Only 17.4 percent of ambulatory care nurses reported compliance in all nine standard precautions for infection prevention, according to a study published in the January issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
Researchers from Northwell Health (formerly North Shore Long Island Jewish Health System) conducted a study of 116 ambulatory care nurses to measure self-reported compliance with standard precautions, knowledge of hepatitis C virus (HCV), and behavioral factors influencing compliance.
The highest rate of compliance was reported with always wearing gloves (92 percent), followed by always wearing a face mask (70 percent). Only 63 percent of participants reported that they always wash hands after removal of gloves and 82 percent reported that they always wash hands after provision of care.
The study also found knowledge of HCV was variable, with more than one in four (26 percent) erroneously believing that it is commonly spread through sexual contact, 14 percent incorrectly believing that HCV causes premature death, 12 percent not knowing HCV antibodies can be present without an infection, and 11 percent not knowing there are multiple HCV genotypes.
"Self-reported data might be an overestimate of actual compliance and that makes these results of particular concern for potential exposure to bloodborne diseases," concluded the study authors. "Overall, the ambulatory care nurses chose to implement some behaviors and not others, and this behavior puts them at risk for acquiring a bloodborne infection."
Standard precautions are the minimum infection control practices that should be used in the care of all patients at all times, whether or not they appear to be infectious. They are used to protect healthcare workers and patients from transmission of diseases that can be spread by contact with blood, body fluids, non-intact skin, and mucous membranes. The nurses surveyed in this study were assessed based on these nine precautions:
- I provide nursing care considering all patients as potentially contagious
- I wash my hands after the removal of gloves
- I avoid placing foreign objects on my hands
- I wear gloves when exposure of my hands to body fluids is anticipated
- I avoid needle recapping
- I avoid the disassembling of a used needle from a syringe
- I use a face mask when exposure to air-transmitted pathogens is anticipated
- I wash my hands after the provision of care
- I discard used sharp materials into sharps containers