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. PARTICIPANTS: 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.
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. PARTICIPANTS: 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.
Authors: David J Murphy; Peter J Pronovost; Christoph U Lehmann; Ayse P Gurses; Glenn J R Whitman; Dale M Needham; Sean M Berenholtz Journal: Transfusion Date: 2014-05-21 Impact factor: 3.157
Authors: Remco H A Ebben; Flaka Siqeca; Ulla Riis Madsen; Lilian C M Vloet; Theo van Achterberg Journal: BMJ Open Date: 2018-11-25 Impact factor: 2.692
Authors: Remco H A Ebben; Lilian C M Vloet; Michael H J Verhofstad; Sanne Meijer; Joke A J Mintjes-de Groot; Theo van Achterberg Journal: Scand J Trauma Resusc Emerg Med Date: 2013-02-19 Impact factor: 2.953