Knowledge and Practice of Standard Precautions and Awareness Regarding Post Exposure Prophylaxis among Interns of B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Introductions: Standard Precautions represent the minimum infec�tion prevention measures that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is de�livered.1 These evidence-based practices are designed to both protect healthcare personnel and prevent the spread of infections among patients. Standard Precau�tions replaces earlier guidance relating to Universal Precautions and Body Substance Isolation. Standard Precautions include: 1) hand hygiene, 2) use of personal protective equipment (e.g., gloves, gowns, facemasks), depending on the anticipated exposure, 3) respiratory hygiene and cough etiquette, 4) safe injection prac�tices, and 5) safe handling of potentially contaminated equipment or surfaces in the patient environment.1,2 Direct or indirect transmission of disease can be prevented by applying standard precaution in day to day practices. So CDC recommended that standard precautions must be applied to all patients irrespective of the nature of the disease pattern. There are various modes of transmissions of disease like airborne disease which can be prevented by special air handing measure and ventilator along with use of mask especially in doing suctioning, endotrachial intubation; likewise indirect transmission of infectious agent can be prevented by using personal protective equipments which must be changed after taking care of patient colonized or infected with an infectious agent. Possibilities of transmitting infectious disease do exist in soiled clothes, so changing of such clothes is a must for caring next patient similarly proper use of needle, with appropriate standard technique for disposing it makes disease transmitting directly is minimized. So proper use of standard precautions in hospital setting is very important for all health care workers to prevent transmission of disease from patient to patient, patient to health care worker and healthcare worker to patient. Objectives: To assess the knowledge on Standard Precautions and awareness regarding post exposure prophylaxis and to observe the practice of interns on Standard Precautions. Methods: This was a cross sectional observational study conducted in the different department of B.P.K.I.H.S. All Interns of MBBS and BDS batch 2011 was considered in this study. Questionnaires were distributed to know the knowledge and attitude of Standard precautions and awareness in post exposure prophylaxis, and all interns were observed to assess the utilization of their knowledge into practice. Results: The topic �Sterile technique and standard precautions� is included in curriculum of this batch of interns, this may be the reason that all the respondents have hered the term Standard Precaution, but only 92.5% differentiate it from Universal Precautions. The main reason for not diffentiating it correctly was because they forgot the learned things. The correct knowledge among the component of standard precautions was found to be relating to hand washing before and after patient care (95%). Even though they have good knowledge on hand washing only 6.7% washed hand before and after touching, only 86.7% washed hand before putting on gloves and 68.3% washed hand after removing gloves. The main reason for not washing hand was due to rush in the department as well as long distance for water supply.53.3% of the participant expressed correct knowledge of not bending or recapping needle before disposal but in practice 31% bend/ recapped before disposing it during working hour. Regarding sharps/needle disposals, the entire participant disposed it correctly (100%) even though only 94.2% expressed correct knowledge on it. The appropriate method of needle recapping if needed before disposal is by using one handed technique, 74.2% of the participant followed this. All the Interns of MBBS expressed correct knowledge on every aspect of blood borne disease but only 92.5% of BDS interns answered it correctly especially in mode of transmission of disease. Knowledge on immediate management on sharp injury is good in all interns as they all wash hand with soap and water immediately after exposure, but only 65% were aware about reporting system of needle stick injury in respective department. 96.7% expressed correct knowledge on post exposure prophylaxis and same percentage expressed the correct regimen of it. Among all participant 65% had complete knowledge on the course of treatment. Conclusion: Knowledge of standard precautions is very important for all health care workers because it has direct impact in health of patient as well as for themselves, so respective institution should have intervention to utilized standard precautions into practices. Proper use of PPE and changing of every soiled garment, regular hand washing before and after patient care, Safe working environment, adequate and proper sized of PPE supply and proper utilization of available resources are the main measures that help to minimize the transmission of all form of diseases. Strategies should be made for promoting injection safety, proper sharp disposal, proper wastage disposal and handling of wastage so that transmission of BBD is minimized.