242905 Nurses and Standard/Universal Precautions: Analysis of Barriers Affecting Strict Compliance

Sunday, October 30, 2011

Katherine Kirkland, DrPH, MPH , Association of Occupational & Environmental Clinics, Washington, DC
Katherine Hunting, PhD, MPH , Environmental and Occupational Health, George Washington University School of Public Health and Health Services, Washington, DC
Glinda Cooper, PhD , US EPA, Washington, DC
Stephanie Chalupka, EdD, PHNCNS-BC , Department of Nursing, Worcester State College, Worcester, MA
Background: This research aimed to identify potentially important risk factors and barriers for less than strict compliance with universal/standard precautions (UP/SP) by nurses in health care settings. The study outcomes were compliance with the use of personal protective equipment (PPE), specifically gloves, eye shields and respiratory shields.

Methods: Members of the Massachusetts Nurses Association (MNA) were surveyed in 2009, utilizing both previously validated questions and questions developed specifically for this research.

Results: While there was a low response rate ( n=95, <5%) the MNA respondents are similar demographically to respondents in previous surveys. Compliance was not universal nor was availability of PPE. Study results supported previously identified barriers to compliance including lack of training, workplace safety climate, and availability of PPE. Higher scores for workplace safety climate, increased age, and longer nursing work experience were positively associated with compliance. The surveyed nurses also reported variation in compliance based on patient characteristics: pediatric patients (0-18), older adults (age 65+), those perceived to be low risk and those who spoke English as a second language.

Conclusion: Variation in compliance by patient demographics indicated that nurses employ personal assessment of risk regarding strict UP/SP compliance. Availability of PPE was variable. Lack of training in UP/SP was a surprising finding, with more than half the respondents receiving 30 minutes or less in annual training.

Learning Areas:
Occupational health and safety
Public health or related nursing

Learning Objectives:
Assess barriers to compliance with universal/standard precautions Formulate ideas for additional barriers to be researched in future Discuss barriers to survey research conducted by students

Keywords: Health Care Workers, Workplace Safety

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have spent the past 20 years working in OEH. The presentation is based on my doctoral dissertation research which will be defended on March 4, 2011.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.