الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Family planning nurses perform a wide range of activities that can put their health
and well-being at risk of harm. So they should follow the standard precautions of infection
prevention and control practices (IPC) to ensure patients and nurses’ safety and decrease
healthcare-associated infections. Standards precautions of infection prevention and control
are designed to protect staff from risks resulting from exposure to blood and body fluids
and to protect patients from potential cross infection. Knowledge about infection
prevention and control practices is continually growing and changing. Therefore, the aim
of the study was to assess nurses’ compliance with infection prevention and control
practices in fixed versus mobile family planning clinics. Research design: A descriptive
comparative research design was utilized to fulfill this study. Setting: The study was
conducted in two settings; the first setting was all fixed family planning clinics in primary
health care facilities for both urban and rural areas from four health directorates out of
sixteen in El Beheira Governorate which included:
1. Rural Fixed Family Planning Clinics are Family Health Units and Family Health
Centers
2. Urban Fixed Family Planning Clinics are Health Office, Sub Clinics,
District Clinics and Maternal and Child Health Centers.
Four selected health directorates were Damanhour, Kafer Eldawar, Etay Elbarod
and Komhamada.
The second setting was all mobile family planning clinics under supervision of
sixteen health directorates in El Beheira Governorate.
Subjects: All nurses were working in fixed and mobile family planning clinics in the
previously mentioned settings which were 409 nurses (382 nurses in fixed family planning
clinics and 27 nurses in mobile family planning clinics). Tools three tools were used for
data collection; Nurses’ health profile and health care-associated infections among nurses
in fixed / mobile family planning clinics structured questionnaire sheet, nurses’ knowledge
about infection prevention and control practices (IPC) in fixed / mobile family planning
clinics structured questionnaire sheet, nurses’ compliance with infection prevention and
control (IPC) practices in fixed / mobile family planning clinics observation checklist.
Results: Concerning to nurses’ ages, the highest percent of nurses who work in fixed and
mobile family planning clinics were aged from 40 to less than 50 years, less than three
quarters and the majority of the studied nurses who work in both settings (fixed and mobile
family planning clinics) had nursing diploma (74.1%, 92.6%), the highest percent (80.1%,
92.6%) of them were married, less than three quarters (58.1%, 70.4%) of them had more
than 20 years of working experiences respectively. There was no statistically significant
difference between both groups
Regarding to the nurses’ knowledge about IPC practices, more than three
quarters (77.8%) of the studied nurses who working in mobile family planning clinics
compared to less than two thirds (62.8%) of the studied nurses who working in fixed
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family planning clinics had good level of knowledge about standard precaution of IPC
practices. there was no statistically significant difference between both groups (p=0.118).
Regarding nurses’ knowledge about hand hygiene, it was observed that more than
one half (59.7%) of the studied nurses who working in fixed family planning clinics had
fair level of knowledge about hand hygiene, while nearly two fifths (40.3%) of them had
good level of knowledge. On other hand less than three quarters (70.4%) of the studied
nurses who working in mobile family planning clinics had good level of knowledge about
hand hygiene, while more than one quarter (29.6%) of them had fair knowledge. There was
statistical significant differences between both groups (p= 0.002*).
In relation to nurses’ knowledge about personal protective equipment, the present
study show that less than two thirds (61.5%) of the studied nurses who working in fixed
family planning clinics had good level of knowledge about personal protective equipment,
followed by more than one third (36.4%) of them had fair level knowledge, and only 2.1%
of them had poor level of knowledge. While more than three quarters (81.5%)of the
studied nurses who working in mobile family planning clinics had good level of
knowledge about personal protective equipment, and less than one fifth (18.5%) of them
had fair level of knowledge. There was no statistical significant differences between both
groups (p=0.108).
Regarding to nurses’ knowledge about safe management of patient care equipment
and soiled linen, the study shows that less than three quarters (70.2%) and less than two
thirds (63.0%) of the studied nurses who working in fixed and mobile family planning
clinics had good level of knowledge about safe management of patient care equipment and
soiled linen, while (27.7%, 37.0%) of them had fair level of knowledge respectively. And
only2.1% of the studied nurses who working in fixed family planning clinics had poor
level of knowledge about safe handling of patient care equipment and soiled linen. There
was no statistical significant difference between both groups (p= 0.468)
Pertaining to nurses’ knowledge about prevention of needle stick/sharp injuries, the
study clears that the highest percent (96.3%, 83.2%) of the studied nurses who working in
mobile and fixed family planning clinics were had good level of knowledge about
prevention of needle stick/sharp injuries. While less than one fifth (16.2%) of the studied
nurses who working in fixed family planning clinics had fair level of knowledge about
prevention of needle stick/sharp injuries compared to only 3.7% of the studied nurses who
working in mobile family planning clinics. There was no statistically significant difference
between both groups (MCp= 0.217).
