Knowledge, attitude, and practice of healthcare workers towards healthcare- associated infections in Jimma University Medical Center, southwestern Ethiopia: using structural equation model

Abstract

Abstract Background: Healthcare-associated infections (HCAIs) are a common challenge faced in healthcare facilities, particularly in low and middle-income countries (LMICs). Evaluating the level of KAP among healthcare personnel regarding HCAI prevention and identifying the relevant factors is important for handling and controlling these infections. Therefore, this study aimed to know the direct and indirect effects of knowledge, attitude, and practices of HCWs towards HCAIs prevention in Jimma University medical center (JUMC). Method: The primary data was collected from the sampled health professionals. The total sample size was 262 from 1354 health professionals working in JUMC using the population proportion stratified random sampling method. An institutional cross-sectional study was conducted from March to April 2022. The data were collected using a self-administered questionnaire. Structural equation modeling (SEM) was used to identify the direct and indirect effects of KAP of HCWs on HCAIs. Results: The study shows that 55% (144 respondents) were nurses and 52.7% were female participants. The goodness of fit indices for the hypothetical model specification and selection proved that the model was appropriate to analyze the data. The study findings indicated that the standardized direct effects of HCW occupational skill in HCAIs prevention on knowledge and attitudes were significant effect (βosk=1.43, Posk=0.004 and βosa=0.65, Posa=0.004).Whereas HCWs’ practice on HCAIs had an effect (βosp=-0.79, Posp=0.004). The attitude of HCWs towards HCAIs prevention practice and knowledge were significant effect with p-value Pap=.002 and Pak=.003 respectively. On the other hand mediating effect showed that the attitude of HCWs toward their knowledge through practice towards HCAIs prevention was significant effects (γak=.426, Pak=.003). At the same time occupational skills of HCWs towards practice of HCAIs prevention through attitude was a significant effect (γosp=.523, Posp=.002). Conclusion: The study results indicated that both attitude and occupational skills can be improved through practice which finally brings a statistically significant improvement in the knowledge of HCWs about HCAIs prevention.