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. 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