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Results for “Universal Precautions”

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At least 127 records · Page 7Linked to original sources
PubMed1994

Compliance with universal precautions and needle handling and disposal practices among emergency department staff at two community hospitals.

BACKGROUND: To describe rates of needle disposal and barrier use within the emergency departments at two privately owned community hospitals in two suburbs of Minneapolis, a study was conducted. This study consisted of direct observation of a cohort of emergency department personnel providing patient care followed by a self-administered survey of the same personnel. METHODS: From June through August 1990, seven specially trained registered nurses observed emergency department personnel for a total of 400 hours. The observers documented the appropriate rates of use of gowns, goggles, masks, and gloves. Observers also noted methods of needle disposal and frequency of needle recapping. After observation, surveys that included items requesting estimates of rates of use for each barrier, as well as estimates of the rates and methods of needle recapping and disposal, were distributed. For each observed and corresponding self-reported behavior, 95% confidence intervals were calculated and compared. RESULTS: A total of 1,822 procedures were recorded. Gloves were observed to be used when appropriate 67.2% of the time, followed by goggles (50.7%), masks (16.0%), and gowns (15.3%). Self-reported barrier rates were slightly higher in all cases except for goggle use. About one third (34.4%) of the needles were recapped; 78.1% of these were recapped two-handed. CONCLUSIONS: Previous studies have documented low universal precautions compliance rates at urban teaching hospitals. Our data indicate less than optimal levels of compliance also at community hospitals, and show that personnel are less than fully aware of their own noncompliance.

Emergency Service, Hospital↗
PubMedDate not supplied

A participatory learning module: asepsis and universal precautions.

Mastery of medical and surgical asepsis principles is mandatory for nurses in today's health care environment. The authors report on the development, implementation, and evaluation of a multimedia asepsis module incorporating universal precautions. Practical application of the content, using graphics, medical supplies, and video, occurs in the four-station participatory learning module. Student evaluations of this learning module are positive.

Asepsis↗
PubMed1995

Universal precautions for the otolaryngologist: techniques and equipment for minimizing exposure risk.

HIV infection transmitted from a patient to a surgeon is a real concern but a remote possibility. However, given the professional and personal impact of HIV seroconversion on a physician, preventive measures need to be instituted. The CDC has developed a policy of universal precautions to help to minimize this risk. We review various measures to institute this policy and other measures that can reduce exposure to HIV. These protocols, when instituted, can maximize safety for all health care professionals and their patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Adoption of guidelines for Universal Precautions and Body Substance Isolation in Canadian acute-care hospitals.

The impact of recently recommended hospital infection control guidelines on Canadian acute-care hospitals is unknown. A confidential cross-sectional mailed survey of all acute-care Canadian hospitals was conducted to determine rates of receipt and adoption of published guidelines for Universal Precautions (UP) or Body Substance Isolation (BSI), rationale for adoption and knowledge of costs and benefits. Five hundred and seventy-nine of 943 sites (61%) responded (exceeding 80% in urban centers); 94% among hospitals with at least 300 beds and 57% among those under 300 beds. Seventy-four percent of responders claimed adoption of UP (65%) or BSI (9%), staff protection being their primary motivation. Adoption of either UP or BSI was associated with size (p less than .001), increasing progressively from 45% in the smallest group (less than 25 beds) to 84% in the largest (greater than or equal to 500 beds). Many hospitals introduced modifications and some substituted names other than UP or BSI in adopting a new strategy. In practice, UP and BSI now mean different things in different hospitals, and the distinction between them has become blurred. Furthermore, only 5% claiming adoption of a new strategy adopted all of the fundamental policies expected under UP or BSI. Receipt of guidelines was also correlated with size: one-third of hospitals under 200 beds had not received key publications defining UP and BSI. Only 19% claiming adoption of a new strategy indicated knowledge of cost implications. These results suggest a need for closer collaboration among hospitals and government agencies in developing uniform infection control policies, and for systematic evaluation of the cost and effectiveness of new strategies.

Body Fluids↗
PubMed1991

Universal precautions and mortuary practitioners: influence on practices and risk of occupationally acquired infection.

