INSTITUTE JOURNAL OF STUDIES IN EDUCATION
PUBLISHED BY
INSTITUTE OF EDUCATION
UNIVERSITY OF ILORIN
ILORIN, NIGERIA
VOL 2 NO. 2
SEPTEMBER, 2005
EDITORIAL LIST
Editor-in-chief
PROF. AGAS OLADOSU
(Director, Inst. Of Educ.)
Managing Editor:
DR. S. B. OLAJIDE
(Dept. of Arts and social Sciences Education)
DR. (MRS) A.T.ALABI.
Editorial Board Members:
DR. (MRS) M. F. SALMAN
(Dept. of Edu. Magt.)
(Dept. of Science Education)
DR. S. AMAELE
DR. O. A. ONIYE
(Dept of Arts and Social Sciences Education)
(Dept. of G&C)
MR O. A. ONIFADE
(Dept. of PHE)
Consulting Editors:
Prof. Babatunde Ipaye
Prof. Isaac Olaofe
Prof. (M) Eunice Olke
Prof. M. Ajibero
Prof. Taoheed Adedoja
Prof. David Jiboyewa
Prof. Ehindero
Prof. Samuel Ayodele
Prof. Shehu Jimoh
Prof. M. E. Ogunniyi
(Dept. of G&C) .
University of Ilorin
(Dept. ofEducation)
A.B. U Zaria
(Faculty of Education)
University of Nigeria, Nsukka
Librarian
University of harm
(Dept. of PHE)
B. U K Kano
(Dept. of Education)
University of Maiduguri
(Dept. of Curriculum Studies)
O. A. U,.Ife
Institute of Education
University of Ibadan
(Dept. of Educational Foundation)
University of Ilorin
Prof Ugur Demiray
Faculty of Communication
Sciences, Aziadolu University
(Director & the UNESCO chair
School of Science & Maths Ed
University of the Western Cape,
South Africa)
Turkey.
NOTES ON CONTRIBUTORS
1.
DR. U. A. AJIDAGBA is a lecturer in the department of Arts and Social
Sciences Education, University of Ilorin; T1&in Nigeria.
2.
DR. JULIET W. MAHARIA is a lecture in the Department of
Communication Studies, Moi University, Ellloret, Kenya.
3.
DR. RAHEEM ADARAMAJA SHEHU is a lecturer in the Department of
Physical and Health Education, University of Ilorin, Ilorin Nigeria.
4.
DR. (MRS) M. F. SULEIMAN is a lecturer in the Department of Physical
and Health Education, Ahmadu Bello University, Zaria Nigeria
5.
DR. J. O. AGBAJE is Principal, Aperan Comprehensive College, OmuAran,
Kwara State, Nigeria.
6.
MR. Z. A. ADESOKAN is a Chief Lecturer, Department of Music, Kwara
State College of Education, Ilorin, Nigeria.
7.
MRS J. C. YUSUF is Head of Department of English, State Kwara College
of Education, Ilorin, Nigeria.
8.
DR. GIDEON PONLE ADETUNJI is Dean of Academic Affairs at the
Nigerian Baptist Theological Seminary, Ogbomosho, Nigeria.
9.
MR. I. O. ENE is a Senior Lecturer in the Department of General Studies,
Federal College of Education, Okene Nigeria.
10.
MR. S. S. OKPANACHI is a Senior Lecturer in the Department of
Educational Foundations, Federal College of Education, Okene, Nigeria.
11.
DR. ABDULRASAQ O. ONIYE is a lecturer in the Department of
Guidance and Counselling, University of Ilorin, Ilorin Nigeria.
12.
DR (MRS) HAUWA IMAM is the Director, Institute of Education,
University of Abuja, FCT, Nigeria.
