Safety precaution knowledge, attitude, practice, and associated factors among medical waste cleaners in governmental hospitals, Northwest Ethiopia

Universal safety precaution is a central component of safe and high-quality service delivery at the facility level. Medical waste cleaners are more vulnerable than other health staff to medical waste-related health problems due to their work characteristics. The purpose of this study was to assess safety precaution knowledge, attitude, practice, and associated factors. An institution-based cross-sectional study design was conducted on 418 medical waste cleaners working in West and East Gojjam Zones government hospitals. Data were entered using Epidata version 3.1 and then exported to SPSS version 25.0 for cleaning, coding, and analysis. In bi-variable logistic regression, variables with a p-value ≤ 0.25 were selected for multivariable logistic regression. Finally, variables with a p-value < 0.05 were used to identify associated factors. In this study, safety precautions, good knowledge, favorable attitude, and good practice levels among cleaners were 70.6 (95% CI: 62, 75), 66.3 (95% CI: 62, 71), and 65.3 (95% CI: 61, 70), respectively. Working in a general hospital [AOR: 0.45 (95% CI: 0.25, 0.91) p = 0.02], > 24 months of work experience [AOR: 2.37 (95% CI: 1.33, 4.21) p = 0.003], and training [AOR: 2.55 (95% CI: 1.56, 2.16) p = 0.001] identified factors for knowledge. Good knowledge [AOR: 3.31 (95% CI: 2.05, 5.33) p = 0.001], working in primary hospital [AOR: 1.87 (95% CI: 1.15, 3.04) p = 0.01], and training [AOR: 1.91 (95% CI: 1.16, 3.13) p = 0.01] were associated with favorable attitude. Good knowledge [AOR: 2.08 (95% CI: 1.31, 3.30) p = 0.02], diploma and above educational [AOR: 0.60 (95% CI: 0.38, 0.97) p = 0.03] and working site in the hospital [AOR: 2.22 (95% CI: 1.03, 4.74) p = 0.04] were associated factors for good practice. Two-thirds or more of participants had adequate safety precaution knowledge, attitude, and practice. Working hospital levels, experience, education, training, and work site in the hospital were identified as factors. Routine training and working site rotation are very important to improve the safety precaution standards of cleaners. Hospital administrators and other stakeholders should give special attention to continuous professional education, mentoring, evaluation, and supervision required to implement standard safety precautions.