Infection Prevention and Control Practices Among Primary Healthcare Nurses Regarding COVID-19 in Saudi Arabia
Conditions: COVID-19 Pandemic
Sponsor: King Saud University

 
 
 
Infection Prevention and Control Practices among Primary Healthcare Nurses 
Regarding COVID-19 in Saudi Arabia 
 
 
 
 
 
 
 
Ayat Zammar & Sami Al-Hamidi  
 
 
 
 
 
 
 
15/09/2021 
 
 
 
 
 
 
 
 
 

Infection Prevention and Control Practices among Primary Healthcare Nurses 
Regarding COVID-19 in Saudi Arabia 
 
Zammar, Ayat1, Al-Hamidi, Sami2 
1Riyadh, General Directorate of Health Affairs, supply department, Al-Rabwa District, Bin Badis Street. Tel: 
+966114919708. e-mail: zammarawrad@gmail.com. 
2Riyadh, King Saud university, Nursing college, Building 24, second floor. 
Tel: +966118063913. e-mail: salhamidi@ksu.edu.sa. 
 
Abstract 
Background: Healthcare providers, particularly nurses, are at risk of infection as part of the 
COVID-19 epidemic chain since they assist in the disease's containment. By recognising the 
risk factors for infection and implementing suitable measures to reduce these risks, all 
reasonable efforts should be taken to control the spread of infection to them. The major aim 
of the present study was to determine the level of infection prevention and control practises 
used by primary healthcare nurses in Saudi Arabia during the COVID-19 pandemic. 
Materials and Methods: This study used a quantitative cross-sectional design to examine 198 
healthcare professionals and community health nurses who worked in primary health 
facilities in southwest Riyadh and were randomly recruited. In this study, a self-administered 
questionnaire was employed to collect data. Demographic information, sources of COVID-19 
information, and COVID-19 infection prevention and control measures were all included of 
the questionnaire. SPSS software was used to perform descriptive and inferential statistical 
methods. In order to recruit subjects, the researcher followed ethical guidelines. 
Results: The study shows that social media is the most prevalent source of information about 
COVID-19, followed by seniors and other co-workers. Furthermore, 94.5% of the 
participants wear a facemask, and 32.8% wash their hands with running water and 
handwashing liquid. Participants' age, income, and work experience were all found to be 
important factors linked with COVID-19 prevention activities. 
Conclusion: Healthcare professionals' COVID-19 practises are generally recognised. Nurses 
and other primary care professionals should pay more attention to and make greater attempts 
to adhere to preventive measures such as personal protective equipment. Policymakers in 
primary healthcare and the Ministry of Health should monitor healthcare providers' practises 
regarding COVID-19 prevention measures, as well as the compliance procedure. 
Keywords: Infection Prevention, Infection Control, Practices, Primary Healthcare Nurses, 
COVID-19, Pandemic. 
 
 

Introduction 
Globally, viral infections continue to emerge; these diseases are regarded as dangerous in the 
perspective of public health. In the last 12 years, epidemics such as the Severe Acute 
Respiratory Syndrome Coronavirus (SARS-CoV), the Middle East Respiratory Syndrome 
Coronavirus (MERS-CoV), and H1N1 influenza have developed [1]. Nowadays, the 
pandemic of new coronavirus illness (COVID-19) is regarded as a severe global threat, with 
34,804,348 confirmed cases and 1,030,738 fatalities [2]. There have been 335,997 confirmed 
cases of COVID-19 in Saudi Arabia, with 4850 fatalities [3]. 
COVID-19 is extremely infectious, thus, the optimal strategy for containing the pandemic is 
to implement preventative measures concurrently with the development of breakthrough 
cures [4]. Additionally, the widespread spread of emerging and re-emerging communicable 
diseases is a significant risk and serious challenge for nurses and other healthcare providers 
due to a lack of awareness of the threat posed by these diseases, as well as limited compliance 
with infection prevention and control practises [5]. 
The fact that healthcare providers, particularly nurses, are at risk of infection is crucial 
because they may be able to assist in containing the outbreak. As a result, all feasible 
precautions must be done to prevent the transmission of infection to nurses, beginning with 
the identification of risk factors for infection and progressing to the implementation of 
suitable risk reduction measures [5]. It is widely recognised that overcrowding, the absence 
of isolation room facilities, and environmental pollution all contribute to disease transmission 
among nurses and other healthcare personnel. This, however, is likely exacerbated by some 
nurses' insufficient awareness of infection protection techniques [6]. 
Knowledge about a disease may impact nurses' knowledge, attitudes, and practises, and 
improper attitudes and actions may result in an increase in infection risk [7]. Understanding 

