• K Henry, S Campbell, and M Maki.
• Department of Medicine, St Paul-Ramsey Medical Center, MM.
• Ann Emerg Med. 1992 Aug 1;21(8):940-6.

Study ObjectivesTo determine the level of universal precautions compliance in a hospital emergency department by two methods (direct observation of subjects versus self-reporting by questionnaire).SettingA 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.ParticipantsED physicians (12 staff plus rotating residents), medical students, nursing staff, and ancillary personnel.MethodsTen 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.ResultsDuring 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%).ConclusionUniversal precautions are not consistently used by ED personnel, and ED personnel significantly overestimate their compliance with universal precautions.

18 keywords...

hide…