Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Universal Precautions”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2001

Noncompliance of health care workers with universal precautions during trauma resuscitations.

BACKGROUND: Universal precautions during resuscitations are mandated by hospital regulations. We documented adherence to universal precautions during trauma resuscitations at our level I trauma center. METHODS: During trauma resuscitations, a medical student using an elevated viewing platform observed health care workers (HCWs) for the use of barrier precautions (BPs): gloves, masks, gowns, and eyewear. Only HCWs having direct patient contact were included. The purpose of the observation was not disclosed to those being observed. RESULTS: In 12 resuscitations involving 104 HCWs, none had 100% compliance with BPs. Compliance rates for individual BPs were gloves, 98%; eyewear (any type), 52%; gowns, 38%; masks, 10%; and eyewear (with side protectors), 9%. Resuscitations in which bleeding was observed involved 59 HCWs with 38% compliance; only 2 used full BPs. No difference in compliance rates occurred during the study period. CONCLUSIONS: Experienced trauma care HCWs are cavalier regarding blood-borne disease exposure risks. Measures to encourage (or force) compliance are needed.

Emergency Medicine↗
PubMed1996

A work-systems analysis of compliance with universal precautions among health care workers.

Universal precautions are work practices designed to protect health care workers from occupational exposure to HIV and other bloodborne pathogens. However, despite aggressive dissemination efforts by CDC and regulatory action by OSHA, compliance remains less than satisfactory. This article argues that the minimization of risk from bloodborne pathogens requires a multilevel or work-systems perspective that considers individual, job/task, and environmental/organizational factors. The available literature on universal precautions suggests the potential of such an approach and provides insight into the limited success of current worker-focused mitigation efforts. In particular, specific opportunities exist to develop and apply engineering controls, to improve the design and organization of jobs and tasks, and to create organizations that facilitate and reinforce safe behavior.

Blood-Borne Pathogens↗
PubMed1996

Blood and body fluid exposures during clinical training: relation to knowledge of universal precautions.

To investigate the relation between knowledge of universal precautions and rates of exposure to blood and body fluid during clinical training, a cohort of 155 students was surveyed following training in universal precautions and 18 months later. A total of 127 students (82%) participated; 58 (46%) experienced at least one exposure during the first clinical training year. Knowledge of universal precautions was inversely associated with the frequency of mucous membrane exposures (p .001); an apparent "dose-response" effect was evident (one-way analysis of variance; F = 5.2, p - 0.007). Students are frequently exposed to blood and body fluid during clinical training. Higher levels of retained knowledge about universal precautions are associated with a decreased risk of mucous membrane exposure.

Health Knowledge, Attitudes, Practice↗
PubMed2004

Universal precautions: a survey of community nurses' experience and practice.

BACKGROUND: Universal precautions are a set of guidelines which aim to protect health care workers from blood-borne infections. Community nurses often have to deliver care to people in less than ideal home conditions, their ability to comply with all universal precautions may therefore be compromised. AIMS AND OBJECTIVES: This paper presents the findings of a questionnaire survey which aimed to explore community nurses' experience and practices of using universal precautions. DESIGN AND METHODS: A questionnaire survey was used for this study. All community learning disability nurses, community mental health nurses and generic community nurses from one Welsh Health Authority were surveyed (n = 543) with a response rate of 70%. RESULTS: The majority of community nurses reported compliance with universal precautions, although a small number of nurses stated that they re-sheathed needles, inappropriately stored sharps containers, inadequately wore gloves and experienced difficulties in handwashing. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: Community nurses work in a unique and unpredictable environment, which may result in nurses being unable to comply with existing universal precautions guidelines. The production of new infection control guidelines for the community by the National Institute of Clinical Excellence in June 2003, has addressed some of the difficulties faced by community nurses.

Attitude of Health Personnel↗
PubMedDate not supplied

Universal precautions: improving the knowledge of trained nurses.

Universal precautions relate to the management of blood-borne viruses such as human immunodeficiency virus (HIV) and hepatitis B and C. Advice on the transmission of blood-borne viruses and the precautionary measures used to reduce or eliminate cross-infection have been addressed by national and professional bodies. There is a significant amount of research which assesses trained nurses' knowledge of universal precautions and includes understanding of the transmission routes of blood-borne viruses and the measures required to prevent cross-infection. However, the majority of the literature indicates an incomplete knowledge among trained nurses of the principles and application of universal precautions. The ability of the trained nurse to fulfil his/her role as health educator, teacher and therefore effective infection control practitioner is questioned by the literature. This article discusses the role of education in improving the knowledge of trained nurses and considers the implementation of in-service training and preregistration education.

