“A descriptive study to assess the knowledge of spill management among house keeping staff in

selected hospital, Dehradun, Uttarakhand.

RESEARCH PROPOSAL

by

(Priyanka Choudhary, Kshitij Nawani, Simran, Akanksha Paul , Megha , Nisha )

B.Sc. Nursing 4th Year.

 Swami Rama Himalayan University
Swami Rama Nagar, Jolly Grant, Dehradun.

I Introduction

In a hospital, or any other healthcare setting, hazardous substances such as bodily fluids, drugs,
cleaning fluids and other chemicals are in very close proximity to hundreds of people each day.
Some of these people, namely the hospital patients, may be extremely susceptible to infection,
due to illness or recent surgery resulting in an open wound(1).

Because a hospital environment necessitates use of hazardous substances, it is vital that contact
with them is kept to a minimum, even by those who are used to handling such chemicals. For
example, many medical instruments contain mercury, which is a powerful neurotoxin, and some
drugs, particularly those used in the treatment of cancer, are cytotoxins, meaning they are toxic
to cells.(2)

Hospital spillages can occur at any time, this can be due to broken or faulty equipment, human
error, and if this happens, everyone in the area is at risk, from staff to visitors to patients. It may
also mean that a department has to close temporarily, which means that vital services may be
denied to those that need them.(3)

. In the year 2002 a study was conducted by the U.S. Public Health Service (PHS) to evaluate the

immunization and post spillage management are main components to prevent infection and also

plays a significant role in workplace safety.(4)

Blood spillage continues to be a major health problem. Spillage of hazardous substances plays a

significant role in increasing the risk of infection. Spillage is the exposure of hazardous fluids

which contain potentially infectious vehicles

Need for the study

In a hospital, hazardous substances such as body fluids, drugs, cleaning fluids and other
chemicals are in very close proximity to hundreds of people each day. Thus in hospital spillage
of blood, body fluids or chemicals can occur at any time due to broken or faulty equipment or
human error. Any such spill poses risk to the staff, visitors and patients who are extremely
susceptible to infection(5).

WHO reported that highest frequencies of HAI from hospital in the Eastern region (11.8%)
followed by South-East Asia where it was 10%. It has also been estimated that at any time over
1.4 million people suffer from infectious complication that has been transmitted in hospital.(6)

In the year 2004 a study was conducted to evaluate the Occupational blood and body fluid
exposure at risk for numerous infections. Approximately 3 million percutaneous exposure to
blood borne pathogens occur annually among 35 million health care workers worldwide.(7)

In a hospital, or any other healthcare facility, hazardous substances such as blood, bodily fluids,
or any other chemical is near hundreds of people each day. Some of these people, namely the
hospital’s patients, may be extremely susceptible to infection, due to illness or recent surgery
resulting in an open wound.(8)

Universal precautions are used to prevent skin exposure of health care workers to infection.
Transmission of some infections has been reported to the skin exposure. Thus exposure plays a
significant role in increasing the risk of health care workers to infection.(9)

In the year 2008 a study was conducted on occupation exposure to body fluids among health care
workers. This study reported highest exposure rate among housekeeping staff and nurses.(10)

Hospital spillages can occur at any time; this can be due to broken or faulty equipment, human
error, and if this happens, everyone in the spillage area is at risk of being infected.

Thus, under NABH guidelines, it is essential that all hospital departments have the right
equipment in hand to deal with any spills immediately when they arise.(11)

Problem Statement

A descriptive study to assess the knowledge of spill management among house keeping staff in

selected hospital Dehradun, Uttarakhand.

Objectives:

1. To assess the level of knowledge regarding spill management among house keeping staff in

selected hospital Dehradun, Uttarakhand.

2. To find the association between levels of knowledge with socio demographic variables of

housekeeping staff in selected hospital Dehradun, Uttarakhand.

Operational Definitions:

Knowledge -

In this study knowledge refers to the understanding and awareness regarding spill management
among housekeeping staff.

Spill Management-:

In this study spill management refers to the measures taken by housekeeping staff to manage
hazardous spillage.

Housekeeping staff -

In this study housekeeping staff refers to the workers who are working in the selected hospital.

Assumptions:

Housekeeping staff will have some knowledge related to spill management of hazardous

substances.

Hypothesis:

There will be significant association between level of knowledge and socio demographic

variables.

II Review of literature:

The review of literature will be divided under following headings-:

 1) Knowledge of spill management among housekeeping staff.

