According to Table 1, 40.0 percent of respondents were from Kibuye Hospital, 50.7 percent were males, 63.3 percent were between the ages of 18 and 35 (mean age: 34.7 years, SD: 8.5, minimum age: 20 and maximum age: 58), married (66.0 percent), 58.2 percent had a secondary education level, more than half (50.2 percent) were nurses, and 52.6 percent had less than 5 years of experience.

According to Table 2, the majority (95.8 percent) of respondents knew that disinfection prevents HCAIs, 90.7 percent believed that antiseptic prevents HCAIs, 56.7 percent believe that chemical sterilization is used for all equipment, 63.7 percent believe that physical sterilization (heat/radiation method) is used for all equipment, and 61.4 percent believe that autoclaviation destroys all microorganisms including spores.

The SPSS score assessment was used to assess nine (9) questions related to IPC knowledge, and the score was two (2) marks for a right answer and zero (0) for a false answer. By adding the scores for each respondent across all nine (9) questions, an overall knowledge score was calculated. According to Table 3, 78.6 percent of respondents had a high level of knowledge about IPC, while 21.4 percent had a low level of knowledge about IPC. The mean knowledge score for all respondents was 11.7 out of a possible 18 (standard deviation = 1.4). The minimum and maximum scores were 10 and 16, respectively.

According to the findings in Table 4, 45.1 percent of participants agreed that when caring for a patient, they must be concerned about exposing their family and friends to the risk of infection HCAIs. 58.1 percent of HCWs in their institution are concerned about acquiring HCAIs while caring for patients; 44.2 percent agreed that washing hands before and after contact with patients reduces the risk of acquiring HCAIs; 70.2 percent agreed that PPE protects HCWs from infections. In the absence of standard safeguards, 42.3 percent agreed that Infection and nosocomial diseases can occur in health care facilities, while 34.0 percent disagreed that the threat of occupational infections between health workers in their workplaces is high.

Each respondent's overall score for the setting was calculated by combining the scores of the six (6th) attitude-related questions. The answers were graded on a scale of 0 to 5. The responses were graded on a Likert scale. According to the results in Table 3, 79.5 percent of respondents have a positive attitude toward IPC, while 20.5 percent have a negative attitude toward IPC. The average attitude rating for all respondents was 22.2 (standard deviation = 6.3, minimum score = 6 points, maximum score = 30 points).

The findings in Table 6 revealed that the majority of respondents (97.2 percent) wash their hands before caring for patients, 94.9 percent wash their hands using soap after patient care/contact with fluid, 65.6 percent did not wash their hands without using soap before and after patient care, 88.4 percent were using PPEs from where the majority of respondents (98.1 percent) protect themselves against HCAIs by using gloves, 91.2 percent are wearing face masks, 70.2 percent are wearing face masks, Almost all participants (96.3%) confirmed the presence of written infection control policies and procedures in their workplace, and 55.8 percent recapped needles before disposal. More than half (67.0 percent) had a history of blood, fluid, or stick injury contact. Following that, 39.0 percent of respondents used post-exposure prophylaxis (PEP) after being exposed to blood or sticky injury, 29.2 percent used alcohol to clean themselves, and 51.3 percent washed them with water. In terms of prevention, 91.6 percent of hospitals provided HCAI health education to patients, 95.8 percent confirmed that their hospitals had a competency-based hand hygiene training program, and 97.2 percent acknowledged that supplies needed for hand hygiene adherence are readily available in their patient care areas. (Table 5)

The 'practice' section included ten (10) IPC-related questions that were graded individually for each respondent. If a respondent gave the correct answer, they received two points. If he/she gave a false response, he/she received a zero. Each respondent received an overall practices score by adding the scores from the ten practice-related questions. According to the research findings presented in Table 3, 63.3 percent of respondents had "good practice" towards IPC, while 36.7 percent had "poor practice." The overall mean practice score was 11.8 (SD = 2.1). The minimum score was 10 and the maximum score was 20.