The study conveys that nearly one half (48.2%, 51.8%) of the studied nurses who
working in fixed family planning clinics had good and fair level of knowledge about
Respiratory hygiene and cough etiquette respectively. On the other hand, nearly three
quarters (74.1%) of the studied nurses who working in mobile family planning clinics had
good level of knowledge about cough hygiene, while nearly one quarter (25.9%) of them
had fair level of knowledge. There was statistically significant difference between both
groups (p= 0.009*).
Additionally, the study shows that more than three quarters (83.2%, 77.8%) of the
studied nurses who working in fixed and mobile family planning clinics had good level of
knowledge about environmental cleaning and spills management respectively. While the
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percent of the studied nurses who working in both settings and had faire level of
knowledge was (16.8%, 22.2%) respectively. There was no statistically significant
difference between both groups (FE p= 0.434).
Pertaining to nurses’ knowledge about waste management, less than three quarters
(72.3%) of the studied nurses who working in fixed family planning clinics had good level
of knowledge about waste management, and more than one quarter (27.7%) of them had
fair level of knowledge. On other hand, more than three quarters (85.2%) of the studied
nurses who working in mobile family planning clinics had good level of knowledge about
waste management, and more than tenth (14.8%) of them had fair level of knowledge.
There was no statistically significant difference between both groups (p= 0.143).
Regarding to nurses’ level of compliance with standard precautions of IPC
practices, it can be observed that less than three quarters(71.7%) of the studied nurses who
working in fixed family planning clinics were fairly compliance with IPC practices, while
more than tenth (14.9%,13.4%) of them were compliance and noncompliance respectively.
On the other hand, more than one half(59.3%) of the studied nurses who working in mobile
family planning clinics were fairly compliance with IPC practices, followed by one third
(33.3%) of them were noncompliance, while only7.4% of them were compliance. there
was a statistically significant difference between the studied nurses in both settings
(p=0.027*).
Regarding to level of compliance with hand hygiene practices, more than one half
(51.9%) of the studied nurses in mobile family planning clinics and less than one third
(30.9%) in fixed family planning clinics were noncompliance with hand hygiene practices,
and the percent of the studied nurses who were fairly compliance in fixed and mobile
family planning clinics were (47.4%, 29.6%), while nearly one fifth (21.7%, 18.5%) of
nurses in both settings were compliance with hand hygiene practices respectively. There
was no statistically significant difference between both groups (p=0 .072).
Concerning to level of compliance with personal protective equipment (PPE), nearly
one half (51.9%, 47.6%) of the studied nurses who working in mobile and fixed family
planning clinics were fairly compliance with uses of personal protective equipment.
Followed by nearly one third (36.6%, 33.3%) of the studied nurses in fixed and mobile
family planning clinics were noncompliance, while more than tenth (15.7%, 14.8%) of
them were compliance respectively. There was no statistical significant difference between
both groups (p=0.913).
Concerning to safe management of patient care equipment and soiled linen, more
than one half (58.4%, 55.6%) of the studied nurses who working in fixed and mobile
family planning clinics were fairly compliance, followed by (35.6%, 14.8%) of them were
compliance respectively, while (29.6%) of the studied nurses in mobile family planning
clinics and only (6.0%) in fixed family planning clinics were noncompliance with safe
handling of patient care equipment and soiled linen. There was statistical significant
deference between both groups (p= <0.001*)
Regarding to nurses’ level of compliance with prevention of needle stick/sharp
injuries, the majority (96.3%) of the studied nurses in mobile family planning clinics and
more than three quarters( 79.8%) of the studied nurses in fixed family planning clinics
were compliance, while 12.3% and 3.7% of the studied nurses in fixed and mobile family
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planning clinics were fairly compliance and only7.9% of the studied nurses in fixed family
planning clinics were noncompliance with prevention of needle stick/sharp injuries. There
was no statistical significant deference between both groups (MC p =0.133).
Regarding to level of compliance with respiratory hygiene and cough etiquette,
(64.6%, 47.1%) of the studied nurses in fixed and mobile family planning clinics were
fairly compliance , followed by (26.2%,22.2%) of them were compliance and only (9.2%,
3.7%) were noncompliance respectively. There was no statistical significant deference
between both groups (p=0.510).