nurses' knowledge, attitudes, and behaviours related to infection and preventive measures and 
practises may aid in predicting the results of intended behaviour. Thus, the primary objective 
of this study is to determine the degree of infection prevention and control techniques used by 
primary healthcare nurses in Saudi Arabia during the COVID-19 pandemic. 
Recent research in underdeveloped nations have found a low level of compliance with 
appropriate infection control procedures and basic precautions. In impoverished nations, a 
lack of proper control methods, resources, and regulation has been noted as a large and 
significant issue that creates hurdles to infection management [8]. Measures and preventive 
standards for COVID-19 infection and prevention have been developed based on experience 
and knowledge gained while responding to outbreaks such as MERS-CoV or SARS-CoV [9]. 
According to existing data, SARS-CoV-2 is genetically identical to SARS-CoV22–24, but it 
has a distinct mode of transmission and other features [10, 11]. As a result, there is a critical 
need to improve nurses' knowledge and behaviours addressing COVID-19-specific infection 
prevention and control methods. This information must be accessible in order to take a 
significant step toward evaluation. Furthermore, current studies have not assessed nurses' 
knowledge and practises regarding infection prevention and control practises for COVID-19 
in primary healthcare facilities in Saudi Arabia, which could result in an increase in disease 
transmission due to non-adherence to these measures and practises. 
The major objective of this study is to determine the amount of infection prevention and 
control methods used by primary healthcare nurses in Saudi Arabia during the COVID-19 
pandemic. Specific objectives were: 
1. To identify the sources of knowledge and associated information among nurses on 
infection control strategies for COVID-19. 

2. To examine community healthcare nurses' infection prevention and control methods during 
the COVID-19 pandemic. 
3. To evaluate the relationship between the infection prevention practices of primary 
healthcare nurses and their demographic characteristics. 
Methods 
Study Design  
This study used a quantitative cross-sectional design. This study was conducted at primary 
health care clinics located in southwest Riyadh. There are 25 of these facilities. The present 
study's population included healthcare practitioners and community health nurses who 
worked at the aforementioned centres. There are 800 nurses in total. 
The determined sample size was 207 healthcare providers. The researcher recruited study 
participants from primary healthcare centres using a straightforward sampling strategy. The 
current study included male and female healthcare practitioners with at least one year of 
experience and who worked in all areas of primary healthcare facilities during the COVID-19 
epidemic. Healthcare providers that are unwilling to participate in the present study have 
been eliminated. In this study, 198 out of 207 participants (95.6%) answered the survey 
questionnaire. This response rate is regarded to be outstanding, as the researcher actively 
urged study respondents to participate. 
Research Instrument 
Data were collected from community health nurses using a questionnaire that was adapted 
from other researchers [12_14]. The questionnaire's first section asked for demographic 
information such as gender, age, the name of the primary healthcare centre, and level of 

education. The second section comprised sources of knowledge on COVID-19; respondents 
replied on a scale of 1 least used (1), occasionally (2), more frequently (3), and most used 
(4). The third section had six items pertaining to nurses' infection prevention and control 
methods with reference to COVID-19, and respondents replied on a scale of yes (2), 
occasionally (1), and no (0). Permission to use the questionnaire has been requested from the 
author and is awaited. 
In order to get feedback on the questions and make sure the questionnaire was reliable, a pilot 
study with 30 healthcare practitioners was done. For Face and content validity, the 
questionnaire was reviewed and confirmed to be adequate by a panel of professional nurses 
with expertise and understanding of research methodologies. The questionnaire was reviewed 
and confirmed to be adequate by a panel of professional nurses with expertise and 
understanding of research methodologies. For Instrument reliability, Cronbach's coefficient 
alpha was used to determine reliability coefficients for the majority of uses. 
Data Analysis 
Demographic data, such as age, gender, experience, and educational level, were maintained 
as categories and numerical variables. The demographics were coded numerically in the 
questionnaire. To address the study topics and analyse the connection between demographic 
data and nurses' knowledge, attitude, and practise, inferential statistics such as the 
independent sample t test and one-way ANOVA were utilised. Significance level was set at 
p<0.05 value indicating a significant connection.  
Results 
Participants’ Demographic  

Table 1 depicted the distribution of study participants by gender, age group, marital status, 
and income level. According to the table, more than half (57.6%) of the present study's 
participants were male, while 42.4% were female. Additionally, more than half (50.4%) of 
research participants were between ages of 30 and 39, and 40.4% are under the age of 30. In 
terms of marital status, more over half (61.6%) of the survey participants were married, while 
35.9% were single. Additionally, 81.8% of research participants earned above 10,000 SAR, 
while 12.6% earn between 5,000 and 10,000 SAR. 
Table 1: Sample Distribution according to the Participants’ Demographics. 
Variables 
Number 
Percentage (%) 
Gender 
Male 
114 
57.6 
Female 
84 
42.4 
Age Groups 
<30 years  
80 
40.4 
30 – 39 years 
100 
50.5 
40 – 49 years 
14 
7.1 
50 years or more 
4 
2.0 
Marital Status 
Married 
122 
61.6 
Single 
71 
35.9 
Divorced 
5 
2.5 
Income 
<5000 SAR 
11 
5.6 
5000 - <10000 
25 
12.6 
≥10000 
162 
81.8 
Job Category 
Nurses  
62 
31.3 
Others 
136 
68.7 
Years of Experience 
0 – 5 years 
85 
42.9 
6 – 10  
36 
18.2 
>10 years 
77 
38.9 
 

