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A comparison of observed and self-reported compliance with universal precautions among emergency department personnel at a minnesota public teaching hospital: Implications for assessing infection control programs

✍ Scribed by Keith Henry; Scott Campbell; Myra Maki


Publisher
Elsevier Science
Year
1992
Tongue
English
Weight
703 KB
Volume
21
Category
Article
ISSN
1097-6760

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✦ Synopsis


Study objectives: To determine the level of universal precautions compliance in a hospital emergency department by two methods (direct observation of subjects versus self-reporting by questionnaire).

Setting: A Level II trauma center located within a university-affiliated medical center in Minneapolis/St Paul, Minnesota. Glove and needle disposal containers were available in each treatment room; gowns, masks, and goggles were readily available.

Partieipants:ED physicians (12 staff plus rotating residents), medical students, nursing staff, and ancillary personnel.

Methods:Ten observers documented six specific behaviors among ED personnel: needle recap frequency, needle recap techniques, and use of gowns, gloves, masks, and goggles. After the observations, surveys were distributed to ED personnel by intrahospital mail in Fall 1989.

Results: During 270 observation hours, 1,018 patient-worker interactions were recorded. Gloves were the barrier worn most frequently when appropriate (74%), followed by goggles (13%), gowns (12%), and masks (1%). Needles were recapped 51% of the time, and most needles that were recapped (79%) were recapped by the two-hand technique; 5% of all needles used were left uncapped at bedside or in the trash. Physicians were observed to use gloves more frequently than registered nurses and nursing assistants; nurses were observed to recap more frequently than physicians. From the survey, the three most common reasons for noncompliance involved time (71%), dexterity (61%), and patient appearance (50%).

Conclusion:Universal precautions are not consistently used by ED personnel, and ED personnel significantly overestimate their compliance with universal precautions. [Henry K, Campbell S, Maki M: A comparison of observed and selfreported compliance with universal precautions among emergency department personnel at a Minnesota public teaching hospital: implications for assessing infection control programs. Ann Emerg Med