A comparison of knowledge and practices of universal precautions among public sector health care workers in Ugu north sub-district, KwaZulu-Natal, South Africa (2010-2014)

Background: Annually, there are a high number of needlestick injuries (NSIs) among health care workers (HCWs) globally. The knowledge and practice of HCWs of universal precautions (UPs) play an important role in determining the risk of an NSI. The objective of this study was to compare the knowledge and practices of UPs among HCWs with NSIs with HCWs without NSIs, in Ugu north sub-district in KwaZulu-Natal (KZN), South Africa, between 2010 and 2014. Methods: A study among HCWs having an NSI (n = 100) between 2010 and 2014 compared with controls (n = 200) was conducted in 2016-2017 at a district hospital and 11 primary health care facilities in Ugu north sub-district, KZN, South Africa. Health care workers' knowledge and practices of UPs were assessed by using a standardised questionnaire. Knowledge and practice responses were scored, and means and standard deviations (SDs) were calculated. Total scores of knowledge and practices were categorised into acceptable and unacceptable, and a binary logistic model was used to identify independent factors associated with being a case. The accepted level of significance was 0.05. Results: The majority of the participants were nurses (n = 233; 77.7%) and female (n = 227; 75.7%). Control HCWs had better practice scores for UPs (86.13%; SD: 16.57) compared with cases (82.43%; SD: 19.98). The logistic regression analysis showed that the HCWs with acceptable knowledge and unacceptable practice were more likely to have had an NSI (odds ratio [OR]: 5.8; 95% confidence interval [CI]: 1.4-24.0). Conclusion: There were significant differences between cases and controls with respect to knowledge and practice of UPs that are important findings for workplace health and safety and HCW training.