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British Journal of Healthcare and Medical Research - Vol. 10, No. 2
Publication Date: April 25, 2023
DOI:10.14738/jbemi.102.14154.
Ogbonda, P. N. (2023). Assessment of Healthcare Workers’ Perception of Health Hazards ond Management’s Safety Practices.
British Journal of Healthcare and Medical Research, Vol - 10(2). 10-24.
Services for Science and Education – United Kingdom
Assessment of Healthcare Workers’ Perception of
Health Hazards and Management’s Safety Practices
Priscilia Nyekpunwo Ogbonda
Rivers State University
Abstract
Health workers are vital workforce in the society globally. In many countries, such
as Sub-Sahara Africa, workers are at great risk of preventable, life-threatening
work-related hazards. The impacts of these hazards are irrefutably crucial
generally such as health workers’ shortage, apathy, patient and health workers’
vulnerability to infections, poor services, cost effect, death etc. Hence, this study
assesses health worker’s perception of health hazards as well as management
safety practices in selected public hospitals in Rivers State, Nigeria. Descriptive
cross-sectional design and a sample size of 347 were used. The study employed a
multi-staged sampling technique and a structured instrument based on a coefficient
of 0.88 as reliability. Descriptive and inferential statistics were used for data
analysis. Results revealed good health worker perception of health hazards but
poor management’s safety practices. However, management opined that there are
protective measures and safety procedures meant to reduce risk of health hazards
in the hospitals. Also, there is no significant (p>0.05) association between health
workers perception of health hazards and socio-demographic variables. Therefore,
to limit frequent health hazards, there is great need for strong advocacy on health
hazards, standard safety rules and good management safety practice in the
hospitals. It is of importance for the government and hospital managements to
develop quality safety management system, integrated standard safety regulation
policies and procedures in conformity with global best practices.
Keywords: Safety, Hazards, Health, Practices, Management
INTRODUCTION
Hospitals and other health care establishments all over the world (most especially in the
developing nations) are susceptible to various health hazards [44]. There is anxiety over the
negligence of safety culture (SC) in hospitals and other health facilities (HFs). Hence, health
hazards (HHs) are principally a recurrent incidence in HFs. HWs are normally categorized as
having high physical work load [15] and are essential service providers. In countless countries,
inclusive of Sub-Sahara Africa, workers are at great risk for preventable, life-threatening work- related hazards. Reports specify that Sub-Sahara Africa accounts for the highest occurrence of
HIV-infected patients and that ninety-percent (90%) of job-related exposure occur in these
countries [14, 46]. The hospital is a place where patients receive care and recover as well as a
source of infection for healthy individuals [13]. The health of personnel is all-important for
efficiency and economic development. Consequently, reestablishing and sustaining decent
working environment is a key purpose of the health services [46]. Annually, roughly thirty-five
(35) million HWs globally are affected by several hazards and greater than 90% of these
hazards occur in the developing countries [23, 47]. These hazards have led to psychological
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Ogbonda, P. N. (2023). Assessment of Healthcare Workers’ Perception of Health Hazards ond Management’s Safety Practices. British Journal of
Healthcare and Medical Research, Vol - 10(2). 10-24.
URL: http://dx.doi.org/10.14738/jbemi.102.14154
stress and substantial health outcomes for HWs, their extended families and loved ones [34].
Some of the infectious diseases, especially blood-borne infections (BBIs) which occur in the
health facilities, do not have available vaccines (e.g., HCV, HIV, malaria) and this spring up
anxiety among HWs [18]. Other frequent work-related illnesses are skin problems,
musculoskeletal disorders, noise-induced hearing losses and chronic respiratory diseases.
