Risk taking by health care workers.

HEALTH CARE WORKERS (HCWs) are at risk for acquiring infections such as human immunodeficiency virus, hepatitis B virus, hepatitis C, and tuberculosis from blood and body fluids. The Centers for Disease Control established guidelines known as universal precautions (UPs) to prevent transmission of blood-borne pathogens in hospital settings, but UPs are not universally followed. CNSs are in a unique position to enhance the practice of UPs and decrease the HCW's risk-taking behavior. CNSs need to identify risk-taking behaviors and help HCWs make the right decision in risky situations. Reasons cited for noncompliance with UPs were habit, forgetfulness, influence of the nurse manager, and perceptions that barrier precautions hinder the ability to perform procedures successfully. Suggestions for improving compliance with UPs were better enforcement of guidelines, a policy mandating compliance, easy and available access to supplies, replacement of hazardous devices with safer ones, and discussion with HCWs on decision making in risky situations. CNSs possess the credibility in the clinical arena to effect change through clinical expertise, role modeling, and collaboration with HCWs.