Body Fluids↗
PubMed1995

Universal precautions training of preclinical students: impact on knowledge, attitudes, and compliance.

BACKGROUND: Little information exists regarding the impact of universal precautions training programs on preclinical students' knowledge, attitudes, and behavior. METHODS: We developed, implemented, and assessed an educational program in universal precautions for 2nd-year medical and preclinical physician assistant students. Students (n = 170) completed pre- and post-training questionnaires to assess universal precautions knowledge and to evaluate attitudes about their perceived risk for bloodborne pathogen infection, the importance of universal precautions procedures, and their willingness to provide care for human immunodeficiency virus (HIV)-positive or acquired immune deficiency syndrome (AIDS) patients. Phlebotomy, intravenous catheter insertion, and arterial blood gas sampling techniques were demonstrated, practiced, and evaluated during practical training sessions. Outcome measures included changes in pre- and posttraining knowledge scores and attitudes, as well as observed compliance with universal precautions during practical training. RESULTS: Universal precautions knowledge scores increased significantly after training (P < 0.0001). Personal assessments of the risk of developing HIV due to patient care significantly decreased (P < 0.0001) and willingness to provide care for AIDS patients increased (P = 0.004) following training. Importantly, students reported that high expected rates of contact with HIV-positive and other patient groups would not significantly affect their specialty choice. Observed compliance with universal precautions procedures during practical training ranged from 95 to 99% for glove use, 76 to 77% for direct sharps disposal without needle recapping, and 56 to 78% for handwashing after glove removal during phlebotomy and intravenous catheter insertion. CONCLUSIONS: This program is effective in increasing students' knowledge of universal precautions. Training favorably affects students' willingness to care for HIV-positive patients and their assessed risk of developing occupational bloodborne infection.

Blood Specimen Collection↗
PubMed1998

Compliance with universal precautions: knowledge and behavior of residents and students in a department of obstetrics and gynecology.

OBJECTIVES: To assess the knowledge of universal precautions for the delivery and operating rooms by residents and students and to evaluate their use of universal precautions. STUDY DESIGN: Obstetrics and gynecology (ob/gyn) residents (n = 30) and students (n = 31) from an inner-city, teaching hospital were polled by anonymous questionnaire to assess their knowledge of the appropriate barrier equipment for certain ob/gyn procedures. To determine actual compliance with universal precautions, 459 ob/gyn procedures were observed. We noted the use of appropriate barrier equipment for each procedure: gloves for pelvic exam and face shields, gowns, gloves, and booties for vaginal delivery, cesarean delivery, and dilation and curettage. The True Epistat statistical software program was used to perform simple regression analysis. RESULTS: Thirty residents (100%) knew the appropriate barrier equipment required for each type of procedure performed. One student (< 1%) did not know that booties were appropriate for the surgical procedures. Rationale for lack of compliance with universal precautions elicited by the questionnaire included time constraints (64%), inconvenience (52%), and presumption that patient was not infected (34%). The observed rate of compliance with universal precautions by participants indicates that individual compliance was inversely related to the years of experience (overall compliance rate of students was 96%; for first-year residents, 92%, second-year residents, 89%, third-year residents, 84%, fourth-year residents, 78%; r = -0.9918, P = 0.0009). CONCLUSIONS: Knowledge regarding universal precautions was nearly 100%, while overall observed compliance was only 89%. Compliance with universal precautions was better among students (96%) than among residents (88%). Compliance with universal precautions was inversely related to years of experience.

Clinical Competence↗
PubMed1993

Senior medical students' knowledge of universal precautions.

BACKGROUND: Few data exist concerning the assessment of medical students' knowledge of universal precautions. The purpose of this study was to assess what students know--immediately before they graduate--about universal-precautions procedures. METHOD: The 151 fourth-year students of the class of 1992 at the University of Washington School of Medicine were given a questionnaire one week before graduation. They were asked to indicate the protective equipment required to safely complete ten common clinical procedures. For each procedure, the proportion of students who correctly indicated the protective equipment was calculated. RESULTS: The questionnaires were completed by 137 (91%) of the students. The mean percentage of correct answers by the responding students was 67%. For five of the ten procedures, from 104 to 123 (76-90%) of the students reported the proper levels of protection. For the remaining five procedures, from 58 to 75 (42-55%) of the students knew the proper levels of protection. CONCLUSION: The results of the survey are worrisome, because many students--immediately before they graduated--lacked adequate knowledge of universal precautions regarding the ten common clinical procedures. More emphasis on universal precautions during undergraduate medical education is needed.

