Project – Knowledge and perception of occupational health safety among accident and emergency nurses of Warri Central

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Occupational health and safety (OHS) are essential components of a functional and effective workplace, particularly in the healthcare sector where workers are exposed to multiple occupational hazards. The primary aim of OHS is to promote and maintain the highest degree of physical, mental, and social well-being of workers in all occupations. In healthcare environments, especially in accident and emergency (A&E) departments, the risks are significantly higher due to the intensity, urgency, and unpredictability of the tasks nurses perform. Nurses in A&E units frequently handle critically ill patients, traumatic injuries, and infectious diseases, often under considerable time pressure. These conditions expose them to numerous hazards, including needle-stick injuries, exposure to blood-borne pathogens such as HIV and Hepatitis B, physical assault, and burnout (World Health Organization [WHO], 2022).

Globally, there has been increasing concern about the protection of healthcare workers as a cornerstone of public health systems. Reports show that healthcare workers suffer more work-related injuries than workers in most other sectors. According to the International Labour Organization (ILO, 2021), the healthcare sector ranks among the most hazardous workplaces globally, with nurses being particularly vulnerable due to their frequent and close contact with patients and hazardous materials. These injuries not only affect the workers but also compromise patient care, resulting in reduced workforce capacity, increased absenteeism, and long-term health issues.

In the Nigerian context, the challenges of ensuring occupational health safety in hospitals are compounded by systemic problems such as inadequate infrastructure, lack of protective equipment, understaffing, and poor enforcement of safety regulations. Research by Okonkwo, Amadi, and Igbokwe (2020) revealed that many Nigerian hospitals either lack formal occupational safety policies or do not effectively implement them, leaving healthcare workers, especially nurses, vulnerable to avoidable harm. Furthermore, the absence of continuous training and safety drills contributes to low compliance with safety protocols, thereby increasing the incidence of occupational injuries.

Accident and emergency nurses are often the first point of contact for patients experiencing life-threatening conditions, making their work both critical and risky. They are expected to make quick decisions and carry out procedures that may involve exposure to blood, body fluids, sharp instruments, and aggressive patient behavior. These nurses are also more likely to suffer musculoskeletal injuries due to patient lifting and prolonged standing. According to Salisu and Jamil (2019), the prevalence of workplace injuries among Nigerian nurses is significantly higher in A&E units than in other departments, highlighting the need for targeted safety measures in this environment.

The level of knowledge and perception that nurses have regarding occupational safety plays a pivotal role in determining how effectively safety protocols are followed. A nurse who understands the importance of personal protective equipment (PPE), safe disposal of sharps, and emergency procedures is more likely to adhere to safety guidelines. Moreover, positive perceptions and attitudes towards occupational health safety can enhance compliance and promote a culture of safety in the workplace. Research conducted by Adebayo and Oladipo (2021) found a strong correlation between nurses’ knowledge of OHS practices and their adherence to safety protocols in public hospitals across Nigeria.

Given the high-risk nature of A&E units and the significant role of nurses in delivering frontline healthcare, it becomes imperative to assess their level of knowledge and perception regarding occupational health safety. Such an assessment will not only identify existing knowledge gaps but also guide the development of tailored interventions to improve safety outcomes. This study, therefore, seeks to evaluate the knowledge and perception of occupational health safety among accident and emergency nurses at Warri Central Hospital, Delta State, with the aim of improving workplace safety, reducing injury rates, and enhancing the overall quality of patient care.

1.2 Statement of the Problem

Despite the increasing emphasis on occupational health and safety (OHS) within healthcare institutions in Nigeria, there remains a significant gap between awareness and implementation of safety protocols. Many hospitals, especially those in under-resourced areas, struggle to maintain consistent adherence to established safety practices. Accident and emergency (A&E) units are particularly vulnerable due to the high-pressure nature of their operations, where nurses often function in unpredictable and hazardous situations. These challenges are further exacerbated by long working hours, shortage of staff, and limited access to personal protective equipment (PPE) (Odeyemi & Oluwole, 2021). Consequently, even well-informed nurses may find it difficult to comply fully with occupational safety standards under such strained conditions.