2) Incidence of spill management

Mr.Pramod tc (2012) conducted a study to assess the knowledge and practice regarding
occupational blood and body fluid exposure. The study utilized a descriptive co-relational study
design and a non-experimental approach, this quantitative study involved interviewer
administered questionnaire of 100 respondents who are staff nurses in selected hospital at
Bangalore. The finding of the study showed that only 60% were having moderately adequate
knowledge, 23% were having adequate knowledge and 17% were having inadequate knowledge.
The study concluded further 39% had inadequate practice 46%had moderately adequate practice
and 15% had adequate practice. (12)

Sreenuvasu Mededla, W Laxmi Tez, KT Reddy, M Sowribala (2015) conducted a study to

assess the knowledge and awareness of standard precautions among health care workers. The
study utilized cross - sectional survey involving 40 item questionnaire provided to 180 health
care workers at Nizam's institute of Medical science , Hyderabad . The finding of study showed
that 53.3% respondents are very knowledgeable and 46.7 % were less knowledgeable. The study
concluded that there is significant difference in knowledge and awareness of standard
precautions among studied health care professionals. (13)

Dr. Jaydeep J Devaliya, Dr. Keyur Brahme, Dr.kalpita Shringarpure (2016) conducted a
study to assess the knowledge, attitude and practice (KAP) of universal precautions in the
nursing staff of tertiary care hospital. The study utilized cross sectional study involved structured
study instrument randomization techniques involve pre designed questionnaire of 52 respondents
who are working in tertiary care hospitals of Western India. The finding of study showed that
out of 52 nurses on 39% had knowledge regarding universal precaution and blood route
transmission. The study concluded that all nurses knew that hand should be washed with soap
and water after attending patients.(14)

Dominic F J Mallon conducted a study to determine the incidence and nature of occupational
exposure to blood and body fluids in health care workers. 32 reports of occupational exposure
were analyzed and are presented. The findings of the study shows that nursing staff occupational
exposure to blood and body fluids is common among health care workers but most exposure
confer a low risk of blood born infection. The introduction of an occupational exposure
assessment program has many benefits, including optimal management of injuries and
acquisition of data on infection control measures ,and may protect health care institutions from
false claims for compensation.(15)

Min Zhang BM, MMS conduct a study to assess to understand current status of occupational
exposure to blood and body fluids, and awareness of knowledge about occupational blood borne
pathogen exposure and universal precautions among hospital - based health care workers. It's
was cross - sectional study conducted during April to May 2004 to study incidence of
occupational exposure to BBF among 1,144 hospital based healthcare workers. The respondents
demonstrated a lack of knowledge regarding transmission of blood born disease and universal
precautions.(16)
MS. Sonia Mathew (2017) conducted a study to assess the knowledge regarding spill
management among staff nurses. The study utilized descriptive Correlation study design,
Non - experimental approach. This Quantitative study involved a interviewer administered
questionnaire of 10 respondents who are staff nurses working in NABH accreditated Hospital,
Indore. The finding of the study showed that staff nurses had average knowledge level with a
Mean value of 9.5, there was a significant association of knowledge score with selected socio
demographic variables.(17)

Mr. S. J. Senanayake conducted a study to asses knowledge the attitudes and practices
regarding handling mercury containing medical devices among nurses in a tertiary care pediatrics
hospital in Sri Lanka.A descriptive cross-sectional study was conducted among nurses (n = 538)
working in Lady Ridgeway Hospital, Sri Lanka, using a self-administered questionnaire. A total
of 472 nurses responded with a response rate of 87.7%. Of the 347 mercury thermometer users,
67.1% had experienced breakages while among 405 mercury sphygmomanometer users, 20.0%
had experienced mercury spillages, during a three months period prior to the study. A majority
(56.8%) had 'good' overall knowledge regarding mercury. (18)

Ms. R. Deepak conducted a study to assess the knowledge and awareness of blood/body fluid
spill management among the third year dental students. Self administered questionnaire was
provided to the 3rd year dental students, which consists of pre-training blood/fluid spill
management questions. One hundred dental students were made to fill this questionnaire and a
training of the protocol was been taught. After this, the post-training survey questionnaire was
been provided to them and the results after the training were been noted. Findings of the study
showed that that before the training the students knew that there is a management for this
blood/fluid spill, but they were unaware of the steps in the blood/fluid spill management
protocol. In this study they ensured that the protocol of the blood/fluid spill management is
educated to all the pre-clinicians of the 3rd year dental students before entering the clinical
exposure. Hence, this study helped the students to get to know more about the precautions and
the prevalence occurring due to the improper management of the blood/fluid spill.(19)

Ms. Pramila D. Souza (2016) conducted a study to assess the Knowledge of Registered Nurses
regarding Hospital Protocols on Biomedical Waste and Spillage Management and Needle Stick
Injury in a Selected Hospital. The study utilized descriptive, non - experimental approach. This
study involved interviewer administered questionnaire on 210 registered nurses of selected
hospital in Mangalore. The finding of the study showed that they have good level of knowledge.
(20)