The distribution of study participants by educational level and years of experience is shown 
in Table 1. According to the data, more than half (74.0%) of the participants in this survey 
hold a diploma (less than a bachelor's degree), whereas 26.0% hold a bachelor's degree or 
higher. Additionally, 47.0% of study participants had fewer than five years of experience, 
while 53.0% had more than five years. 
Source of Information Regarding COVID-19 
Table 2 summarised the sources of knowledge on COVID-19 prevention methods. Social 
media was the most often cited source (69.25%), followed by seniors and other co-workers 
(61.25%). Newspapers and magazines were the least often cited sources (44.75%). 
Table 2: Mean, SD and Percentage of Participants’ Source of Information regarding COVID-19. 
Source 
Mean 
SD 
% 
Social Media 
2.77 
0.98 
69.25 
Seniors & Other Colleagues 
2.45 
0.95 
61.25 
Seminars & workshops 
2.30 
0.99 
57.50 
Radio & television 
2.15 
0.99 
53.75 
Posters & Pamphlets 
2.11 
0.94 
52.75 
Newspapers & Magazines 
1.79 
1.00 
44.75 
 
Preventive Practices Measures in COVID-19 Pandemic 
Table 3 summarised the mean and SD of each participant's practises. The chart indicated that 
94.5% wore a facemask in crowds, 92.5% discarded used tissues, and 92.5% covered their 
noses and mouths with tissues while sneezing or coughing. Additionally, 91.0% of 
participants washed their hands constantly with soap or hand sanitizer. 82.0% of them, on the 
other hand, taught their patients about the illness. 
 
 

Table 3: Frequency, Mean, and Percentage of Participants’ Preventive Practices Measures in COVID-19 
Pandemic. 
Participants’ Practices 
No 
(%) 
Sometimes 
(%) 
Yes  
(%) 
Do you educate your patient about the disease? 
11 
(5.6) 
49  
(24.7) 
138 
(69.7) 
Do you use facemask in crowds? 
3  
(1.5) 
14  
(7.1) 
181 
(91.4) 
Do you avoid touching your eyes, nose or mouth as 
far as you can? 
9 
 (4.5) 
38 
 (19.2) 
151 
(76.3) 
Do you throw the used tissue in the trash? 
4 
 (2.0) 
21 
 (10.6) 
173 
(87.4) 
Do you cover your nose and mouth with a tissue 
during sneezing or coughing? 
0  
(0.0) 
28  
(14.1) 
170 
(85.9) 
Do you use soap or hand sanitizer to wash your 
hands continuously? 
2  
(1.0) 
30  
(15.2) 
166 
(83.8) 
 
The techniques adopted by participants to wash their hands on duty were visualized in Fig 1. 
According to the data, 32.8% cleansed their hands with running water and handwashing 
liquid, 29.8% used alcohol hand rub, 14.1% used running water and a skin disinfectant, and 
13.1% used running water and bar soap. 
 
Figure 1: Methods which are Used by the Participants when Washing their Hands on Duty. 
 
Circumstances of Wearing a Medical Utility  
The results showed that 65.2% of the participants wore medical utilities during prescribing 
drugs, 20.0% of them wore medical utilities when using the computer, desk, or patient‐care 
equipment in the ward, while 11.6% wore medical utilities when making clinical rounds. 
Circumstances of Washing Hands on Duty 
The results displayed that 98.5% of the participants washed their hands before meals, 94.9% 
of them washed their hands before performing invasive bedside procedures, 92.9% of them 

washed their hands between two different procedures on different patients, while 90.4% 
washed their hands before and after examining patients. 
Personal Protective Equipment 
Figure 2 showed the percentage of wearing personal protective equipment among study 
participants. About 77.9% of the participants wore a mask, 62.88% of them wore a surgical 
mask, 60.48% wore gloves, while 42.17% wore a gown. 
Figure 2: Personal Protective Equipment 
Table 4 demonstrated a significant difference in the mean score of participants' behaviours 
for COVID-19 preventative measures by age group (p<0.01). The post hoc test with Tukey 
test revealed a difference in mean level of practises between those aged 30–39 years and 
those aged less than 30 years, with those aged 30–39 years having a significantly higher mean 
level of practises than those aged less than 30 years. On the other hand, there is no 
statistically significant variation in the mean score of participants' practises regarding 
COVID-19 preventative measures by gender or married status (p>0.05). 
The table demonstrates a significant difference in the mean score of participants' practises for 
COVID-19 preventative interventions by income level (p<0.01). The post hoc Tukey test 
revealed a difference between those with incomes below 5000 SAR and those with incomes 
between 5000 and 100,000 SAR, with those with incomes between 5000 and 100,000 SAR 
having a substantially greater mean level of practises than those with incomes below 5000 
SAR. 
The table demonstrates a statistically significant difference in the mean score of participants' 
behaviours for COVID-19 preventative measures based on their job experience (p<0.01). The 
post hoc Tukey test revealed that there is a difference between those with 0–5 years of 
experience and those with >10 years of experience, with those with >10 years of experience 