Nurses in A&E departments are frequently exposed to a range of occupational hazards, including exposure to infectious diseases, physical assault, and musculoskeletal injuries. The emergency nature of their work often demands immediate response with little room for procedural delays, sometimes resulting in the circumvention of safety protocols. Studies have shown that in such settings, even minor lapses in safety practices can lead to serious consequences, including needle-stick injuries, cross-contamination, or transmission of blood-borne diseases (Adebayo & Oladipo, 2021). These risks not only affect the nurses themselves but also compromise the safety of patients and other healthcare staff, making the enforcement of OHS practices a matter of critical importance.

Preliminary observations at Warri Central Hospital indicate a troubling inconsistency in how occupational safety measures are understood and practiced among A&E nurses. While some staff demonstrate a strong grasp of safety protocols, others appear to lack the motivation, training, or institutional support to implement them consistently. For example, during periods of patient surges, adherence to standard safety procedures often deteriorates due to urgency and workload. These inconsistent behaviors may be linked to varied levels of training, differing attitudes towards risk, and organizational culture that does not prioritize safety enforcement (Okonkwo, Amadi, & Igbokwe, 2020). As a result, preventable injuries and avoidable health risks continue to persist among nurses in these high-stakes environments.

Furthermore, there is a noticeable gap in empirical data assessing the knowledge and perception of occupational health and safety specifically among A&E nurses in Delta State. Most existing studies focus on general hospital environments or tertiary healthcare centers in more urbanized regions, leaving smaller but critical facilities like Warri Central Hospital underrepresented in the literature. Without localized data, interventions and training programs risk being poorly targeted and ineffective. Understanding the specific challenges and perceptions of nurses in this context is necessary to design relevant, sustainable, and impactful health and safety strategies.

Therefore, this study seeks to address the lack of evidence-based data on the subject by investigating the knowledge and perception of occupational health and safety among A&E nurses at Warri Central Hospital. By identifying the gaps in understanding and the factors influencing compliance, this research aims to inform hospital administrators, policymakers, and public health educators in improving workplace safety standards. A better-informed workforce, supported by strong institutional policies and ongoing training, will not only enhance the well-being of nurses but also contribute to better patient care and overall health system resilience.

1.3 Objectives of the Study

The main objective of this study is to assess the knowledge and perception of occupational health safety among accident and emergency nurses at Warri Central Hospital.

Specific objectives include:

1. To assess the level of knowledge of occupational health safety among A&E nurses.
2. To examine the perception of A&E nurses towards occupational health safety practices.
3. To identify factors influencing compliance with occupational safety protocols.
4. To explore the relationship between knowledge level and perception of occupational health safety.

1.4 Research Questions

1. What is the level of knowledge of occupational health safety among A&E nurses at Warri Central Hospital?
2. What are the perceptions of A&E nurses towards occupational health safety?
3. What factors influence adherence to occupational health safety measures?
4. Is there a relationship between nurses’ knowledge and their perception of occupational health safety?

1.5 Research Hypotheses

Hypothesis One:

H₀: There is no significant relationship between nurses’ level of knowledge and compliance with OHS protocols.

H₁: There is a significant relationship between nurses’ level of knowledge and compliance with OHS protocols.

Hypothesis Two:

H₀: There is no significant relationship between nurses’ perception and their compliance with OHS protocols.

H₁: There is a significant relationship between nurses’ perception and their compliance with OHS protocols.

1.6 Significance of the Study

This study is significant as it seeks to provide a detailed assessment of the knowledge and perception of occupational health and safety (OHS) among accident and emergency (A&E) nurses, a critical but often overlooked segment of the healthcare workforce. Nurses in A&E units are constantly exposed to life-threatening hazards, including exposure to infectious diseases, physical injuries, and violent confrontations. Understanding how well these professionals comprehend and perceive occupational health safety measures is essential in developing appropriate support systems that prioritize their well-being and enhance the quality of patient care.

The findings from this study will offer hospital administrators evidence-based data to assess the effectiveness of existing safety protocols and identify areas where improvements are necessary. If gaps in knowledge or negative perceptions are identified, it could prompt hospital leadership to invest more in occupational health safety training, update institutional policies, or provide adequate resources such as personal protective equipment (PPE) and incident reporting systems. Strengthening these administrative responses could significantly reduce the risk of workplace-related injuries and illnesses among emergency nursing staff.

