Epistemic Gaps and Cognitive-Practice Disconnects in Knowledge and Awareness of Healthcare Personnel in South-West Nigerian Tertiary Hospitals

Frontline cognitive readiness and behavioral adherence represent the baseline structural pillars governing infection control compliance in acute hospital settings. This multi-center cross-sectional epidemiological investigation evaluated the baseline knowledge, awareness patterns, and epistemic gaps regarding infection prevention and control (IPC) protocols among diverse clinical and non-clinical cadres within selected federal tertiary teaching hospitals in South-West Nigeria. Utilizing a proportional-to-size stratified probability framework, a cohort of n = 350 healthcare personnel was recruited from Lagos University Teaching Hospital (LUTH, n = 175), Federal Teaching Hospital, Ido-Ekiti (FETHI, n = 110), and Federal Medical Centre, Owo (FMC Owo, n = 65). A psychometrically validated 10-item knowledge-and-awareness diagnostic was administered, and bivariate associations were evaluated utilizing Chi-Square tests of independence. The overall composite awareness index across the multi-center network was calculated at a moderate baseline of 44.3%, displaying negligible variance across individual facilities (LUTH: 45.5%, FETHI: 42.6%, FMC Owo: 44.9%). While self-reported awareness regarding personal safety, including blood-spill personal protective equipment (PPE) utilization (85.1% overall correct) and terminal cleaning protocols (78.0%), was highly established, severe technical deficits were identified regarding chemical disinfection kinetics. Specifically, only 38.3% of participants could identify the standardized 1:10 sodium hypochlorite dilution ratio, and only 34.0% correctly recognized active chlorine-based chemistry parameters. Bivariate analysis utilizing contaminated surfaces as a key indicator of cognitive risk-recognition demonstrated a highly significant association between facility background and staff awareness level (X 2 = 22.48, df = 2, p < 0.001), with FMC Owo displaying the highest proportion of highly aware respondents (86.2%) and LUTH the lowest (59.4%). These findings mathematically demonstrate a profound disconnect between high general awareness of hospital hazards and low technical proficiency in basic environmental decontamination chemistry. To safeguard patient safety, public healthcare administrations must transition from passive policy guidelines to mandatory, hands-on, continuous professional training matrices that actively integrate clinical and environmental cleaning staff.