Surgical site infections, pneumonia, lower respiratory tract infection, UTI and sepsis are the most commonly occurring infections in all over the world (Kaushal et al., 2015). Among all the patients who were admitted in hospital 8.7% had HAIs (Healthcare Associated Infections) showed by a report of WHO (CDC, 2021). Failure in sterilization considered the primary reason for the infections in clinical sites and hence many reports have been found about HAIs worldwide due to improper sterilization (Rutala et al., 2016).

Sterilization is such a process of killing or destroying all kinds of microbes including spores which is neither easy to achieve nor easy to prove. Disinfection is kill-ing or destruction of various organisms with the help of chemical or other solution and this procedure is considered to be less fatal than sterilization (Damani, 2019). Sterilizing equipment is very important for the patients who come in exposure with surgical inst-ruments, syringes, bandages and gauges all the time. Ensuring the safety for the patients, all the medical equipment and consumables must be clean, disin-fected and sterilized. All the microorganisms which are pathogenic should be completely destroyed to mini-mize HAIs (Shahen et al., 2019). HAIs are caused due to many reasons like contaminated products, sterili-zation failure of surgical and other instruments, breach of sterility during procedures, inappropriate hygiene of the staffs involved in the procedures and contaminated environment, etc. 

Invasive and non-invasive medical devices safety cannot be achieved if disinfection and sterilization are not properly done. Principal criteria of international patient safety goal are prevention of HAI. Controlling and prevention of HAIs are a big challenge for the physicians. To cut back on the threat of HAIs, im-provement in the application of sterilization and dis-infection in hospital settings is necessary (Zaman et al., 2021). Protocols and procedures for cleaning, dis-infection and sterilization apply to anyone repro-cessing medical equipment/devices in the health care organization. Mandatory evaluation by the practi-tioners are necessary to evaluate, establish and update the settings and by their continuous supervision pro-tocols and control strategies the infection prevention rate can be improved (RCDSO, 2012).

To perform these activities, professionally educated and trained healthcare staffs are required in hospital settings. Continual learning with practical implication must be ensured for all the staffs that provide health-care services. This study is done to assess the require-ments of education intended for the healthcare staffs that perform sterilization and disinfection of surgical instruments in the hospitals.

Study area and population

The study was done from 3rd July to 5th August, 2020 in a super specialized hospital in Dhaka. Total 73 res-ponses were collected in this study which included the nurses and technicians who were involved in steri-lization and disinfection procedure of surgical instru-ments. Among them, 39 were nurses who completed their diploma or B.Sc in nursing and 34 were tech-nicians and these technicians were not qualified by any degree of medical science. 

Data collection

A close-ended questionnaire survey was administered. The format of the questionnaire was in English. The information on demographic variables such as sex, age, educational qualification of the participants was wrapped up by the questionnaire. The questionnaire also included the details to discover the awareness and attitude level on sterilization and disinfection practice of both educated and uneducated healthcare staffs. All the 73 staffs were requested independently to take a part in this cross-sectional survey. It was assured to the participants about the confidentiality of their res-ponses.

Institutional clearance

Institutional clearance was granted from the hospital before starting the questionnaire survey.

Questionnaire:

Fundamental profile of health care workers among study population (n=73) 

The percentages of positive response in awareness and attitudes of both educated and uneducated healthcare staffs concerning sterilization and disinfection are given below:

Fig 3: Positive responses of healthcare staffs (both educated and uneducated).

The necessity of education is very much clear when the above results are considered. We can comprehend by the current study that educated healthcare staffs had more positive attitude than the uneducated staffs. All the educated staffs had a positive attitude on having a centralized sterilization facility but the uneducated staffs had only 58.52% positive attitude. 100% of the staffs who were educated had the knowledge of dif-ferent sterilization and disinfection methods and their harmful effects but this result was 73.52% in unedu-cated staffs. 

Almost half of the responding health care workers did not have the awareness of post sterilization handling of surgical instruments according to our study. The per-centage of positive response in using various methods of sterilization monitoring tools was not satisfactory as few people were not aware of it; the result was 87.17% in educated population. Whereas a very poor result had been detected with the similar question from the uneducated staffs, which was 55.88%. Similar type of result was also detected in the attitude level of using distinct methods of disinfectants for processing sur-gical instruments. The positive response was 94.87% in educated staffs whereas 64.70% in uneducated staffs. So, it was very clear that there was a huge gap in awareness and attitude level between the educated and uneducated staffs, this practice brings about great harm to the sick people who would be taken service from the uneducated staffs. The value of education in sterile processing was indicated in a study done by (Ahmed et al., 2017). 

Dispersal of the nurses opinion in percentage regar-ding the central sterile supply department services were very much praiseworthy, which corroborates the value of learning and practical implication in sterile processing (Ahmed et al., 2017). A study done by (Zaman et al., 2021) showed both home and abroad training facilities should be carried out for the heal-thcare staffs to enrich themselves. Hence, there is no alternative of knowledge to provide quality service to the sick people by the healthcare staffs (Alabrah et al., 2021; Zaman et al., 2021). 

Continuous education and training program is necessary for both the educated and uneducated healthcare staffs for raising awareness in sterilization and dis-infection practice. Education and training for the health care staffs must be conducted by the hospital infection prevention and control team/officer regarding proper reprocessing of surgical instruments, at least once per month. The uneducated healthcare staffs need to be focused more as it is perceived that there is a huge gap in the positive awareness and attitude level from the above result. Therefore, educational programs and con-tinuous training programs should be the main factors to overcome the problem.

We would like to thank Mr. M. Kamal Uddin, Managing Director, Medlife Healthcare Limited for his assistance and tremendous support throughout the research work. 

This clear declaration from authors that there are no conflicts with due respect to the publication of this article.