Evaluation of the Impact of Universal Precautions Training on Nurse Midwives Knowledge, attitude and Practices toward Prevention of HIV Transmission in Khartoum State Teaching Hospitals, 2006-2010

Abstract

Application of the universal precautions during the process of labor decreases spread of HIV infections. No information exists regarding the impact of universal precautions training programs on midwives practices in Sudan. This hospital based study was conducted in Khartoum State to evaluate the effect of training program on the nurse midwives performance during the process of labor to prevent HIV transmission. The study utilized an interventional design to elicit the effect of training programme on the nurse/midwives practices to prevent HIV transmission. An educational program in universal precautions for nurse/ midwives was developed, implemented, and assessed (n = 180) (drawn from six selected hospitals through stratified cluster random sampling method. Official permission was obtained from the institutions and verbal consent from participants. The study was implemented in three phases, pre-training base line assessment using a structured interview questionnaire to assess the knowledge, attitudes and practices towards HIV infection and prevention. Observation check list to assess application of universal precautions during the process of labor (two paths pre and post intervention).Universal precautions procedures, were taught, demonstrated, practiced (n=176) participants were re-evaluated (n=169) post intervention. Results revealed the following: Regarding the knowledge the study revealed that general knowledge towards HIV infection>80%, knowledge towards prevention of HIV (UPs) > 70% and attitude > 60%. This study showed a high rate of needle stick injuries among nurse midwives > 80%Universal precautions application scores increased significantly after training from 40.9 % - 55.2% (P < 0.005). The study concluded that training program is effective in increasing nurse midwives application of universal precautions. Also the study revealed that the nurse/midwives were highly knowledgeable. Their attitudes were fairly appropriate. Three years post intervention the impact of training was reassessed aiming to determine practices of the nurse /midwives towards prevention of HIV infections during the process of labor .participants were re-evaluated (n=159). Results revealed that Universal precautions application scores decreased significantly after three years from 55.2% - 40.85% (P < 0.005). The study concluded that impact of training program after 3 years no longer exist . The study recommended that creation of a body to supervise application of universal infection control precaution to grantee the continuity of the program.