For policymakers and public health regulators, the study will serve as a resource to support the formulation or revision of national occupational health safety standards, especially as they relate to frontline healthcare workers in high-risk units. Many existing health policies in Nigeria are broad and do not account for the unique circumstances of A&E environments. This research can provide the empirical backing necessary to advocate for more context-specific policies that ensure the safety of nurses and other emergency healthcare providers.

Additionally, the study will inform the design and implementation of educational and training programs for nurses. By identifying the strengths and weaknesses in nurses’ knowledge and attitudes, nursing schools, hospital training departments, and professional health organizations can tailor their curricula and workshops to address the most pressing challenges. Emphasis can be placed on practical safety procedures, emergency preparedness, and strategies to enhance risk perception and personal accountability among nurses.

This study also contributes to the academic and scientific community by filling an existing gap in literature concerning occupational health and safety among A&E nurses in Delta State, Nigeria. There is currently limited localized research in this area, and this study will serve as a reference point for future investigations. Scholars interested in occupational safety, healthcare management, and nursing practices can build upon these findings to explore related issues such as burnout, job satisfaction, and retention in high-stress medical environments.

Finally, the study holds significance for the nurses themselves. By highlighting the risks they face and the level of support they receive or lack, the research may empower nurses to advocate for safer working conditions and greater institutional accountability. When nurses feel their safety is prioritized, it can foster a culture of trust, motivation, and improved service delivery. Thus, this study not only seeks to benefit institutions and policymakers but also aims to promote the health, dignity, and professional fulfillment of A&E nurses in Warri Central Hospital and beyond.

1.7 Scope of the Study

The study is limited to nurses working in the accident and emergency department of Warri Central Hospital, Delta State. It focuses on assessing their knowledge, perception, and influencing factors concerning occupational health safety.

1.8 Operational Definition of Terms

Occupational Health Safety (OHS): This refers to the comprehensive set of practices, protocols, guidelines, and institutional policies designed to protect the physical, mental, and emotional well-being of workers within their professional environment. In the context of healthcare, and more specifically accident and emergency (A&E) departments, occupational health safety includes infection control measures, safe handling of medical instruments, use of personal protective equipment (PPE), emergency response preparedness, and workplace violence prevention strategies. The goal of OHS is to minimize the risk of workplace-related injuries, illnesses, and hazards while promoting a culture of safety for both workers and patients.

Knowledge: Knowledge in this study pertains to the level of awareness, understanding, and familiarity that A&E nurses possess regarding occupational health and safety. This includes their ability to identify workplace hazards, understand standard precautions, use protective equipment correctly, and implement infection control measures. It also encompasses their knowledge of safety policies, emergency procedures, and reporting mechanisms for workplace accidents or exposures. A nurse with high knowledge of OHS is more likely to make informed decisions that prevent occupational harm and ensure a safer working environment.

Perception: Perception refers to the individual nurse’s personal beliefs, attitudes, and viewpoints concerning occupational health and safety measures. It influences how seriously a nurse takes safety protocols and how motivated they are to comply with them. Perception may be shaped by past experiences, cultural beliefs, peer influence, workplace environment, and institutional leadership. A positive perception encourages active engagement with safety practices, whereas a negative or indifferent perception may result in negligence or non-compliance. Understanding nurses’ perceptions helps in identifying barriers to adherence and in developing tailored interventions.

Accident and Emergency (A&E) Nurses: A&E nurses are licensed or registered nursing professionals who provide urgent and life-saving care to patients presenting with acute illnesses, traumatic injuries, or other critical conditions. Their role involves rapid assessment, triage, stabilization, and often involves performing procedures in high-stress and potentially dangerous situations. Due to the unpredictable nature of emergency care, these nurses are frequently exposed to occupational risks, making them a key focus group in studies of workplace safety. Their experiences and practices offer valuable insights into the effectiveness of OHS protocols in real-time, high-pressure healthcare environments.

Compliance: Compliance denotes the degree to which A&E nurses follow established occupational health and safety guidelines and institutional procedures. It involves consistently wearing PPE, following hand hygiene protocols, reporting injuries or exposures, attending safety trainings, and adhering to hospital policies. High compliance is indicative of a safety-conscious workforce and is usually correlated with better patient outcomes and reduced incidence of workplace injuries. Conversely, low compliance suggests the need for improved education, supervision, or systemic support to ensure the safety of both healthcare personnel and patients.

Project – Knowledge and perception of occupational health safety among accident and emergency nurses of Warri Central