having a considerably higher mean level of practises than those with 0–5 years of experience. 
On the other hand, there is no statistically significant variation in the mean score of 
participants' behaviours regarding COVID-19 preventative measures by job type (p>0.05). 
Table 4: Differences in the Participants Practices about Preventive Measures about COVID-19 with regard to 
their Demographics. 
Preventive Measures 
N 
Mean 
SD 
t/f statistics (df) 
p value1 
Gender 
Male 
114 
1.77 
0.30 
-1.465 (196) 
0.145a 
Female 
84 
1.83 
0.24 
Age groups 
<30 years  
80 
1.72 
0.31 
3.952 (3, 194) 
0.009b 
30 – 39 years 
100 
1.85 
0.19 
40 – 49 years 
14 
1.83 
0.39 
50 years or more 
4 
1.62 
0.43 
Marital status 
Married 
122 
1.82 
0.27 
2.845 (2, 195) 
0.059 b 
Single 
71 
1.74 
0.28 
Divorced 
5 
1.96 
0.07 
Income 
 
 
 
 
 
<5000 SAR 
11 
1.56 
0.41 
4.672 (2, 195) 
0.010a 
5000- <10000 SAR 
25 
1.78 
0.30 
 
 
≥10000 
162 
1.81 
0.25 
 
 
Work experience 
 
 
 
 
 
0 – 5 years  
85 
1.72 
0.30 
9.387 (2, 195) 
0.000a 
6 – 10 years 
36 
1.74 
0.28 
 
 
> 10 years 
77 
1.90 
0.20 
 
 
Job category 
 
 
 
 
 
Nurses 
62 
1.85 
0.25 
3.590 (2, 196) 
0.060b 
Others 
136 
1.77 
0.28 
 
 
a Independent sample t test, b One-Way ANOVA 
Differences in Wearing Gloves 
Table 5 revealed that there was a significant difference in the mean score of participant 
practises concerning wearing gloves based on gender (p<0.01). Wearing gloves had a 
considerably higher mean score among female participants than among male participants. A 
significant difference existed between the mean scores of participants' practises related to 

wearing gloves, and this difference is related to their age groups. A post hoc Tukey test 
revealed a significant difference in the mean level of glove wearing between people under the 
age of 30 and those 30 to 39 years old, with the latter group having a considerably greater 
degree of glove wearing than the former. Wearing gloves, on the other hand, did not differ 
significantly in the mean score depending on marital status (p>0.05). 
With relation to the practise of wearing gloves, Table 5 demonstrated a significant variation 
in the mean score of participants depending on their income (p<0.01). A post hoc Tukey test 
revealed a significant difference in the mean level of glove wearing between people with an 
income of less than 5000 SAR and those with an income of more than 10,000 SAR, with the 
other group having a considerably higher mean level. However, the mean score for wearing 
gloves did not change significantly based on participant experience or job group (p>0.05). 
Differences in Using Mask 
When it comes to mask use behaviours, men and women have significantly different mean 
scores (p<0.01), as seen in Table 5. Female participants' mean score for mask use 
was substantially greater than male participants. Additionally, there was no statistically 
significant variation in the mean score of participants' habits regarding the use of masks 
based on their age group (p>0.05) or marital status (p>0.05). 
With regard to their earnings, there was a significant difference in the mean score for 
participants' behaviours of using masks (p<0.001). According to the results of a post-hoc 
Tukey test, there was a significant difference between those with incomes under 5000 SAR 
and those with incomes of 10,000 SAR or more in terms of the mean level of mask use. 
However, the mean score of utilising masks does not change significantly based on 
participant experience or job category (p>0.05). 
 

Differences in Using N95 Respirator 
The mean score of individuals who practised using a N95 respirator was significantly 
different depending on their age group (p<0.001). One-way ANOVA revealed that 
individuals 30-39 years of age had considerably greater mean values of N95 respirator use 
than those 30-39 years of age, with the other group having significantly lower mean values of 
N95 respirator use. However, the mean score of participants' behaviours of using a N95 
respirator did not change significantly based on gender or marital status (p>0.05). 
Wearing a N95 respirator differed significantly from using a standard respirator in terms of 
participant experience (p<0.01). A post hoc Tukey test revealed a difference between those 
with 6-10 years of experience and those with more than 10 years of experience, with those 
with more than 10 years of experience using N95 respirators had a considerably higher mean 
value than those with 6-10 years of experience. In addition, the mean score of participants 
differed greatly depending on their job category when it comes to wearing a N95 respirator 
(p<0.001). The average rate of N95 respirator use among nurses was much greater than that 
of other healthcare personnel. However, the mean score of individuals who used the N95 
respirator did not change significantly depending on their income (p>0.05). 
Differences in Using Surgical Mask 
On the basis of gender, age group, or marital status, there were no significant differences in 
the mean scores’ participants have regarding using surgical masks (p>0.05) (Table 5). A 
comparison of participant habits for wearing a surgical mask and their income showed a 
significant difference in the mean score (p<0.05). The difference between those with an 
income of less than 5000 SAR and those with an income of more than 100,000 SAR was 
shown by a post hoc Tukey test, which revealed that those with an income of more than 
100,000 SAR had a substantially greater mean level of surgical mask use than those with an 