Concerning to environmental cleaning and spills management, less than two thirds
(63.0%, 35.3%) of the studied nurses in mobile and fixed family planning clinics were
fairly compliance with environmental cleaning and spills management, while more than
one half (51.6%, 33.3%) of them in fixed and mobile family planning clinics were
noncompliance, and only (13.1%, 3.7%) in fixed and mobile family planning clinics were
compliance with environmental cleaning and spills management. There was statistical
significant deference between both groups (p=0.013*).
Regarding to nurses compliance with waste management, (64.1%, 51.9%) of the
studied nurses in fixed and mobile family planning clinic were fairly compliance, while
nearly two fifths in mobile family planning clinics and one quarter in fixed family planning
clinics were noncompliance, and only10.7%, 7.4% of them in fixed and mobile family
planning clinics were compliance with waste management respectively. There was no
statistical significant deference between both groups (p=0.200).
Concerning to the relationship between the studied nurses’ knowledge about
standard precautions of IPC practices and their socio demographic characteristics,
there was a statistically significant relationship between nurses’ knowledge and their age
(p=0.008*, p=0.002*) in both settings (mobile and fixed family planning clinics)
respectively, there was no statistically significant relationship found between level of
education and the total knowledge score (p=1.000, p=0.440) in both settings (mobile and
fixed) respectively. Significant relationship was found between years of work experience
and total score of knowledge of the studied nurses who working in fixed family planning
clinics (p= 0.003*), there was no significant relationship found between years of work
experience and the total score of knowledge in mobile family planning clinics (FEp=0.633).
Regarding to the relationship between the studied nurses’ level of compliance
with standard precautions of IPC practices and their socio demographic
characteristics, there was no statistically significant relationship was found between level
of nurses’ compliance and age (p= 0.233, MC p=0.351), level of education (p=0.348,
p=0.143), years of work experience (p=0.057, p=0.083) in fixed and mobile family
planning clinics respectively.
In relation to correlation between the study variables, there was a statistically
significant positive correlation between nurses’ knowledge about IPC practices and their
level of compliance in fixed family planning clinics as hand hygiene(r= 0.175*, P
=0.001*)personal protective equipment (r= 0.104* , P =0.042*),safe handling of patient
care equipment and soiled linen (r=0.234*, P = 0.001*), prevention of needle stick/sharp
injuries (r=0.272*, P =0.001*)waste management (r=0.121*, P = 0.018*).On the other
hand, there was no statistically significant positive correlation between nurses knowledge
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and their level of compliance regarding respiratory hygiene and cough etiquette (r=0.030,
P=0.558) and environmental cleaning and spills management(r=0.040, P=0.435).
There was no statistically significant negative correlation between nurses’ knowledge
about IPC practices and their level of compliance in mobile family planning clinics as hand
hygiene (r = -0.283, P =0.152), prevention of needle stick/sharp injuries(r = -0.139,
P=0.489), respiratory hygiene and cough etiquette (r= -0.205, p=0.305), environmental
cleaning and spills management(r=-0.067, p= 0.739),waste management (r= -0.043, p=
0.830).On the other hand, there was no statistically significant positive correlation between
nurses’ knowledge about IPC practices and their level of compliance regarding personal
protective equipment(r = 0.343, P=0.080 ) and safe handling of patient care equipment and
soiled linen(r= 0.220, P=0.270).
Concerning to univariate linear regression analysis, there was a statistically significant
regression factors affecting level of knowledge of the studied nurses who working in fixed
family planning clinics as marital status (p=0.003*), years of work experience (p=0.002*),
history of chronic diseases(p=0.001*), while no statistically significant regression
parameters affecting overall level of knowledge of nurses who working in mobile family
planning clinics. There was a statistically significant regression factors affecting level of
compliance of the studied nurses who working in fixed family planning clinics as history
of chronic diseases (p=<0.001*), history of surgical operation(p= 0.039*),while
statistically significant regression factors affecting overall level of compliance of nurses
who working in mobile family planning clinics was income (p=0.022*).
Conclusion: Based on the findings of this study, it can be concluded that more than
three quarters of the studied nurses who working in mobile family planning clinics
compared to less than two thirds of the studied nurses who working in fixed family
planning clinics had good knowledge about standard precaution of IPC practices.
On the other hand, less than three quarters of the studied nurses who working in
fixed family planning clinics were fairly compliance with IPC practices, while more than
tenth of them were compliance and noncompliance respectively. while more than one half
of the studied nurses who working in mobile family planning clinics were fairly
compliance with IPC practices, followed by one third of them were noncompliance, while
only of them were compliance. There was a statistically significant difference between the
studied nurses in both settings (p=0.027*). Recommendations:
Implementing
educational programs for family planning nurses in primary health care facilities to
improve nurses’ knowledge and compliance with IPC practices.