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1996-02-27
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Document 0252
DOCN M9630252
TI Compliance with universal precautions among health care workers at three
regional hospitals.
DT 9603
AU Gershon RR; Vlahov D; Felknor SA; Vesley D; Johnson PC; Delclos GL;
Murphy LR; Department of Environmental Health Science, Johns Hopkins;
University, the School of Hygiene and Public Health, Baltimore,; MD
21205-2179, USA.
SO Am J Infect Control. 1995 Aug;23(4):225-36. Unique Identifier : AIDSLINE
MED/96026633
AB OBJECTIVE: To assess and characterize self-reported levels of compliance
with universal precautions among hospital-based health care workers and
to determine correlates of compliance. DESIGN: Confidential
questionnaire survey of 1716 hospital-based health care workers.
PARTICIPANTS: Participants were recruited from three geographically
distinct hospitals. A stratified convenience sample of physicians,
nurses, technicians, and phlebotomists working in emergency, surgery,
critical care, and laboratory departments was selected from employment
lists to receive the survey instrument. All participants had direct
contact with either patients or patient specimens. RESULTS: For this
study, overall compliance was defined as always or often adhering to the
desired protective behavior. Eleven different items composed the overall
compliance scale. Compliance rates varied among the 11 items, from
extremely high for certain activities (e.g., glove use, 97%; disposal of
sharps, 95%) to low for others (e.g., wearing protective outer clothing,
62%; wearing eye protection, 63%). Compliance was strongly correlated
with several key factors: (1) perceived organizational commitment to
safety, (2) perceived conflict of interest between workers' need to
protect themselves and their need to provide medical care to patients;
(3) risk-taking personality; (4) perception of risk; (5) knowledge
regarding routes of HIV transmission; and (6) training in universal
precautions. Compliance rates were associated with some demographic
characteristics: female workers had higher overall compliance scores
than did male workers (25% of female and 19% of male respondents circled
always or often on each of the 11 items, p < 0.05); and overall
compliance scores were highest for nurses, intermediate for technicians,
and lowest for physicians. Overall compliance scores were higher for the
mid-Atlantic respondents (28%) than for those from the Southwest (20%)
or Midwest (20%, p = 0.001). CONCLUSIONS: This study supports earlier
findings regarding several compliance correlates (perception of risk,
knowledge of universal precautions), but it also identifies important
new variables, such as the organizational safety climate and perceived
conflict of interest. Several modifiable variables were identified, and
intervention programs that address as many of these factors as possible
will probably succeed in facilitating employee compliance.
DE Blood-Borne Pathogens Chi-Square Distribution *Cooperative Behavior
Disease Transmission, Patient-to-Professional/*PREVENTION & CONTROL
Female Human HIV Infections/PREVENTION & CONTROL Knowledge,
Attitudes, Practice Logistic Models Male Mid-Atlantic Region
Midwestern United States Motivation Odds Ratio Organizational Culture
*Personnel, Hospital Risk-Taking Socioeconomic Factors Southwestern
United States Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S.
*Universal Precautions JOURNAL ARTICLE MULTICENTER STUDY
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).