income of less than 5000 SAR. The mean score of participants' practises on using a surgical 
mask did not change significantly depending on their level of expertise or job type (p>0.05). 
Differences in Wearing Goggles 
The results demonstrated that there were no gender, age, or marital status effects on the 
average score of participants' goggles using practises (p>0.05). A comparison of participant 
behaviours regarding the use of goggles and their income showed a significant difference in 
the mean score (p<0.01). The post hoc Tukey test revealed a difference between those with 
those with an income of less than 5000 SAR and those with an income of more than 10,000 
SAR, with those with an income of more than 10,000 SAR having a substantially greater 
mean scores of goggles use than those with an income of less than 5000 SAR. The mean 
score of participants' practises on wearing goggles did not change significantly based on their 
prior experience or job type (p>0.05). 
Differences in Wearing Apron 
No significant differences were found among participants in terms of gender, age, or marital 
status when it came to the mean score for practising apron use (p>0.05). With reference to 
their income, participants' behaviours of wearing an apron reveal a significant difference in 
the mean score (p0.01). A post hoc Tukey test revealed a significant difference in the mean 
level of apron use between those with incomes under 5000 SAR and those with incomes 
above 10000, with those with income over 10000 having considerably higher mean rates. The 
mean score of participants' behaviours concerning wearing an apron does not change 
significantly depending on their level of expertise or job type (p>0.05). 
Differences in Wearing Gown 
A comparison of participant practises concerning wearing gown indicated a significant 
difference in mean scores across age groups (p<0.01). A post hoc Tukey test revealed a 

significant difference in the mean level of apron use between those under 30 and those 30-39 
years old, with those 30-39 years old had a considerably higher mean level.  A look at the 
results indicated that there was no significant difference in the mean score between men and 
women when it comes to how often they wear gowns. 
A significant difference between participants' mean scores on gown practises and their 
income was seen in the table 5 (p<0.01). One-way ANOVA revealed that there was a 
significant difference between people with incomes under 5000 SAR and those with incomes 
over 10000 SAR in that those who earned more than 10000 SAR had a considerably higher 
mean of gown use. 
And the mean score for participants differed greatly when it comes to their experience with 
gown (p<0.01). Tukey's post-hoc analysis revealed a significant difference between those 
with experience ranging from 0 to 5 years and those with experience of more than 10 years 
(those who have experienced 10 years had a greater mean level of gown use than those with 
experience of 0 to 5 years). To make matters more interesting, the mean score of participants 
varied markedly depending on the job type (p<0.01). The average of gown use among nurses 
seemed to 
be 
much 
greater 
than 
that 
among 
other 
healthcare 
personnel.

Table 5: Differences in the Participants Practices about Personal Protective Equipment with regard to their Demographics 
 
Gloves 
Mask 
N95 Respirator 
Surgical Mask 
Demographics 
N 
Mean 
SD 
t/f (df) 
p1 
N 
Mean 
SD 
t/f (df) 
p 
N 
Mean 
SD 
t/f (df) 
p 
N 
Mean 
SD 
t/f (df) 
p 
Gender 
Male 
114 
2.17 
1.43 
-2.989 
 (196) 
0.003a 
114 
2.94 
1.43 
-2.163 
 (196) 
 