EDITORIAL
This Journal is a Publication of the institute of Education, University of
Ilorin, Ilorin. The Journal Publishes the reports of both theoretical and empirical
researches in all areas of education. Since its inception in 1988, it has been
subscribed to by distinguished scholars from within and outside of the country; a
fact which has conferred on it the status of an internationally recognized Journal
The present edition presents articles related to the theory and practice of
Language Education, Music Education, and Science Education.
The Journal continues to welcome articles from contributors with a
promise that our high standard will not only be sustained, but also always
improved upon.
Professor AGAS Oladosu
Editor-in-Chief
CONTENTS
Assessing Students Performance in Some Languages In Nigerian
Secondary Schools: 1995-1997.
-Prof. A.GA.S. Oladosu
87
Problems Militating AgainstAnimal Protein and its Effects on Health of
People of Yagba West LGA, kogi State
- Onifade, O. A. & Owojaiye, S. O
96
Health for All: The Aspirations and Goals of Community Health in
Contemporary Society
- M. Ikorok, Ph. D., Lawal, S. O. & F S. Ekpu
105
Injection Practices among Nurses in South West Nigeria
- L.O.Olaitan
113
Frigidity; Causes and Consequences on Nigerian Women
- S.C. Oniyangi
118
Moral Education: A Panacea for National Development
- L. Ogunlola
126
Factors influencing Civil Servants Choice of Recreational Activities
in Kwara State
- T. O. Ibrahim
133
Selection and Utilization of Learning Resources in Social Studies
- M. O. Yusuf, Ph. D.
138
The Role of Expatriate Teachers in the Teaching and
Learning of Science in Kwara State Secondary Schools (1969-1979)
-P. F. Adebayo, Ph.D.
145
Physics Enrolment Pattern in Nigerian Colleges of Education A case study
of the Kwara State College of Education, Ilorin
-A. O. Akanbi
162
A Critical and Situational Analysis of Further Mathematics
in the Northern States of Nigeria
- O.I. Inekwe, Ph. D.
167
Students Perception on Causes and Effects of Examination
Malpractice in Kwara State Colleges of Education
- M. B. Taiwo, Ph. D.
175
INJECTION PRACTICES AMONG NURSES IN SOUTH-WEST NIGERIA
BY
OLAITAN, L. 0.
Abstract
The study was to determine the injection practices among nurses in south-west
Nigeria. A total of 390 were interviewed in June, 2005 using a proportional
sampling technique and a standardized questionnaire was used as the tool to
gather information from the subjects. The hypotheses formulated were analysed
using an inferential statistics of chi-square (x2) at 0.05 level of significance. The
findings revealed that the hypothesis was rejected which means the nurses
practices have influence on the transmission of blood borne pathogen in the
health care settings also 99% of the respondents were aware of universal
precaution to prevent blood borne pathogen transmission. No respondent
reported reusing syringes or needles on different patients. While 13.9% reported
that they would reuse a syringe or needle on the same patient only on
emergency, 73.3%were unaware that Hepatitis B Virus (HBV)remains infectious
in the environment for up to I week,(Although 74% reported that at lease one
incident of lacerating a finger while opening glass medication ampoules to
prepare injection). It was recommended among others that designated area for
injection preparation should be made available, appropriate handling. Placing of
puncture -proof sharp containers in each room, where injections are given and
giving and covering of lacerations should be intensified.
Introduction
In the early 90s Human Immunodeficiency Virus (HIV) infection associated with
possible reuse of syringes and needles was reported among children in Romanian
orphanages (herch, Popovici & Jezek, 1993). These findings led health- care
workers to use new disposable syringes and needles for administering injections.
Bythe mid 1990s; reports suggested that new disposable syringes and needles
had become standard for all injections. However, surveillance data collected by
the infectious Disease Society (IDS) of America during 1995-1997 indicated that
acute hepatitis B virus (HBV) infection was associated with receiving injections
among children aged v5 years (Hutin Cracium, lon-Nedelcu, mast, Alter &
Margolis, 1998). In Nigeria, Injection is frequently used to administer medication,
and nurses administer most injections (Centre for Disease Control (CDC), 1999).