Embalming, the most common funeral practice in the United States, may expose the embalmer to infectious diseases and blood. We surveyed the 860 members of the National Selected Morticians in 1988 to estimate the incidence of self-reported occupational contact with blood and infectious disease, assess morticians' knowledge of acquired immunodeficiency syndrome (AIDS), determine their adherence to universal precautions, and identify predictors of practices designed to reduce risk of occupational exposure to infections. Of 539 (63%) respondents, 212 (39%) reported needle-stick injuries in the past 12 months, and 15 (3%) reported percutaneous exposures to the blood of a decedent with AIDS. Those rating the risk of occupationally acquired human immunodeficiency virus infection as very high or high (194/539 [36%]) were more likely to decline funerals of decedents with antemortem diagnosis of AIDS (59/194 [30%]) and/or to charge more for such funerals (133/194 [69%]) than those who rated the risk as low to moderate (31/345 [9%], 174/135 [51%]).

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Universal precautions in pain medicine: a rational approach to the treatment of chronic pain.

The heightened interest in pain management is making the need for appropriate boundary setting within the clinician-patient relationship even more apparent. Unfortunately, it is impossible to determine before hand, with any degree of certainty, who will become problematic users of prescription medications. With this in mind, a parallel is drawn between the chronic pain management paradigm and our past experience with problems identifying the "at-risk" individuals from an infectious disease model. By recognizing the need to carefully assess all patients, in a biopsychosocial model, including past and present aberrant behaviors when they exist, and by applying careful and reasonably set limits in the clinician-patient relationship, it is possible to triage chronic pain patients into three categories according to risk. This article describes a "universal precautions" approach to the assessment and ongoing management of the chronic pain patient and offers a triage scheme for estimating risk that includes recommendations for management and referral. By taking a thorough and respectful approach to patient assessment and management within chronic pain treatment, stigma can be reduced, patient care improved, and overall risk contained.

Analgesics↗
PubMed1990

Adverse exposures and universal precautions practices among a group of highly exposed health professionals.

An anonymous national survey of a representative population of healthcare workers who were thought likely to have frequent and intensive exposures to blood and other body fluids (certified nurse-midwives [CNMs]), was conducted to assess the type and frequency of self-reported occupational exposures to blood and body fluids experienced, the extent to which barrier precautions and other infection control measures were used, whether or not reported use of barriers was associated with a lower perceived rate of exposures and factors that influenced the use of infection control procedures. Of those responding, 74% had soiled their hands with blood at least one time in the preceding six months, 51% had splashed blood or amniotic fluid in their faces and 24% reported one or more needlestick injuries during that same period. Our study also found evidence of an association between the practice of needle recapping and the occurrence of needlestick injury (p = .003). Despite a high level of training and knowledge, only 55% reported routinely practicing universal precautions (UPs). Several factors that potentially influenced the use of UPs were studied, including healthcare worker perceptions of risk of occupational bloodborne infection, knowledge of routes of transmission of bloodborne pathogens and rationale for not using appropriate barriers. Our data suggest that occupational exposures occur frequently and that healthcare workers' (HCWs') perceptions of risk for occupational infection play an important role in influencing use of UPs. This study emphasizes the importance of developing new strategies for UP training.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Prevalence of human immunodeficiency virus and hepatitis B virus in unselected hospital admissions: implications for mandatory testing and universal precautions.

The prevalence of human immunodeficiency virus (HIV) and hepatitis B virus in serial unselected hospital admissions was determined to examine the potential efficacy of a system of universal blood and body fluid precautions versus a system based on selected or unselected screening. Serum was obtained from 616 (97%) of the 636 patients admitted during a 1-month period and interviews were completed on 540. Of the 616, 23 (3.7%) were confirmed positive for HIV, and 12 (2.0%) of 612 for hepatitis B surface antigen. Of 33 infected persons, only 8 were known to be positive on admission and only 22 were in "high-risk" groups; therefore, selective precautions would not have been effective. Mandatory testing would have required 1216 tests to identify 25 infected persons and would leave in doubt the presence of other transmissible diseases. On the basis of these data, it appears that universal precautions are a logical system of infection control.

Communicable Disease Control↗