0.032a 
 
114 
1.18 
1.06 
-0.414  
(196) 
0.679a 
114 
2.35 
1.55 
-1.688 (196) 
0.093a 
Female 
84 
2.75 
1.19 
84 
3.34 
1.03 
84 
1.25 
1.14 
84 
2.72 
1.44 
Age Groups 
<30 years  
80 
2.20 
1.30 
5.497  
(3, 194) 
0.001b 
80 
3.07 
1.29 
2.547 
 (3, 194) 
0.057b 
80 
0.81 
0.81 
7.785  
(3, 194) 
0.000b 
80 
2.28 
1.51 
2.488  
(3, 194) 
0.062b 
30 – 39 years 
100 
2.75 
1.27 
100 
3.28 
1.15 
100 
1.50 
1.16 
100 
2.79 
1.42 
40 – 49 years 
14 
1.64 
1.69 
14 
2.42 
1.74 
14 
1.64 
1.39 
14 
1.92 
1.81 
50 years or more 
4 
1.25 
1.25 
4 
2.25 
2.06 
4 
0.50 
0.57 
4 
2.25 
2.06 
Marital Status 
Married 
122 
2.35 
1.36 
1.034 
 (2, 195) 
0.357b 
122 
3.09 
1.36 
0.067 
 (2, 195) 
0.936b 
122 
1.25 
1.11 
0.372  
(2, 195) 
0.690b 
122 
2.48 
1.57 
0.286  
(2, 195) 
0.752b 
Single 
71 
2.47 
1.37 
71 
3.15 
1.19 
71 
1.12 
1.10 
71 
2.53 
1.43 
Divorced 
5 
3.20 
1.09 
5 
3.20 
1.09 
5 
1.40 
0.54 
5 
3.00 
1.41 
Income 
<5000 SAR 
11 
1.09 
1.37 
5.972  
(2, 195) 
0.003a 
11 
1.63 
1.43 
8.212 
 (2, 195) 
0.000a 
11 
1.00 
0.63 
2.297 
 (2, 195) 
0.103a 
11 
1.36 
1.43 
3.508 
 (2, 195) 
0.032a 
5000- <10000 SAR 
25 
2.64 
1.11 
25 
3.20 
1.00 
25 
1.64 
1.25 
25 
2.48 
1.19 
≥10000 
162 
2.47 
1.35 
162 
3.20 
1.26 
162 
1.16 
1.09 
162 
2.59 
1.54 
Work Experience 
<30 years  
85 
2.41 
1.29 
0.243  
(2, 195) 
0.784a 
85 
3.08 
1.23 
1.798 
 (2, 195) 
0.168a 
85 
0.88 
0.89 
7.091 
 (2, 195) 
0.001a 
85 
2.41 
1.50 
0.462 
 (2, 195) 
0.631a 
30 – 39 years 
36 
2.55 
1.27 
36 
3.47 
0.99 
36 
1.44 
1.10 
36 
2.69 
1.41 
40 – 49 years 
77 
2.36 
1.48 
77 
2.98 
1.44 
77 
1.46 
1.22 
77 
2.54 
1.58 
Job Category 
Nurses 
62 
2.67 
1.26 
1.810 (196) 
0.072b 
62 
3.19 
1.22 
0.569 
 (196) 
0.570b 
62 
1.66 
1.18 
4.020 
 (196) 
0.000b 
62 
2.67 
1.39 
1.016 (196) 
0.311b 
Others 
136 
2.30 
1.39 
136 
3.08 
1.32 
136 
1.00 
0.99 
136 
2.44 
1.56 
1 significant, p < 0.05, a One-Way ANOVA, b Independent sample t test 
 

Continue 
 
Goggles Mask 
Apron 
Gown 
Demographics 
N 
Mean 
SD 
t/f (df) 
p1 
N 
Mean 
SD 
t/f (df) 
p 
N 
Mean 
SD 
t/f (df) 
p 
Gender 
Male 
114 
1.06 
1.09 
-1.085  
(196) 
0.279a 
114 
1.05 
1.08 
-0.042 
 (196) 
0.966a 
114 
1.60 
1.31 
-1.017 (196) 
0.310a 
 
 
Female 
84 
1.25 
1.35 
84 
1.05 
1.19 
84 
1.79 
1.31 
 
Age Groups 
<30 years  
80 
0.88 
1.04 
2.425 (3, 194) 
0.067b 
80 
0.88 
1.04 
1.595 (3, 194) 
0.192b 
80 
1.37 
1.24 
3.889 (3, 194) 
0.010b 
 
 
 
 
 
30 – 39 years 
100 
1.31 
1.27 
100 
1.17 
1.128 
100 
1.97 
1.30 
 
 
 
40 – 49 years 
14 
1.50 
1.45 
14 
1.35 
1.54 
14 
1.71 
1.43 
 
 
 
50 years or more 
4 
0.75 
0.95 
4 
0.50 
1.00 
4 
0.75 
0.95 
 
 
 
Marital Status 
Married 
122 
1.18 
1.17 
0.351 (2, 195) 
0.704b 
122 
1.02 
1.10 
0.298 (2, 195) 
0.742b 
122 
1.6557 
1.27 
0.298 (2, 195) 
0.742b 
 
 
 
 
 
Single 
71 
1.05 
1.30 
71 
1.08 
1.20 
71 
1.7183 
1.40 
 
 
 
Divorced 
5 
1.40 
0.54 
5 
1.40 
0.54 
5 
2.0000 
1.22 
 
 
 
Income 
<5000 SAR 
11 
0.90 
1.04 
5.656 (2, 195) 
0.004a 
11 
1.27 
0.90 
5.633 (2, 195) 
0.004a 
11 
1.09 
1.04 
9.633 (2, 195) 
0.000a 
 
 
 
 
 
5000- <10000 SAR 
25 
1.88 
1.36 
25 
1.72 
1.24 
25 
2.68 
1.10 
 
 
 
≥10000 
162 
1.04 
1.16 
162 
0.93 
1.09 
162 
1.57 
1.29 
 
 
 
Work Experience 
<30 years  
85 
0.92 
1.14 
2.659 (2, 195) 
0.073a 
85 
0.91 
1.11 
1.132 (2, 195) 
0.324a 
85 
1.37 
1.28 
6.439 (2, 195) 
0.002a 
 