To identify the practices that might have resulted in injection- associated HBV
transmission. Selected clinic and hospital nurses were surveyed. The survey,
indicated that although nurses used new disposable syringes and needles, other
inadequate infection-control practices might explain injection-associated HIV
transmission. World Health Organization (WHO) (1998) and CDC (1999) reported
that the results of the survey were used4to prevent nocosomial infections to
prepare standards for injection safety to protect patients and health-care workers
from HBV infection. Also, HIV infection can transmit through unsterilized syringes
and or needles used in the HIV seroprevelence area, this can lead to
transmission of HIV infection from patient to patient to health care workers. This
can particularly occur when there is accidental exposure to blood (AEB). Olaitan
(2002) opined that universal precaution by providing punctured proof sharp
containers and making use of surgical gloves for any blood or body fluid contact
will help to control the prevalence of transmission rate of HIV in the health care
settings.
Simonsen; Kane; Lloyd; Zaifran, & Kane (1999) asserted that overuse of
injections and unsafe injection practice may lead to large-scale transmission of
blood borne pathogens. Although, most injection-associated blood borne
pathogen transmission in health-care facilities can be attributed to reuse of
unsterilized syringes and needles. In 1998, almost all Nigerian adults were aware
of the risk of HIV infection associated with the reuse of syringes and needle
(CDC, 1999). Patients either provided their own equipment or observed the
opening of the package containing a new needle and syringe before receiving an
injection (CDC, 1999).
Snydman, Bryan, Moan &Gregg (1996) and Alter, Ahtone & Maynard
(1993) claimed that injections prepared in areas potentially contaminated with
blood, multidoes vial mishandling and
inadequate supplies were reported by
nurses and validated by observation. They further said that in the United States
similar practices have been associate with HBV transmission in hemodialysis
settings, in which frequent percutaneous exposures in a population with a high
prevalence of chronic HBV infection may facilitate nocosomial HBV transmission.
WHO/UNESCO, (1994) and Simonsem. et al, (1999) asserted that in Nigeria
where chronic HBV is endemic and injections are often used to administer
medication, these practice might explain injection-associated HBV transmission in
the absence of syringe and needle reuse. Bond Favero Peterson Gravelle Ebert
&Maynard, (1989), reported that persists in the environment for at least I week
and that the risk for transmitting HBV through injections can be up to 100 times
greater than the risk for transmitting HIV>Gerberdine (1994) highlighted that
nurses might not have perceived the risks for HBV transmission associated with
unsafe injection practices.
Purpose of the study
This study seeks to investigate the injection practices among nurses in
south-west Nigeria. It will also try to identify the nurses practices that might
result into injection-associated Hepatitis B virus (HBV) transmitted in the
teaching hospitals in south-west Nigeria. Also, it seeks to determine whether the
nurses in south-west Nigeria are aware of the universal precaution as regards
handling of injection and transmission rate of HIV in the health care settings.
Research Questions
-
What are the injection practices among the nurses in south-west Nigeria?
-
To what extent are the nurses in south-west Nigeria aware that Hepatitis
virus (HBV) & HIV can be transmitted through injection practices?
-
To what extent are the nurses in south-west Nigeria aware that universal
precaution can help reduce the transmission of injection-associated in the
health care setting?
Research hypothesis
There is no significant influence of injection practices on blood borne
pathogen transmission among the nurses in southwest Nigeria.
Methodology
The population consists of 2640 nurses in the five (5) teaching hospitals in
South-west Nigeria. However, 460 were selected as sample using a proportional
sampling technique. Thus 113 nurses from Lagos University Teaching Hospital
(LUTH) ldi-Araba,151 nurses from University College Hospital (UCH) Ibadan, 103
nurses from Obafemi University Teaching Hospital (OAUTHC) Ile-ife, 44 nurses
from Ladoke akintola University of Technology Teaching Hospital (LAUTECHTH),
Osogbo, and 49 nurses from Olabisi Onabanjo University Teaching Hospital
(OOUTH) Sagamu (see Table 1).
