Evaluating the knowledge, attitude, and practice of Ghanaian healthcare workers to inform strategies to prevent healthcare-associated spread of respiratory infections

Abstract

Healthcare-associated respiratory infections affect patients in healthcare facilities. These infections are not present or incubating at admission time and include respiratory infections acquired by discharged patients and occupational infections among healthcare workers. COVID-19 is a rapidly expanding pandemic caused by a highly infectious novel human coronavirus. Healthcare workers lead the combat against the disease and aim to protect themselves and their patients from the virus; therefore, they have the daunting task of implementing preventive measures. Their knowledge, attitudes, and practices regarding COVID-19 may influence how much they adhere to strategies to prevent the spread of respiratory infections. Phase 1 of the study involved a quantitative cross-sectional interview to determine healthcare workers’ knowledge, attitudes, and practices towards COVID-19 prevention. A structured questionnaire with Cronbach’s Alpha value of 0.71 was used to collect data from 373 healthcare workers and their managers, sampled through a multistage random technique. A descriptive and inferential analysis was performed using the Statistical Package for Social Sciences (SPSS). In Phase 2, the findings of Phase 1 and an extensive literature review were used to draft strategies to prevent the healthcare-associated spread of respiratory infections. Focus group interviews with 10 healthcare managers, purposely selected from the five selected hospitals, were conducted to refine the strategy. The study established that 85.8% of the healthcare workers embraced good knowledge of COVID-19. Age and religious affiliation were significantly associated with factors affecting the knowledge level about the novel coronavirus disease; 56.6% of the participants had a good attitude towards COVID-19. The duration of the experience and marital status of the participants were strongly associated with their attitudes. Less than 50% of the participants had excellent preventive practices for COVID-19. Gender, level of education, and source of information were associated with the participants’ practices towards COVID-19 prevention. Ten strategies were developed during Phase 2 to prevent healthcare-associated spread of respiratory infections. These strategies include ensuring triage, early recognition, source control, applying standard and transmission precautions, education and training of healthcare workers, engineering controls, active surveillance programme for staff, visitors, and patients with acute respiratory infections, restriction of visitors and caregivers, vaccination of healthcare workers as recommended by the World Health Organization and the Ministry of Health, promotion of healthy behaviours to strengthen the immune system, adequate supply of personal protective equipment, monitoring and evaluation, and investing in research. Preventing the spread of respiratory infections in the healthcare setting is imperative. Strategies to avoid the healthcare-associated spread of respiratory infections have been developed and presented based on the current study's findings.