 
 
 
 
30 – 39 years 
36 
1.16 
1.10 
36 
1.19 
1.14 
36 
2.27 
1.27 
 
 
 
40 – 49 years 
77 
1.36 
1.29 
77 
1.14 
1.14 
77 
1.75 
1.27 
 
 
 
Job Category 
Nurses 
62 
1.3226 
1.23 
1.427 (196) 
0.155b 
62 
1.27 
1.14 
1.846 (196) 
0.066b 
62 
2.06 
1.19 
2.775 (196) 
0.006b 
 
 
 
 
 
Others 
136 
1.0588 
1.19 
136 
0.95 
1.11 
136 
1.51 
1.33 
 
 
 
1 significant, p < 0.05, a One-Way ANOVA, b Independent sample t test 
 

Discussion 
Source of Information regarding COVID-19 
The survey found that social media was the most prevalent source of knowledge on COVID-
19, followed by colleagues and seniors, while newspapers and periodicals were the least 
common. As Saqlaina et al. [12] found, the media is the primary source of knowledge on 
COVID-19 in the United States. On the other hand, the findings of Saqlaina et al. [12] 
suggested that the World Health Organization and Centres for Disease Control were the most 
prevalent sources of information for the general public, while the television was the source of 
information for the general population. 
It also was consistent with the findings of Wang et al. [15], who found that COVID-19 was 
widely disseminated over the internet and social media. Many individuals, including nurses 
and other healthcare practitioners, regard media sources like Facebook and WhatsApp to be 
the primary sources for information. This might be a contributing factor in the current study's 
findings. Other types of social media, such as Facebook and Twitter, were deemed more 
convenient than reading newspapers and magazines when it comes to learning about 
pandemic diseases. 
Participants’ Practices about Preventive Measures about COVID-19 
According to the findings of the present study, 94.5% of participants used facemasks while in 
large groups, and 92.5% of them tossed the used tissues in the garbage after using them. In 
addition, 91.0% of the participants washed their hands with soap or hand sanitizer on a daily 
basis. While 82.0% of them educated their patients on the condition, preventive measures 
were practised 89.5% of the time, which is regarded excellent. Health care professionals in 
the research by Saqlaina et al. [12] were found to have outstanding COVID-19 practises. 

Another research in Uganda, by Olum et al. [13], found that only 23% to 28% of healthcare 
practitioners had a solid understanding of COVID-19 infection and preventive control 
techniques. As Zhang and colleagues [16] found that 90.7% of health care professionals 
adhered to correct infection and preventive control procedures for COVID-19, the current 
findings were likewise in line with their findings. According to Saqlain et al. [12], hand 
washing with soap was the most common good habit (96.10%), and it was found that 
95.4% and 85.7% of healthcare providers washed their hands constantly, respectively, 
although the current results are not comparable [17, 18]. 
According to Nour et al. [17], 95.4% and 85.7% of nurses and healthcare professionals used 
to wash their hands continually. However, in the research of which the findings were 
identical, different results were found. Deressa et al. [18] found that the most common 
practise among healthcare workers was to use facemasks. These findings are similar with the 
current findings. Face masks have been shown to be the most commonly used technique of 
preventing infection among healthcare workers and nurses, based on the results of the present 
study. Because of this, they were more likely to employ this strategy. While 82.0% of them 
educate their patients on the condition. This suggests that the staff at this hospital were just 
not doing enough health education to avoid COVID-19 on a daily basis. The findings of 
Saqlain et al. [12] suggested that 95.4% of participants educate their patients about the 
condition, which is not consistent with this study's findings. 
Personal Protective Equipment 
According to current findings, 77.9% of participants used a mask; 62.8 % of those used 
surgical masks; 60.4% wore gloves; and 42% wore gowns. These findings were in line with 
the findings presented above, which showed that the most effective technique entailed the use 
of a facemask. According to Oladele et al. [20], 20.6% of nurses used facemasks, which 
would be significantly lower than this study's findings. Most recommendations for infection 

prevention and control encouraged the use of surgical masks and N95 respirators for all 
aerosol-transmitted operations by health care workers, hence the participants in this research 
were more likely to use facemasks on a regular basis [5]. 
Personal safety equipment, such as face masks and gowns, were in insufficient supply, 
according to the present findings. The high number of COVID-19 cases might be a factor in 
this, as they limit the supply of personal protective equipment for healthcare workers, 
particularly nurses. 
Demographic factors and nurses’ practises regarding COVID-19 
It turned that the mean score of participants' preventative measures for COVID-19 varied 
considerably by age group, with those aged 30 to 39 having a much higher mean level of 
practises than those aged under 30. With regard to gender and marital status, there was no 
significant variation in the mean score of participants' practises regarding COVID-19 
preventative measures. 
There was a substantial correlation between age and COVID-19 preventative measures, with 
the 31-39-year-old age group being a key determinant for excellent practise for COVID-19, 
according to Saqlain et al. [12]. In the current study, healthcare practitioners between the ages 
of 30 and 39 had a considerably higher mean level of practises. Health care practitioners in 
this age group were characterised by a high level of activity and attention to preventative 
measures. Furthermore, the bulk of participants in this study were healthcare practitioners 
between the ages of 30 and 39. So it might have a considerable impact on the average degree 
of practises for each individual. 
According to Saqlain et al. [12], there was no significant correlation between gender and 
behaviours related to COVID-19 preventative measures when looking at participants' gender 
and their preventive measures. Both male and female nurses utilised the same COVID-19 