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

Compliance with universal precautions in a medical practice with a high rate of HIV infection.

BACKGROUND: Universal precautions have been recommended to limit occupational exposure to the human immunodeficiency virus (HIV) and other infectious agents, but whether these recommendations have been incorporated into routine practice has not been demonstrated. METHODS: Using a one-group, before-after design, we assessed the knowledge and attitudes concerning universal precautions and the level of compliance with these recommendations. The health care professionals had various levels of training and worked in an ambulatory practice with a high rate of HIV. A total of 195 procedures involving potential exposure to various body fluids were observed. RESULTS: No improvement in compliance with recommended precautions was observed following a didactic educational program for either latex glove use (44 percent versus 49 percent, chi 2 less than 1, P greater than 0.2) or appropriate use of hand washing (34 percent versus 47 percent, chi 2 = 3.38, P = 0.07). Faculty demonstrated the lowest levels of adherence to universal precautions. While knowledge of precautions was high, staff members at all levels overestimated their own compliance with these recommendations. CONCLUSIONS: Although the number of observations limits the conclusions, the results suggest that the basic protective measures included in universal precautions are not being routinely applied in ambulatory medical practice. Furthermore, didactic educational programs might not be sufficient to improve compliance. Finally, faculty in training programs should monitor their own compliance with universal precautions because of their responsibilities as role models for physicians in training.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Compliance with universal precautions among pediatric residents.

BACKGROUND: There are few data on the rate of compliance with universal precautions among pediatricians. We hypothesized that compliance in pediatrics would be poor because of the intrinsic difficulties in performing invasive procedures in small subjects. DESIGN: Prospective, observational study. SETTING: Tertiary care children's hospital. STUDY PARTICIPANTS: A convenience sample of pediatric house staff. MAIN OUTCOME MEASURES: Pediatric house staff members were observed while performing invasive procedures. Procedure type, number of attempts required, and patient's age and diagnosis were recorded. Degree of compliance with universal precautions was judged by means of Centers for Disease Control and Prevention guidelines. Comparisons between the compliant and noncompliant groups were analyzed by chi2 and 2-tailed t test. RESULTS: A total of 128 procedures performed by 43 house officers, 4 advanced medical students, and 3 chief residents or fellows were observed. Sixty-nine (53.9%) of the 128 procedures were performed correctly according to universal precaution guidelines. Rate of compliance did not appear to be influenced by small patient size, as judged by the lack of association with the age of the patient (mean+/-SD, 4.8+/-5.7 years among those in whom universal precautions were properly used vs 4.9+/-5.4 years among patients in whom precaution guidelines were breached; P=.96). Moreover, the number of attempts required in compliant procedures (1.31+/-0.53) was almost identical to that in noncompliant procedures (1.28+/-0.49; P=.73). Additionally, compliance did not improve with advanced level of training. CONCLUSIONS: Failure of compliance among pediatricians has no apparent association with procedure difficulty, and compliance rates continue to be poor through the course of pediatric training. These findings underline the need for effective education concerning universal precautions throughout pediatric residency, and they suggest that such efforts will not be precluded by obstacles intrinsic to performing invasive procedures on young subjects.

Humans↗
PubMed1993

Occupational exposure to bloodborne diseases and universal precautions: measurement of health care workers' self reported attitudes.

1. As the numbers of persons infected with bloodborne diseases continues to increase, it is paramount that all health care workers exhibit behaviors reflecting unerring compliance with universal precautions. 2. Physicians and RNs who are highly trained in bloodborne diseases and universal precautions, who have the tools available for universal precautions, and who are exposed to people with bloodborne diseases, are overwhelmingly not complying with universal precautions. 3. To better understand how attitudes impact behaviors, a valid and reliable tool was developed which measured health care workers' attitudes toward bloodborne diseases and universal precautions. 4. Training programs addressing attitudes and knowledge may help change health care workers' non-compliant behaviors into behaviors reflecting compliance with universal precautions.

Blood-Borne Pathogens↗
PubMed2001

Knowledge and performance of the universal precautions by nursing and medical students in Korea.

