Knowledge and Compliance with Standard Precautions for Nosocomial Infection Prevention Among Undergraduate Nursing and Midwifery Students in Ghana

ABSTRACT Background Healthcare-associated infections (HAIs) represent a significant patient safety challenge in sub-Saharan Africa, where gaps in infection prevention and control (IPC) practice remain prevalent. Nursing and midwifery students are particularly vulnerable during clinical training, yet evidence on their IPC knowledge and compliance in Ghana is limited. Objective To assess the knowledge of nosocomial infections and the degree of compliance with standard precautions among third-year nursing and midwifery students at Kwame Nkrumah University of Science and Technology (KNUST), Ghana. Methods A descriptive cross-sectional study was conducted between 28 June and 9 July 2021 at KNUST, Kumasi, Ghana. A total of 150 third-year students (65 nursing, 85 midwifery) completed a structured, self-administered questionnaire adapted from WHO and CDC guidelines. Knowledge was assessed using a 19-item binary scale and compliance using a 17-item Likert-type scale. Respondents were categorised into knowledge and compliance groups using predefined score thresholds for analytical purposes. Chi-square tests, Fisher’s exact test, and Spearman’s rank correlation were used to examine associations between knowledge and compliance. Results Overall, 143 respondents (95.3%) were categorised as having high knowledge of nosocomial infections and standard precautions (mean score: 16.44/19; SD: 1.59). High compliance with standard precautions was reported by 112 respondents (74.7%; mean score: 59.13/68; SD: 5.89). Compliance was strongest for hand hygiene and glove use but notably lower for PPE use during splash-risk procedures and safe needle-handling practices. No statistically significant association was found between categorised knowledge level and categorised compliance level (χ² = 0.47, df = 1, p = 0.491; Fisher’s exact p = 0.679). When analysed as continuous scores, a modest positive correlation was observed (Spearman’s rho = 0.326, p < 0.001). Conclusion High knowledge of nosocomial infections did not translate uniformly into high compliance across all standard precaution domains. Practical training, simulation-based learning, and supervised clinical reinforcement are needed to bridge the knowledge–practice gap in nursing and midwifery education in Ghana.