Current status of standard precautions: a cross-sectional evaluation of healthcare workers’ knowledge and practice across northern Nigeria

Unsafe injection practices and inconsistent adherence to standard precautions remain important drivers of healthcare-associated infections (HAIs) in resource limited settings, exposing patients and health workers to bloodborne pathogens. This study assessed knowledge and practices (KP) of injection safety and standard precautions among healthcare workers. Using structured questionnaire, a cross-sectional survey of 912 healthcare workers across tertiary, secondary, and primary healthcare facilities was performed in Katsina State, Borno State and the Federal Capital Territory - Abuja. Data on KP of injection safety and standard precautions were obtained. Descriptive statistics, chi-square tests, binary and multivariable logistic regression were performed using SPSS version 27.0 at p < 0.05 to identify associations and predictors of good KP. Of the 912 respondents, 45.8% demonstrated good knowledge while only 2.3% demonstrated good practice. Needle recapping (69.5%) and needlestick injuries (62.8% within the past year) were prevalent. Females were nearly three times more likely to demonstrate good knowledge (AOR = 2.883, 95% CI = 1.837–4.523, p < 0.001). Also, 1–5 years of service (OR = 2.873, 95% CI = 1.613–5.120, p < 0.001) and 6–10 years (OR = 2.191, 95% CI = 1.224–3.921, p = 0.008) significantly predicted good knowledge. Conversely, more than 10 years of service significantly predicted lower odds of good knowledge (OR = 0.200, 95% CI = 0.112–0.330, p < 0.001). Although good knowledge of injection safety and standard precautions was observed in less than half of the study participants, practices were alarmingly weak, exposing HCWs to occupational hazards. Sustained interventions are needed, including periodic refresher training, strict enforcement of no-recapping policies, safety-engineered devices, and cadre-specific programs.