Knowledge and Self-Reported Adherence to Infection Prevention in Primary Health Care: Insights into Infection Containment Readiness

Abstract

Healthcare-associated infections remain a major public health challenge, and primary health care (PHC) plays a critical role in preventing and interrupting transmission within communities. This study assessed knowledge and self-reported adherence to Standard Precautions and Transmission-Based Precautions among nursing professionals working in PHC. The findings were subsequently interpreted through the conceptual perspective of Infection Containment Readiness (ICR). A cross-sectional census study was conducted in 16 PHC units in Mato Grosso do Sul, Brazil, including 75 eligible nursing professionals. Knowledge was assessed using a validated instrument comprising 47 items distributed across five domains, while adherence was evaluated through 12 self-reported practice indicators. Overall knowledge was satisfactory, with a mean accuracy rate of 78.9%. Higher performance was observed in medication safety and sharps disposal (92.0%), glove use (81.8%), and hand hygiene (77.0%), whereas lower scores were identified in risk recognition (75.6%) and respiratory precautions and cough etiquette (68.2%). Important misconceptions were identified regarding tuberculosis transmission and respiratory infection control. Self-reported adherence was heterogeneous, particularly for respiratory protection measures, tuberculosis-related practices, glove use during capillary blood glucose testing, and participation in continuing education activities. Based on the observed findings and current infection prevention literature, we propose a hypothesis-generating conceptual framework for interpreting ICR in PHC. These findings suggest that strengthening infection prevention in PHC requires strategies that address not only knowledge acquisition but also risk recognition, contextual decision-making, and organizational support for preventive practices.