III Research Methodology:

Research Approach - Quantitative approach:

 Research Design-: Descriptive- survey design

 Research setting-: Selected hospital, Dehradun ,Uttarakhand

 Population-: Male and female housekeeping staff nurses working at selected hospital,
Dehradun, Uttarakhand

Sample-: Male and female housekeeping staff

Sample Size-:100
 Sampling Technique -: Simple random sampling technique

Sample Selection Criteria-:

i) Inclusion criteria – The inclusion criteria for the study:-

1. The house keeping staff working in selected hospital Dehradun , Uttarakhand.

2. Housekeeping staff giving written consent to willingly participate in study

3. Housekeeping staff having the ability to read and write Hindi language

ii)Exclusion criteria –

1. The members those are not available at the time of the study.

Data Collection Instruments- :

The data for this present study will be collected by two instrument tool

PART A-: Socio-demographic profile

PART B-: Structured knowledge questionnaire

Content Validity

The study will be conducted in two parts. First part will be to conducted to establish the content

Validity of the developed questionnaire will be from a experts. Ad reported in literature content

validity assess whether an instrument adequately contains all the items necessary to represent the

concept being measured and second part will be to conduct the reliability of

the content validity using a test and re test. Participants for the content validation will be

Experts and participatory the reliability test would be from the selected setting.
Reliability

The method use for assessing the knowledge of spill management among house keeping staff is

self structured questionnaire and analysis of data will be carried out. The test to be conducted in

two halves to check the reliability of the tool. After pilot study tool will be evaluated for

reliability.

Pre testing -:

Ethical Consideration

The proposed study will be conducted after taking written permission from the principal of

1) Himalayan College of Nursing, S.R.H.U

2) Written permission from ethical committee, S.R.H.U

3) Informed consent will be taken from the participants

Pilot Study-:

A pilot study will be conducted in selected hospital Dehradun, Uttarakhand to assess the

feasibility and practicability of the study and to decide statistical analysis for the researcher. Ten

participants were selected by using convenient sampling technique. The subject for pilot study

met the same criteria as the sample for final study. The data of the questionnaire will be analyzed

by using descriptive statistics.

Method of Data Collection

Before the data collection formal permission is to be obtained. The purpose of the study is to be

explained and consent is to be obtained for cooperation. The data to be collected using self

structured questionnaire.

Plan for Data Analysis

Data analysis will be planned based on the objective stated in the study by using descriptive and
inferential statistics.

Limitations

Work Plan:

Budget

Sr. No Content Amount

1 Internet 1500

2 Stationary 1000

3 Printing 2500

4 Binding 2000

5 Telephone 500

Total 7500

References)
1. https://vikaspedia.in/health/sanitation-and

hygiene/swachhta_abhiyaan_guidelines/management-of-spills-body-fluid-chemicals-

mercury.

2. https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.hse.ie/eng/

about/who/healthwellbeing/infectcont/sth/gl/section-3-7-management-of-blood-

and.pdf&ved=2ahUKEwjIivDgwbzuAhU1meYKHcUeD3oQFjALegQIHRAB&usg=AO

vVaw2W2-ySi-hHkYpqbMGGxRoV

3. https://www.google.com/url?sa=t&source=web&rct=j&url=https://jprsolutions.info/

files/final-

file5e7d8d168dfe47.89112927.pdf&ved=2ahUKEwjRyuKewbzuAhXDmeYKHbRBDIc

QFjADegQIGxAB&usg=AOvVaw3iCLr4pplLLkgRaqLOStvQ

4. Chitnis V, Chitnis S, Patil S, Chitnis D. Practical limitations of disinfection of body fluid spills with

10,000 ppm sodium hypochlorite (NaOCI). Am J Infect Control 2004;32:306-8. 2.

5. Mathur P. Role of hospital housekeeping and materials management including disinfection and

waste management. In: Hospital Infection Prevention New Delhi: Springer; 2014. p. 81-9. 3.

6. Peate I. Body fluids part 1: Infection control. Br J Healthc Assist 2008;2:6-10. 4.

7. Davies CG, Khan MN, Ghauri AS, Ranaboldo CJ. Blood and body fluid splashes during surgery-the

need for eye protection and masks. Ann R Coll Surg Engl 2007;89:770-2.
8. Pramila Dsouza et al., Nitte University Journal of Health Science, NUJHS Vol. 6, No.1, 2016, ISSN

2249-7110., http://www.nitte.edu.in/journal/march2016/o8.pdf.