BACKGROUND: Like the health care workers, nursing and medical students have to go through clinical practices; accordingly, they run a high risk of being exposed to bloodborne diseases. But there are few studies on the realities of preventive education or measures to be taken after exposure to such diseases. The purpose of this study was to identify a knowledge of universal precautions and their performance in practice among the nursing and medical students in Korea. METHOD: This study was based on survey questionnaires with a total of 714 nursing and medical students for the period between November 2, 1998, and April 30, 2000. RESULTS: The average knowledge level of the universal precautions was 267.8 +/- 21.3 (scores ranged from 150 to 300). The knowledge level of the universal precautions of the nursing students (270.4 +/- 19.4) was higher than that of the medical students (261.0 +/- 24.4; P =.000). The average performance level of the universal precautions was 52.7 +/- 6.2 (scores ranged from 14 to 70). The students of the nursing college showed a higher performance level of the universal precautions (53.2 +/- 5.9; P =.002). The correlation between knowledge and performance of the universal precautions showed a weak and positive correlation (r =.317; P=.000). CONCLUSION: The study demonstrated that the knowledge level of the nursing students about universal precautions was relatively higher than that of medical students. The group that receives education about universal precautions has a higher level of knowledge and performance of the universal precautions than that group that receives no such education. The education about universal precautions is indispensable; it is desirable to raise the relative importance for the curriculum of both nursing and medical colleges.

Cross Infection↗
PubMed1992

Healthcare workers' risk of contact with body fluids in a hospital: the effect of complying with the universal precautions policy.

OBJECTIVE: To test whether healthcare workers' knowledge of and compliance with the basic principle of the Universal Precautions policy (i.e., that all patients should be treated equally regarding contact with body fluids) influenced the rate of contact with patient blood. DESIGN: Survey based on anonymous questionnaires. SETTING: A 380-bed secondary and tertiary care hospital receiving emergency and elective patients. PARTICIPANTS: All employees having any contact with patients. Nine hundred one of 1,308 (69%) of the questionnaires were returned. RESULTS: Twelve percent of the respondents (95% confidence interval [CI95] = 10.0%-14.4%) had experienced any contact with patient blood in the week preceding their answer. Physicians had the highest rate of contact with blood followed by nurses. In the five groups--physicians, nurses, laboratory technicians and phlebotomists, nursing aides, and student nurses--contact with blood was less frequent in the subgroup that did know and comply with the basic principle of the Universal Precautions policy, compared with the subgroup that did not. When adding the results for the 5 groups, contact with blood was experienced by 91 of 571 (15.9%, CI95 = 13%-19%) of the personnel who did not know and comply with Universal Precautions. The personnel who did know and comply with Universal Precautions had a significantly lower (9 of 111 [8.1%], p < .05, CI95 = 3.8%-15%) rate of contact with blood. CONCLUSIONS: The healthcare workers who knew and complied with Universal Precautions had a significant lower rate of contact with patient blood than those who did not.

Blood↗
PubMedDate not supplied

Universal precautions--do Irish anaesthetists comply?

BACKGROUND: Anaesthetists are at high risk from blood-borne pathogens. Universal Precautions (UP) include the routine use of appropriate barrier precautions and techniques to reduce the likelihood of exposure to blood, body fluids and tissues that may contain pathogens. The compliance of Irish anaesthetists with these precautions has not been studied. AIM: To study the attitudes of Irish anaesthetists to Universal Precautions. METHOD: A postal questionnaire was sent to 210 anaesthetists currently practising in Ireland. The questionnaire was based on a model used in Australia and New Zealand. RESULTS: There was a 50% response rate to the survey. Only 15% of respondents had taken a risk history from a patient in the preceding four weeks. Resheathing of needles was commonplace. The effectiveness of hepatitis B immunisation was rarely checked and only 66% of respondents believe implementation of Universal Precautions to be practical. CONCLUSION: Irish anaesthetists comply poorly with Universal Precautions.

Anesthesiology↗
PubMed1999

Occupational exposures and knowledge of universal precautions among medical students.

PURPOSE: To examine the relationship between occupational exposures and knowledge of universal precautions among medical students. METHOD: Graduating medical students were given a survey regarding occupational exposures suffered during their clinical rotations. The survey also tested students' knowledge of universal precautions by asking them to indicate what combination of gloves, mask, and eyeshields should be worn to satisfy universal precautions for ten common procedures. RESULTS: At a seminar one week before graduation, 45 senior medical students were given the questionnaire. The response rate was 100% 84% of the surveyed students suffered at least one occupational exposure during their clinical training. Of those who had an exposure, 42% reported at least once to an exposure center. The mean percentage of correct answers on the protective equipment questionnaire was 71%. No correlation between number of exposures and score on the protective equipment questionnaire was found (r = 0.0). CONCLUSION: Occupational exposures to blood are common among medical students. Few students report to exposure centers. Knowledge of universal precautions may not correlate with reduced risk of occupational exposures among medical students.