Table 1:
Composition of selected hospitals, population and sample of nurses in
the South West Nigeria
Hospitals
Sample Selected % Selected
LUTH, Idi-Araba
No. of
Nurses
648
113
17.4
UCH, Ibadan
867
151
17.4
OAUTHC, Ile-ife
591
103
17.4
LAUTECTH, Osogbo
253
44
17.4
OOUTH, Sagamu
281
49
17.4
TOTAL
2640
460
17.4
The study was conducted in June, 2005 using a standardized
questionnaire. Information collected included gender, work history awareness
level, injection practices and procedures. The hypothesis formulated was
analysed using an inferential statistic of Chi-square (X2) at =0.05 level of
significance.
Results and discussion
Of the 2640 nurses on the payroll in the selected teaching hospitals for
the study, 460 (1 7.4%)were included in the sample: 390(84.8%) agreed to
participate in the study. Of t[è 390, 360 (92.3%) were female, the mean age
was 38 years (range: 23-60 years,) and the mean number of years of practice
was 20 years (range: 1-42- years). Awareness of universal precautions to
prevent blood borne pathogen transmission was reported by 99% of
respondents: this is in agreement with Olaitan (2002), who asserted that
universal precaution by providing puncture proof sharp containers and making
use of surgical glove for any blood or body fluid contact will help to control the
prevalence of transmission rate of HIV in the health care settings.
Of the 390,356 (91.2%) of the respondents reported attending at least
one training session on universal precautions. No respondent reported reusing
syringes or needles on different patients, 14 (13.9%) reported that they would
reuse a syringe or needle on the same patient only in an emergency,
286(73.3%) were unaware that HBV remains infectious in the environment for
up to I week, and 198 (50.8%) of the respondent reported that separated from
where blood and blood-contaminated objects might be handled. Fourteen (1
3.9%) were aware that following a needle stick the risk of transmission from an
infected patient was greater for HBV infection than for HBV infection: 290
(74.4%) reported at least one incident of lacerating a finger while opening a
glass medication ampoules to prepare injections. Shortage of infection-control
supplies, including puncture-proof sharps containers, disinfection solutions, and
single-use gloves, were reported by 244 (62.6%), 204 (52.3%, and 271 (69.5%)
of the respondents respectively (see Table 2).
Table 2: Composition of sample according to sex, general awareness
level, attitude and practices on injection, syringes and needles.
Nurses
No
%
Male
30
7.7
Female
360 92.3
Total
390 *
Aware of universal precaution
386 99.0.
Unaware that HBV remains infectious for up to I week on needles 286 73.3
and syringes
Aware that HBV risk infection was greater than for HIV through 14
13.9
needle stick
Attending training session on universal precaution
356 91.2
Will reuse a syringe or needle on patient
0
Will reuse a syringe or needle on same patient only on emergency 14
0
13.9
Incidence of lacerating a finger during opening injection bottles 290 74.4
(ampoules)
With a separated place providing for preparing injection
189 50.8
With shortage of punctured-proof of container for sharp
244 62.6
With shortage of disinfecting container in clinics
204 52.3
With shortage of single-use glove
271 69.5
In table 3, the calculated Chi-square (X2) value of 69.22 which is greater
than critical value of 43.78 at the degree of freedom 30 under = 0.05 the null
hypothesis was rejected, which means the alternative hypothesis was, accepted
i.e. there existed a significant influence of injection practices on blood borne
pathogens transmission among the nurses in South west Nigeria. This is in line
with Simonsen et al (1999) who highlighted that, overuse of injections and
unsafe practices may lead to large scale transmission of blood pathogens.
