An Evaluation of Knowledge and Practice of Injection Safety Among Student Nurses in Lagos State University College of Medicine
This study evaluates student nurses at Lagos State University College of Medicine, revealing that while they possess moderate-to-good knowledge and self-reported practices regarding injection safety, significant gaps in aseptic compliance persist, underscoring the need for reinforced curricula and targeted training to enhance clinical competence and patient safety.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Every day, millions of needles pierce skin across the globe to deliver vaccines, medicines, and fluids. While these injections are vital for health, the tools used to deliver them carry a hidden danger if not handled with extreme care. When a needle is reused, or when a used one is not disposed of immediately, it can become a bridge for deadly viruses like hepatitis and HIV to jump from one person to another. This risk is not limited to the patients receiving the shot; it also threatens the healthcare workers who administer them. In many parts of the world, the gap between knowing the rules of safety and actually following them creates a persistent hazard. The question is not just whether medical students learn these rules in a classroom, but whether they can carry them out when the pressure is on and the equipment is scarce.
Researchers set out to examine this exact gap among student nurses in Lagos, Nigeria. They focused on a specific group of trainees at the Lagos State University College of Medicine, looking at those who were already working in hospitals alongside qualified staff. The goal was to see if these future nurses truly understood the principles of injection safety and, more importantly, if they were practicing them correctly. The team surveyed 103 students, asking them detailed questions about what they knew regarding sterile techniques, hand washing, and the disposal of sharp objects. They also asked the students to report how often they followed these safety steps during their daily clinical work.
The results revealed a complex picture of competence and caution. The students generally possessed a solid grasp of the theory. On average, they answered more than two-thirds of the knowledge questions correctly, with a significant majority recognizing that single-use syringes are essential and that hand washing is mandatory. However, a troubling disconnect appeared when the researchers looked at what the students actually said they did. While most claimed to practice safety, specific habits showed cracks in their routine. For instance, only about half of the students reported that they never recap used needles, a dangerous practice where a needle is placed back into its cap, which frequently leads to accidental pricks. Similarly, fewer than sixty percent said they always washed their hands before every injection or immediately threw used sharps into a safety box.
The study found that knowing the rules helped, but it was not a perfect guarantee of safe behavior. Students who scored higher on the knowledge test were more likely to report safe practices, yet even those with good knowledge sometimes slipped up. The researchers also looked at whether age, gender, or how far along a student was in their training made a difference. They found that female students tended to have slightly higher knowledge scores than their male counterparts, but the level of education—whether a student was in their third, fourth, or fifth year of study—did not significantly change their knowledge or their reported habits. This suggests that simply spending more time in school does not automatically fix unsafe behaviors if the environment does not support them.
When the students were asked to explain why they might fail to follow safety protocols, they pointed to real-world obstacles rather than a lack of understanding. The most common barrier cited was a simple lack of supplies; many reported that gloves or safety boxes were often unavailable. Others mentioned that they felt overwhelmed by the number of patients they had to care for, leaving little time to be meticulous. A significant number also admitted to a fear of reporting needle-stick injuries, worrying that they would be blamed or punished by their instructors rather than supported. This fear creates a silent cycle where injuries go unrecorded, and the true extent of the danger remains hidden.
The researchers concluded that while these student nurses are well-educated on the theory of safety, their daily practice is often compromised by a lack of resources and supervision. The study suggests that teaching the rules is only the first step. To truly protect both patients and future healthcare workers, medical schools and hospitals must ensure that the necessary equipment is always available and that students are guided by mentors who model safe behavior consistently. Without a supportive environment that removes the fear of punishment and provides the tools needed to do the job right, even the most knowledgeable students may struggle to keep themselves and others safe.
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