preventive measures and procedures, which may explain why there was no significant 
correlation between gender and nursing practises. 
This study found that COVID-19 preventative measures practises differed considerably 
among participants based on their income, with those earning between 5,000 and 10,000 SAR 
having a significantly greater mean level of practise than those earning below 5,000. Those in 
this income bracket were more likely to stick around because they were more satisfied than 
those in lower-income groups. 
There was also a significant difference in the mean score of participants' COVID-19 
preventive measures practises based on their work experience, with those with more than ten 
years of experience having a significantly higher mean level of practises than those with less 
than five years of experience. Similarly, Saqlain et al. [12] found that experience and 
behaviours related to COVID-19 prevention were linked. Compared to healthcare 
professionals with less than 10 years of experience, healthcare providers with more than 10 
years of experience were more knowledgeable and aware of COVID-19 prevention measures, 
leading to greater adherence to COVID-19 prevention procedures. Healthcare practitioners 
with fewer than 5 years of experience, on the other hand, require further training in 
preventative measures. 
Study participants' habits regarding COVID-19's preventative measures did not change 
significantly based on their job classification. However, this study's findings were not in line 
with those of Saqlain et al. [12], who found a correlation between job category and 
behaviours related to COVID-19 prevention. As a result, just 31.3% of participants were 
nurses, while 68.7% were other healthcare workers; this indicated that the two 
professions were not interchangeable. 
 

Conclusion 
Healthcare practitioners' overall procedures involving COVID-19 were acceptable, according 
to the findings of the research. With running water and hand-washing liquid, one third of 
healthcare providers washed their hands; with an alcohol hand rubs, less than a third of them 
do so. The age, income, and number of years of experience of healthcare practitioners were 
all linked to their COVID-19 practises.  Nurses and other healthcare workers in primary care 
should be aware of these implications. 
Preventive measures, such as wearing personal protective equipment (PPE), should be a 
higher priority for primary care nurses and other healthcare personnel. Those who adhere to 
these preventative measures should serve as role models for patients and the general public. 
Personal protective equipment, comprising gloves, apron, gown, and mask, should be utilised 
by healthcare personnel. In addition, nurses and other healthcare professionals should 
familiarise themselves with COVID-19 practises. They need to put this new information into 
practise on a regular basis. 
Implications For Health Policy and Primary Healthcare 
COVID-19's preventative measures should be monitored by health officials in primary care 
and the ministry of health, and the process of compliance should be monitored in-service. In 
order to raise the knowledge of healthcare practitioners regarding these behaviours, 
educational and training methods must be used. There should be a greater focus on healthcare 
practitioners with less than six years of experience. Those who earn less than 5,000 SAR 
should also be considered. Nurses and other healthcare workers should be encouraged to use 
personal protection equipment by policymakers. Personal protection equipment for nurses 
and other healthcare workers should be provided to primary healthcare facilities by the 
ministry of health. 

Limitations 
Nurses and other healthcare professionals had been the focus of this research. In this study, 
there were no distinct categories of healthcare professionals, which makes it impossible to 
compare the results to other groups. In addition, the number of nurses in this study is quite 
low when compared to that of other types of healthcare professionals. Although this study 
used a self-reported questionnaire to collect data, alternative approaches may have been more 
accurate in determining the amount of practise of participants. 
Author contribution 
Ayat Mohammad Zammar (AM): Conducted the literature search and wrote the paper. 
 
Sami Abdul Rahman Al-Hamidi (SA): Editing of writing. 
Ethical approval 
Ethical Approval has been taken from King Saud University 
No: KSU-HE-21-35 
Date: 02-02-2021  
Sources of funding 
No source of funding. 
Registration of research studies 
1. Name of the registry: 
2. Unique Identifying number or registration ID: 
3. Hyperlink to your specific registration (must be publicly accessible and will be checked): 
Guarantor 

Ayat Mohammad Zammar 
Sami Abdul Rahman Al-Hamidi  
Consent 
Written informed consent was obtained from the patient for publication of this case report 
and accompanying images. A copy of the written consent is available for review by the 
Editor-in-Chief of this journal on request 
Provenance and peer review 
Not commissioned, externally peer-reviewed. 
CRediT authorship contribution statement 
Ayat Mohammad Zammar: Data curation, Formal analysis, Software, Writing - original draft, 
Writing - review & editing. 
 Sami Abdul Rahman Al-Hamidi: Editing of the paper. 
Declaration of competing interest 
No conflicts of interest. 
 
 
 
 
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