Degree of nursing care provision to HIV infected patients is dependent upon the knowledge and attitude of the nursing personnel towards HIV infection and AIDS. Inadequate knowledge has been associated with fear, inappropriate attitudes and poor handling of HIV infected patients, leading onto provision sub-standard nursing care. A necessary step in improving nursing care of patients would be to provide nurse with the necessary knowledge regarding HIV infection.
HIV emerged in Tanzania in 1983 and has been since taught in nursing schools regarding its transmission, prevention and nursing care, Despite these efforts, the knowledge and attitudes of the nurses has not been determined.
A study has been done to aim investigating the knowledge and attitudes of certificate create and diploma nursing students of Muhimbili Medical Centre (MMC) in Dar-e-Salaam regarding HIV infection and AIDS, identifying in the process, areas which need to be changed or emphasized for provision, of better nursing care of HIV–infected and AIDS patients, and with minimal occupational risk of acquiring HIV infection.
Findings show generally good knowledge of HIV; its transmissibility and preventing measures, and a willingness of majority of students to attend HIV infected and AIDS patients.
However, it is apparent that additional information is required regarding the transmissibility of HIV infection; to correct the noted misconceptions such as HIV could be transmitted by shaking hands, sneezing and coughing. There problem therefore, appears to be inadequate knowledge of HIV and AIDS infection control rather than lack of enthusiasm. It also important to educate on the co-infectious agents among HIV infected individual which are likely to cause cross– contamination. The disease has so many core– infections. It is therefore important to note that HIV is only one of many infectious pathogens that can be occupationally transmitted from health care workers to patients and vice versa.
Some students were unable to correctly identify the basic transmission modalities of HIV infection like sexual intercourse and blood transmission or the requirements for necessary precaution during different procedures to prevent transmission of HIV infection, according to study. Other students thought that HIV could not be transmitted via mother to child, breast-feeding, sharing toothbrushes, razors and needle stick injuries.
Needle punctures present the greatest risk of transmission of HIV and other blood borne infection. This is because blood is a dingle most important source of infection of HIV in health care facilities. It is vital to note that if splashing is anticipated, gowns/aprons and eye protection should be worn to prevent exposure. Intact skin remains the most effective barrier in decreasing the risk of transmission of HIV and other blood borne diseases, superficial cuts or chapped skin may become portals of entry for organisms.
It is important to reinforce the necessary precautions to be undertaken during performance of various procedures. This has to be preceded by ranking each procedure according to the health hazard involved. There is thus, a need to establish. Guidelines for different procedures, trying to follow the recommended international infection control procedures.
Health hazards in a particular procedure involves that body fluids to be encountered and their potential for transmitting the HIV. The possibility of noninfectious agents in the body fluid should also be considered. The guidelines should be simple, practical, achievable and effective to make them relevant. Need to set-up a committee to formulate guidelines for infection control for different procedures without elevating treatment cost too much.
The committee needs to include members from peripheral hospitals, health centers, dispensaries and maternal and health clinics where there is usually a heavy patient load and resources are scarce.
Continuing education in the form of seminars, practical sessions and changes in curricula are needed to able to achieve the required standards of low asepsis in the work of the growing problems of HIV in this society.
The present study involved student nurses alone. However it seem necessary to evaluate knowledge, attitude and practice of different cadres of graduate nurses and identify areas needing retraining and conducting continuing education courses on infection, control procedures– seminars, practical sessions and preparation of handouts.
These measures should go hand in hand with provision of the necessary facilities/resources. The study results demonstrate that education and reinforcement of some infection control procedures such as gown/waterproof apron, and eyeglasses are necessary.
(ResearchSEA)
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