mandatory regular IPC training and improved resource availability are urgently recommended to enhance safety.

Key words: Universal precautions, infection prevention, healthcare workers, knowledge-attitude-practice, Nigeria, tertiary hospital