# Knowledge, Attitudes, and Practices Related to Sterilization Among Healthcare Workers at a Tertiary Care Hospital of Jharkhand: A Cross-Sectional Study

## TL;DR

This study evaluates healthcare workers' knowledge, attitudes, and practices regarding sterilization at a hospital in Jharkhand, finding moderate knowledge and positive attitudes but significant gaps among support staff.

## Contribution

The study provides insights into sterilization KAP among HCWs in a resource-limited tertiary hospital in India, highlighting disparities and barriers.

## Key findings

- Only 28.3% of healthcare workers had formal infection control training.
- CSSD technicians had the highest sterilization knowledge scores, while support staff had the lowest.
- Positive attitudes were common, but insufficient resources and time constraints were major barriers.

## Abstract

Background: Healthcare-associated infections (HAIs) remain a major threat to patient safety in India, particularly in tertiary care teaching hospitals with high patient loads and limited resources. Effective sterilization of medical instruments is fundamental to infection prevention; however, healthcare workers’ (HCWs) knowledge, attitudes, and practices (KAP) directly influence its implementation.

Objective: The objective of this study is to assess the KAP regarding sterilization among HCWs at Rajendra Institute of Medical Sciences (RIMS), Ranchi.

Methods: A hospital-based cross-sectional study was conducted among 223 HCWs, including nurses, technicians, resident doctors, and support staff. Data were collected using a validated, semi-structured questionnaire evaluating demographics, professional characteristics, knowledge, attitudes, and practices related to sterilization. KAP scores were analyzed using descriptive statistics, ANOVA, and correlation tests.

Results: Of 223 participants, the majority were aged 31-40 years (45.3%), female (58.7%), and predominantly nurses (42.6%). Most worked in operating theaters (28.7%) and general wards (24.2%). Only 28.3% had formal infection control training, though 52.9% had attended sterilization-related training in the past two years.

The mean knowledge score was 14.2 ± 3.1 out of 20 (71.0%), with 23.8% scoring excellent, 41.7% good, 28.3% moderate, and 6.2% poor. Central Sterile Supply Department (CSSD) technicians scored the highest (16.8 ± 2.2) while support staff had the lowest scores (10.3 ± 3.6) (p < 0.001). Higher education and prior training were significantly associated with better knowledge levels (p < 0.001).

Attitudes were largely positive, with a mean score of 4.2 ± 0.6 out of 5; 78.5% demonstrated highly positive attitudes, particularly regarding patient safety (96.4%) and personal responsibility (94.2%). However, perceived barriers included insufficient resources (62.8%) and time constraints (58.7%).

Correlation analysis revealed significant moderate positive associations between knowledge and practice (r = 0.467, p < 0.001) and knowledge and attitude (r = 0.342, p < 0.001). Support staff demonstrated the weakest knowledge-practice relationship (r = 0.247, p = 0.012).

Conclusion: Sterilization knowledge among HCWs at RIMS, Ranchi was moderate overall, with clear disparities across professional categories and education levels. Attitudes toward sterilization were highly positive, but knowledge gaps, especially among support staff, and institutional barriers limited consistent practice. Regular, targeted training, competency evaluation, and improved institutional support are critical to strengthening sterilization practices and reducing HAIs in tertiary care hospitals.