Nurses as health care workers are at risk of biological agents such as bacteria, viruses and others. At health care settings exposure to bloodborne pathogens can cause infections through needlestick injuries. The objectives of this research were to determine factors surrounding recapping needles in hospital nurses and to implement an educational strategy to reduce the recapping practices. It was a descriptive and exploratory approach where the PRECEDE component of the PRECEDE/PROCEDE Model was used as the framework to systematize and analyze the information obtained from the focus group sessions. A total of 120 nurses participated from four different departments. The study was conducted in three phases: diagnosis, implementation and evaluation of the educational strategy. The results obtained from the focus group sessions revealed that predisposing, reinforcing, enabling and environment factors were related to the practice of recapping and needlestick injuries. Most of this information represented the essential basis for the implementation of the educational strategy. During the diagnostic phase, the percentage of needles without recapping was 24% contrasting with 40% found after the educational strategy. The percentage difference (16%) was statistically significant (p < 0.001). The odds ratios calculation in the departments studied showed that the educational strategy was a protective factor to avoid the recapping of used needles. An important conclusion is that the educational strategy, which focused on the practice and habit of what should be done (e.g., NOT recapping used needles), contributed to the decrease in recapping practice. However, nurses perceived did it not provide a safe working environment. The implications are focused on: nurses and hospital management have to engage in an active role to promote a safety work environment where nurses and other health care workers can be protected. The incorporation of educational strategies, continuous and updated training, as well as the evaluation and monitoring process can play a determinant role in the control of hazard exposures. It is imperative that a safe and healthy workplace for the personnel be provided; not less important is the acquisition of equipment and devices for sharp handling and disposal, to complement the prevention of accidents related to needlestick injuries.

Background: Healthcare workers’ hand hygiene remains a key pillar because it prevents and controls healthcare associated infections. Healthcare Workers’ hand hygiene compliance is suboptimal. Aim: The study developed contextualised guidelines for Healthcare Workers’ hand hygiene and infection control in patient care. Methods: The Precede-Proceed model with Theory of Planned Behaviour guided the study. The study was conducted following the mixed methodology approach, observational survey, exploratory, descriptive and contextual in nature study with mixed thematic analyses in a research wheel process. Data were collected through direct participant observation of hand hygiene opportunities through observing (n=95 Healthcare Workers; n=570 practices). Self-administered questionnaires were used to collect data from Healthcare workers (n=189) regarding challenges they faced in achieving hand hygiene. Structured interviews were conducted with patients (n=574). Retrospective reviews of healthcare associated infections and their associated mortalities were carried out from mortality records. Data were analysed retrospectively. Partly the data were statistically and mixed thematically analysed. Guidelines were developed using intervention alignment throughout, mapping, matching, pooling, patching and validation corroborated with Precede-Proceed models’ best practices. The study was ethically reviewed and approved by University of South Africa and the Medical Research Council of Zimbabwe project numbers, 6067662 and MRCZ/B/208. Results: Hand hygiene non-compliances were mostly found in the following contexts, after touching patients’ surroundings, and before doing an aseptic procedure. A non-hand hygiene compliance of Healthcare workers 167(29.3%) and compliance 403(70.7%) in context was suboptimal with sad patients and challenges faced by Healthcare workers. Conclusion: Healthcare Workers had gaps in hand hygiene compliance and availability of required resources. Gaps were also noted in ongoing hand hygiene promotion educational strategies and guidelines to comply and prevent. Guidelines to enhance hand hygiene included, attend to hand hygiene strictly after touching patient surroundings, bed linen, lockers and curtains to prevent gastroenteritis; follow standard precautions against HCAIs from spreading to patients' environments; and comply with hand hygiene guidelines, policies and regulations for best practice with patients. The study contributes generalisable knowledge. / Health Studies / D. Litt et Phil. (Health Studies)