Despite these illnesses, majority of countries’ nurses and physicians are poorly educated to
tackle occupational health issues and several countries likewise do not offer postgraduate
learning in occupational health [46]. HWs also show a greater incidence of low back pain [7]
than several other work-related groups [19, 22]. The yearly occurrence of low back pain among
HWs is as high as 77% [19]. One hundred and sixty (160) million persons from the worldwide
workforce were projected by International Labor Organization (ILO) to be suffering from
occupational illnesses inclusive of musculoskeletal disorders (MSDs) and mental health issues
[20]. Annually, three (3) million HWs encounter percutaneous exposure to blood-borne
pathogens (BBPs) worldwide and two (2) million of these are continually being susceptible to
HBV, HIV (170,000) and HCV (0.9 million). These work-related illnesses may result in 70,000
HBV, 15,000 HCV and 1,000 HIV cases globally. Ninety percent (90%) of these blood-borne
infections (BBIs) occur in developing countries [18, 27, 41]. Despite improvements in research,
job-related hazards remain a main public health problem [42]. The real extent of illness
affecting HWs is poorly reported for most Sub-Saharan African (SSA) countries partially owing
to absence of studies [21]. The health and standard of life of HWs is influenced by the
overwhelming consequences of these health hazards [27]. The health of personnel is a critical
precondition for domestic income, efficiency and commercial development [46].
According to Oluwagbemi [28], health facilities (HFs) in Nigeria have improved in experience,
variety and magnitude in the past thirty years with challenges in protecting and nourishing best
performs and equipment required for high-risk clinical procedures. In dispensing their
constitutional obligations, HWs may be endangered to hazards which remarkably diminish
their health and value of life, with multiple consequences on their direct and extended family
members. Hence, HWs need protection from workplace hazards likewise employees in other
high-risk workstations like mining or building works. This study therefore aim to assesses
health worker’s perception of health hazards as well as management safety practices in selected
public hospitals in Rivers State, Nigeria
Theoretical Models
Health Belief Model (HBM):
HBM specifically explains health behavior and was originally developed due to failed
tuberculosis health screening programs. Since the perceived susceptibility of individuals to
infection and the perceived benefits of screening exercise, have relationship with their
acceptance of chest X-ray. The model has five constructs, which are perceived susceptibility,
severity, benefits, barriers and cues to action. The model explains that HWs will likely practice
a healthy behavior if they perceive susceptibility to a negative outcome. Likewise, if they
perceive that the barriers will protect them as well as benefits from practicing a positive
behavior. Perceived barriers are proven to be the most powerful single predictor across all
behaviors. HBM is applied mostly by the combination of variables in a linear or addictive model
to test i.e. the addition of susceptibility, severity and (benefits - barriers). However, some initial
expression of the model suggested a multiplicative model (i.e. the multiplication of
susceptibility, severity and (benefits - barriers)) [24].
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British Journal of Healthcare and Medical Research (BJHMR) Vol 10, Issue 2, April- 2023
Services for Science and Education – United Kingdom
Bird and Germain’s Loss Causation Model:
Bird & Germain [48] developed an improve form of Henrich’s domino sequence model as they
noted that management plays a key role in preventing and controlling accidents. Also, that
management is directly associated with causes and effects of accidents. They recognized the
significance of management preventing and controlling accidents in highly complex settings
due to improvements in technology. This model was represented by a line of five dominos in a
linear sequence linked together and named the Loss Causation Model.
METHODOLOGY
Study Design
The study employed a descriptive cross-sectional design.
Study Location
The study was conducted in the two tertiary hospitals namely Rivers State University Teaching
Hospital (RSUTH), University of Port Harcourt Teaching Hospital (UPTH), and the zonal
hospitals (Okrika, Ahoada, Bori, Bonny, Isiokpo and Degema) in Rivers State, Southern Nigeria.
Population of Study
A total of 3876 HWs was used.
Inclusion Criteria:
All direct HWs that render health services on daily basis. These individuals must have worked
for at least 6 months and above.
Exclusion Criteria:
These are HWs that are on brief internship, students, security personnel, administrative
workers and females on maternity leave.
Sample Size
Sample size for this study was computed using Fischer’s formula for determining size of a
sample, given as [12, 17]:
2
2
d
Z PQ
n =
(1)
where n is sample size, Z is the normal deviation at confidence interval at 95% (1.96), P is the
proportion of the population with the desired characteristics (63.8%), Q is the proportion of
the population without the desired characteristics i.e. 1- P (1-0.638 = 0.362) and d is the desired
level of precision (0.05).
Therefore,
354.89 355
0.0025
0.8872
0.05
1.96 0.638 0.362
2
2
= =
n =
Since the population target is < 10,000, the sample adjustment was done using the formula [31]:
nf = n
1+
n
N
(2)