Table 3: Chi square result on influence of injection practices .on blood
borne pathogens transmission in the health care settings
N = 390
Variables
Calc x2 value
DF
Crt value
To validate the survey result, unannounced visits were made to three
outpatient clinics and all wards of five hospitals to observe to nurses injection
practices and adherence to universal precautions. In outpatient clinics, patients
usually provided their own new disposable syringes and needles, and
government provided clinics with new disposable syringes and needles for
recommended vaccinations. However, this sterile equipment might have become
contaminated with blood before use (eg blood specimens were collected in open
wide- mouthed vials that were handled and placed on tables. Where injections
were prepared, needles were placed in multidose vials to serve as access ports,
and finger lacerations were left uncovered before preparing or administering
injection).
Conclusion and Recommendations
Poor handling of injection ampoules have resulted into transmission of
some Olaitan, L. O. blood borne pathogens, such as HIV and HBV in the health
care settings Majority of the nurses in South- West are aware that universal
precaution could help to control the transmission of infection in the health care
settings Based on the findings of this study, the following recommendations were
made;
Establishing
designated
areas
for
injection
preparation
in
the
clinic/hospitals.
Nurses should be more careful and appropriate in handling multidose
vials.
Placing of puncture-proof sharps containers in each room where injections
are given should be intensified covering of lacerations immediately should be the
order of the day in the clinic/hospital settings.
An integrated information, education and communication campaign based
on targeting patients and health care workings should be launched for the nurses
and all health care workers.
Above all, nurses should undergo refreshers course in Health Education to
improve their injection practices in the health care settings.
References
Alter, M.J, Ahtone J & Maynard, J.E (1993) Hepatitis B virus transmission
associated with a multiple-dose vial in a hemoclialysis unit Annals internal
Medibine, 99, 330-3.
Bond, W.W Favero, M.S Peterson, NJ, Gravelle, CR Ebert J.E & Maynard, J.E
(1981). Survival of hepatitis B after drying and storage for one week.
Lancet 1,550-1.
Center for Disease control (CDC) (1999) Frequency of vaccine- related and
therapeutic injection---Romania, 1998 M MWR, 48,271-4.
Gerberding, J.L (1994). Incidence and prevalence of human immunodeficiency
Virus, hepatitis B virus, and cytomegalovirus among.
Health care personnel at risk for blood exposure: final report from a longitudinal
study. Journal of infections Disease, 170,1410-7
Hersch, B.S, Popvici, F& Jezeki, Z. (1993). Risk factors for HIV infection among
abandoned Romanin children. AIDS,7, 1617-24.
Hutin, Y.J.F,Cracium, D, lon-Nedelcu, N,Mast, EE,Alter. M.J & Magolis
H.S (1998). Using surveillance data to monitor key aspects of the epidemiology
of hepatitis B virus (HBV) infection. Poster presented atthe 36t annual
meeting of the infection Disease society of America, Denver, Colorado,
November.
Olaitan, O. L (2002). Knowledge of HI V/A IDS among student of tertiary
institutions in Kwara State. An unpublished. M.Ed Dissertation submitted
to the Department of physical and Health Education. University of llorin,
Ilorin.
Simonsen, L,Kane,A,Lloyd, J,Zaffran, M&Kane, M. (1999). Unsafe injections in
the developing world and transmission of blood borne pathogens: a
review. Bulletin of World Health Organization, 77,789-800
Snydman, D. R., Bryan, J. A, MACN, E.J, &Gregg, M.B (1996). Hemodialysised
associated hepatitis: report of an epidemic with further evidence on
mechanisms
of
transmission.
American
Journal
of
Epidemiology,
104,563-70.
World Health Organization (WHO). (1998). Safe injection global network
http:/www.injectionsafety.org. .
WHO/UNESCO (1994). School health education to prevent AIDS and STD: a
resource package for curriculum planners. Three volumes. Geneva 10 and
UNESCO.