Age, educational level, work experience, level of knowledge, and attitude toward IPC practices were factors that were significantly associated with IPC practice in the bivariate analysis. However, in the multivariate analysis, all variables were found to be meaningfully associated with IPC practice (Table 6). HCWs over the age of 45 were about 3.1 times more likely to engage in infection prevention activities than those between the ages of 18 and 35 (AOR = 3.1; 95 percent CI = (2.16-5.25); p=0.024). In terms of educational level, HCWs with a university level were 3.3 times (AOR = 3.3;95 percent CI = (1.56-7.56); p=0.035) more likely to practice Infection prevention activities as medical staff with diplomas(Table 4.9). Furthermore, HCWs with 5 to 10 years of experience had a higher likelihood of achieving infection prevention practices/activities than those with less than five years of experience (AOR = 1.7; 95 percent CI = (1.37-5.45); p=0.003) (Table 6).

According to multiple regression analysis, the odds of having good practice towards IPC were 2.7 times higher (AOR=2.7; 95 percent CI: (1.68-7.95); p=0.045) among HCWs with a high level of knowledge towards IPC compared to those with a low level of knowledge, and the odds of having good practice towards IPC were 2.3 times higher (AOR=2.3; 95 percent CI: (1.36-7.72); p=0.017) among those with.

According to this study, 78.6 percent of healthcare workers are knowledgeable about infection prevention and control. This result indicates that a high proportion of medical staff in the three hospitals studied have infection prevention and control skills, consistent with similar and related studies in Zambia (74.4 percent) 29. The study finding was better than studies done in Nigeria(65%) 30,Nepal (22%) 31, Palestine (53.9%) 32 and Iran hospital (57%) 33. Due to a difference in knowledge scores; despite being lower than studies done in Bahirdar city, 84.5 percent 27 and in Ethiopia (84.7%) 34, Addis-Abeba 26 and Dessie Referral Hospital (95.7%) 28. This difference could be attributed to a lack of in-service training, a small sample size, or socio-demographic differences.

According to the findings of this study, approximately three-quarters (79.5 percent) of the respondents had positive attitudes toward IPC. This could be because the study was conducted during a novel coronavirus pandemic (COVID-19), during which people were more sensitive to IPC measures. Though, a similar study found a higher percentage (93.4 percent) of HCWs with a positive attitude toward IPC 22. Another study found that a lower percentage (55.6 percent) of HCWs had a positive attitude toward infection prevention 27. The differences observed in these studies could be attributed to differences in the study setting and study participant composition. A positive attitude towards IPC is preferred as it is believed to lead to best practices that are protective for healthcare workers.

According to a study directed in an Egyptian hospital, 63.3 percent of healthcare workers practice good infection prevention and control activities (67.1 percent) 35 and in Bahirdar city(64.2%) 27. However, this is much lower than studies conducted in Dessie referral hospital, Ethiopia (87.5%) 28, Nepal (73.0%) 31 and Palestine (91.1%) 32. This difference could be attributed to differences in infection prevention knowledge, methodology, sample size, socio-demographic differences, a lack of education and infection prevention services, and professional noncompliance with infection prevention.

In this study, age is one of the significant factors in infection prevention and control practice. It showed that health workers older than 45 years were about 3.1 times more likely to practice infection prevention and control activities than those who were 1835 years old. This is comparable with other studies conducted in Northwest Ethiopia 36 and in Wolaitta SodoOtona teaching and referral hospital 22. This could be due to the fact that years of service increase with age, this, in turn, improves their performance over time.

In terms of educational attainment, higher levels of education were positively associated with better infection prevention intervention implementation than lower levels of education. This finding contradicts a study conducted in the Amhara region 36. The difference could be due to sampling size, differences in study participants, or misreporting or self-reporting. This may also be due to the fact that higher educated healthcare workers may have acquired essential information, leading to the acquisition of infection prevention and control courses and trainings 3032.

Furthermore, this study found that work experience is a important factor in the practice of infection prevention and control activities. According to a study conducted in Bahirdar, healthcare workers with 5 to 10 years of experience were 1.7 times more likely to engage in infection prevention and control activities 27. This could be because healthcare workers are continually exposed and gaining experience as the number of years of practice increases.

In addition, up-to-date knowledge and skills in infection prevention and control can increase healthcare professionals' confidence in adhering to suggested procedures and available services. In this study, healthcare workers with a high level of knowledge about IPC were 2.7 times more likely to practice IPC than those with a low level of knowledge. This is consistent with the findings of studies conducted in Northwest Ethiopia 36 and Edo State, Nigeria 30. This could be due to the fact that those who have never received training or consulted various sources of information on IPC are less likely to receive updated information, making it difficult to keep up with infection prevention knowledge.