Improving compliance with universal precautions: effectiveness of interventions.
AAOHN J 1995 Jul; 43(7):362-370
A comprehensive literature review was undertaken to identify effective interventions to increase health care worker (HCW) compliance with universal precautions. The 13 reviewed studies were published between 1989 and 1992, with 75% published in medical journals. The studies were mainly atheoretical, with nonexperimental designs. Samples were convenient and the emergency room the predominant setting. Sampling size ranged from four to 283 individuals and 40 to 1861 events. Personnel studied included nurses, physicians, and emergency medical technicians. HCW patient contact was classified according to blood and body fluid exposure risk or type of barrier required. Although analyses of power were lacking in all studies, six studies contained sufficient data to generate such an analysis. The likelihood of detecting small treatment effects from these studies was minimal. Education was used as an intervention in all but one study, with performance feedback, reminder posters and equipment purchases also used. Compliance with universal precautions was not consistently defined. Glove use was measured in all studies, with additional barriers assessed in 62% of the reports. Compliance was measured by observation in ten studies and by self report in three studies. The greatest compliance achieved was with glove use, which varied from 15% to almost 100% before intervention and 49% to 97% after intervention. Two studies reported no change in compliance after intervention. Other studies indicated that compliance was associated with type of contact. The author concludes that HCW compliance varied with type of barrier used, type of patient contact and type of HCW.
NIOSH-Grant; Training; Health-care-personnel; Personal-protective-equipment; Hand-protection; Occupational-exposure; Biohazards; Body-fluids; Infection-control; Medical-personnel
Medicine University of Illinois P.o. Box 6998 Chicago, IL 60680
AAOHN Journal - American Association of Occupational Health Nurses Journal
University of Illinois at Chicago, Chicago, Illinois