Determinants of Practice and Adherence to Infection Prevention and Control of Neonatal Sepsis Among Nurses in Selected Health Facilities of Pwani Region, Tanzania.

Abstract

Background: Although guidelines on neonatal care and infection prevention exist, it is unclear what factors influence nurses' adherence to infection prevention and control (IPC) in neonatal care. This study aimed to assess the determinants of nurses' adherence to IPC in neonatal sepsis prevention in the Pwani Region, Tanzania.

Methods: A cross-sectional study with 282 nurses was conducted. Assessing the how Socio demographic characteristics, Health facility factors, attitude of the nurses affect the Nurse's practices on adherence to IPC for prevention of neonatal sepsis. Data collection methods included a questionnaire and an observation checklist. Bivariate and multivariate logistic regression were employed to determine the factors influencing nurses' adherence to IPC. Nurse's adherence to IPC was measured using the mean score whereby those who score above the mean were regarded as adequate adherence. A Probability value of .05 and a 95% confidence interval was regarded as statistically significant.

Results: The present study found that only one-third (37.0%) of the nurses had adequately adhered to IPC. Significant associations were observed between nurse's adherence to IPC in the prevention of neonatal sepsis and; working experience of 13 to 24, 7 to 12, and 6 months [AOR =5.30, p<.001], [AOR=3.9, p<.024] and [AOR=3.640, p<.001] respectively, >10 years in nursing professional [AOR=2.627, p<.023], staffing of 6-10 and 1-5 [AOR=5.992, p<.001] and [AOR=3.791, p<.001] respectively, 3 and >3 staffs per shift [AOR=3.276, p<.017] and [AOR=2.364, p<.017) respectively, working at District and regional hospitals [AOR=1.101, p<.001] and [AOR= 2.320, p<.028] respectively, on-job training [AOR = 2.08, p<.034], isolation room availability [AOR=1.783, p<.042], SOPs and IPC guidelines availability [AOR=4.320, p<.004], sufficient medical equipment and supply [AOR =1.414, p<.015] and positive attitude [AOR=1.490, p<.035].

Conclusion: The study results indicated Nurse's adherence to IPC in the prevention of neonatal sepsis is associated with working experience, staffing, healthcare level, on-job training, isolation room availability, current SOPs and IPC guidelines, access to medical equipment/supply, and positive attitude. Strategies should be employed to strengthen the adherence of nurses to IPC guidelines to minimize the morbidity and mortality resulting from neonatal sepsis. Interventional studies from each factor for nurse's adherence to IPC in the prevention of neonatal sepsis should be of priority.