Curriculum↗
PubMed1990

Universal precautions to prevent HIV transmission to health care workers: an economic analysis.

The universal precautions recommended by the US Centers for Disease Control (CDC), Atlanta, for the prevention of HIV (human immunodeficiency virus) transmission to health care workers are widely accepted, despite little documentation of their effectiveness and efficiency. We reviewed the evidence on the risk of HIV transmission to hospital workers and the effectiveness of the universal precautions. We also evaluated the costs of implementing the recommendations in a 450-bed acute care teaching hospital in Hamilton, Ont. On the basis of aggregated results from six prospective studies the risk of HIV seroconversion among hospital workers after a needlestick injury involving a patient known to have AIDS (acquired immune deficiency syndrome) is 0.36% (upper 95% confidence limit 0.67%); the risk after skin and mucous membrane exposure to blood or other body fluids of AIDS patients is 0% (upper 95% confidence limit 0.38%). We estimated that 0.038 cases of HIV seroconversion would be prevented annually in the study hospital if the CDC recommendations were followed. The incremental cost of implementing the universal precautions was estimated to be about $315,000 per year, or over $8 million per case of HIV seroconversion prevented. If all HIV-infected workers were assumed to have AIDS within 10 years of infection the of the program would be about $565,000 per life-year saved. When less conservative, more probable assumptions were applied the best estimate of the implementation cost was $128,862,000 per case of HIV seroconversion prevented. The universal precautions implemented in the study hospital were not found to be efficacious or cost-effective. To minimize the already small risk of HIV transmission in hospitals the sources of risk of percutaneous injury should be better defined and the design of percutaneous lines, needles and surgical equipment as well as techniques improved. Preventive measures recommended on the basis of demonstrated efficacy and aimed at routes of exposure that represent true risk are needed.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Universal precautions: costs for protective equipment.

BACKGROUND: The amount and costs of protective equipment used to implement universal precautions in Thailand have not previously been studied. METHODS: A cross-sectional study was done to determine the frequency of clinical and laboratory procedures requiring universal precautions and the amount of protective equipment needed for each. RESULTS: The study was performed in 24 government hospitals in Thailand in December 1993. Totaling 6549 beds, these hospitals had provided service to 357,391 inpatients and 3,411,122 outpatients during the previous year. The annual number of procedures performed in these hospitals was estimated at 17.5 million, with expenditures for protective equipment of $2.4 million (U.S.) per year. The average overall cost for protective equipment was U.S. $5.37 for one inpatient stay and U.S. $0.15 for one outpatient visit. The projected national expense for these barriers was U.S. $41.5 million per annum. The cost for these barriers after the implementation of universal precautions was 2.5 times the cost before implementation. CONCLUSIONS: Overuse of sterile and examination gloves and gowns and underuse of heavy-duty gloves, masks, aprons, goggles, and boots were discovered during the study. Appropriate use of disposable and reusable universal precautions equipment would free health care dollars for other purposes.

Costs and Cost Analysis↗
PubMedDate not supplied

Knowledge and practice of universal precaution in a tertiary health facility.

BACKGROUND: The increased risk of health workers to contract HIV, hepatitis B and C viruses in their work place led to the development of universal precaution or infection control policy. This policy where applied, has been found to reduce the risk of contracting these infections in the work place. The aim of this study is to determine the knowledge and practice of this policy in University of Nigeria Teaching Hospital (UNTH), Enugu. METHODS: This study was cross-sectional in design. Subjects were health workers likely to be exposed to body fluid. The study tool was a self administered pre-tested questionnaire. Statistical analysis was done using SPSS version 11.5 software. RESULTS: Two hundred and forty six health workers participated in the study, consisting of 150 females and 96 males. The male to female ratio was 1: 1.6. Majority of the respondents were between ages 20-49 years. One hundred and twenty four (50.4%) of the respondents were aware of universal precaution, while 88 (35.8%) knew the correct definition of universal precaution. Thirty four (13.8%) had received training on universal precaution however no ward attendant was trained. On multiple regression (P = 0.049) and training (P = 0.006) were the variables that were predictive of correct definition of universal precaution. Hands gloves were used by 86.6% of the respondents, 32.9% did not re-sheath needles and 43.9% practiced appropriate hand washing. CONCLUSION: The level of knowledge and compliance with precaution by health workers in UNTH Enugu is low. Low level of training and unequal training exposure among the various occupations contributes to this.

Adult↗