Assessment of Nurses Knowledge about Transmission and Prevention for Hepatitis B Virus Infection by instruments in Operating Room at Wasit Teaching Hospital

: Background: The hepatitis B virus causes a potentially fatal liver infection called hepatitis B. (HBV). It is a significant global health problem. It can lead to chronic liver disease and infection, as well as an increased risk of death from cirrhosis and liver cancer. Aims of the study: To assess Nurses Knowledge about transmission and prevention of hepatitis B virus infection by instruments in operating room. And find out the relationship between demographic characteristics and the variables. Methodology: A descriptive study was carried out at Al-Zahraa Teaching Hospital and Al-Karama Teaching Hospital in Wasit City, from the period 28 \ September \ 2020 until 6 \ February \ 2021. A non-probability (convenience) sample of (60) nurses working Operating Room in Al-Zahraa Teaching Hospital and Al-Karama Teaching Hospital was used. The tool used in the study was a self-administered structured questionnaire. The data was collected by self-reporting technique. Data was analyzed by using descriptive and inferential statistical data analysis. Results: the study results shows that nurses are with age group of 29-34 year (31±6 years), shows the high percentages were refer to female nurses (83.3%). the majority of the staff are nursing school graduated, shows the year of experience in nursing field is referring to 6-10 year (56.7%). Conclusion: the study concluded that the Knowledge of Nurses' was Poor knowledge; also there is no relationship between Knowledge Regarding prevention of hepatitis B virus in operating room and age and educational level. There was poor knowledge and in total knowledge there is non-significant deferential except in two domain (nurses knowledge about prevention of hepatitis B virus) and (nurses knowledge about Nursing role in operating room to prevent Hepatitis B virus. Recommendations: Training course is necessary to increase nurses’ knowledge toward preventing of HBV in operating room, and regulate continuing education curriculum for all nurses and operating room-specific.


INTRODUCTION
Hepatitis B virus is a DNA virus that replicates in hepatocytes and causes liver damage as a result of the immune system's reaction to the virus. Vertically at birth, horizontally by unprotected intercourse, sharing injecting supplies, and near contact between infants and neonates, the virus is transmitted. Another route of transmission is by unscreened blood products, as blood remains contagious for several weeks after it has been dried. Patients infected with the human immunodeficiency virus (HIV) are often co-infected with HBV due to similar modes of transmission. About two to four million HIV patients are expected to be infected with HBV globally (1) .
Vaccination, the use of protective procedures when handling infectious materials, proper sterilization of medical supplies, and proper waste management will also help to break the chain of infection transmission for hepatitis B. However, studies have shown that there is a significant awareness gap among health professions trainees about the risks of HBV infection in the workplace (2) .
The operating room is a fast-paced, technological environment wherein the perioperative registered nurse must be able to think quickly and accurately, as well as advocate for the patient while the patient is under anesthesia. Working in the operating room is a privilege, and it should always be looked upon as an honor to be the nurse providing optimal care to the surgical patient. This requires the nurse to use not only his or her basic nursing skills, but additional skills, such as aseptic technique, knowledge of surgical procedures, and understanding of specialized equipment that are many times learned on the job (3) .

AIMS OF THE STUDY
To assess Nurses Knowledge about transmission and prevention of hepatitis B virus infection by instruments in operating room. And find out the relationship between demographic characteristics and the variables.

METHODOLOGY
A quantitative design (descriptive study) of the current study was carried out to assess knowledge of Nurses' regarding prevention of hepatitis B virus in operating room from the period Septem er 28th 2020until of Fe ruary 6th, 2021 at Al-Zahraa Teaching Hospital and Al-Karama Teaching Hospital in Wasit City. A non-pro a ility sample of (60) working in Operating Room in Al-Zahraa Teaching Hospital and Al-Karama Teaching Hospital. The tool used in the study was a self-report structured questionnaire. The correct answer of knowledge was given a score (1) and the incorrect answer was scored (0). The test related to nurses' knowledge was carried out during the morning and evening shifts. A out (20-30) Minutes were given to each nurse for test completion. It consisted of two parts: Demographic data (5) items. Knowledge of HBV (31) items, which consist of general knowledge about of HBV, strategy for controlling and preventive measures of HBV. The results were analyzed through the application of statistical Package of Social Sciences analysis (SPSS). The analysis of this ta le shows that nurses are with age group of 29-34 year (31±6 years) (47.7%). Regarding gender varia le, high percentages were refer to female nurses (83.3%). The study indicates in this table that 56.7% are graduated from nursing secondary school, and shows the year of experience in nursing field is referring to 6-10 year (56.7%). Participation in training courses a out prevention of viral hepatitis B, only 20% is participated.

DISCUSSION
The analysis of table (1) shows that nurses are with age group of 29-34 year (31±6 years) (47.7%). This study is consistent with a study conducted (4) , they found in their study that 36.7% of the study at age 30-39 years old.
Regarding gender varia le, high percentages were refer to female nurses (83.3%).this study agreement with study (5) , they found in their study The participation group consisted of 179 female students (77%) and 54 male students (23%).
Ta le (2) shows that regarding Qualification: The study indicates that 56.7% are graduated from nursing secondary school. This study agree with the study (6) , show the level of basic education of health workers in White Nile hospitals was significantly associated with the knowledge about HBV prevention. Regarding Years of experience in nursing: The study results show the year of experience in nursing field is referring to 6-10 year (56.7%), The finding of this study disagree with that of the study done (7) shows that high proportion (58%) of nurses had experience of 1-5 years, and only 4% of the sample had experience of 20-25 years. Regarding Participation in courses about infection control, the study show participation in training courses about prevention of viral hepatitis B, only 20% is participated. This result is incompatible with (8) which indicated that more than half of nurses (55%) take (1-5) training course.  (4) shown the study findings of this study presents the assessment of nurses knowledge measures taken to prevent infection after exposure to needle stick, are showing poor level of knowledge. (11) Indicated that a out half of the respondents (50.6%) knew they should not recap the needle with two hands to prevent needle stick injury, and they should dispose of the used needle and syringe into a sharp container immediately without recapping the needle (47.1%).
Also study (12) shows that nurses have poor knowledge and practices regarding needle stick injury, only few nurses (17.1%) applied preventive measures after getting needle stick Injury.
Table (5) depicts that there is no significant relationship etween nurses' knowledge and their age. This study consistent with study done (13) that shows no significant statistical differences were found between mean knowledge scores towards age. Also the findings of the study done (14) posited that the level of knowledge was not significantly associated with age.

CONCLUSION
The study concluded that the Knowledge of Nurses' was Poor knowledge; also there is no relationship between Knowledge Regarding prevention of hepatitis B virus in operating room and age and educational level. There was poor knowledge and in total knowledge there is non-significant deferential except in two domain (nurses knowledge about prevention of hepatitis B virus) and (nurses knowledge about Nursing role in operating room to prevent Hepatitis B virus.

RECOMMENDATIONS
Training course is necessary to increase nurses' knowledge toward preventing of HBV in operating room (15) , and regulate continuing education curriculum for all nurses and operating room-specific.