Kelen G, DiGiovanna T, Kalainov D, Bisson L, Scott C; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 63 (abstract no. W.A.O.4).
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
OBJECTIVE: To assess adherence to "Universal Precautions" (UP) among health care workers (HCWs) in an emergency department (ED) with high prevalence (6.0%) of HIV-1 among its patient population. METHODS: We prospectively observed 129 HCWs performing 1274 interventions on 151 consecutive patients requiring rapid interventions. Institution-wide and departmental instructional sessions on UP were held for HCWs throughout the year prior to the initiation of the study. Interventions were classified as major (42.5%) or minor (57.4%) depending on the potential for exposure. RESULTS: Overall adherence was adequate during 16.5% of major interventions and 64.8% of minor interventions (p less than .05). During minor interventions, adherence was the same for trauma presentations (62.9%) and non-trauma presentations (67.0%) (p greater than .05). However, in the presence of profuse bleeding, adherence during minor interventions declined to 19.7% in traumatic presentations (p less than .05) and 0.0% in non-trauma presentations (p less than .05). During major procedures, adherence was 34.0% with traumatic presentations and 0.8% with non-trauma presentations (p less than .05). The overall adherence rate for HCWs was: Residents 58%; Attendings 38%; Consultants 43%; Nursing staff 44%; Paramedics 8%; X-ray technicians 14%; and Housekeeping 91%. When precautions were inadequate, surgical masks were used least (22.4%), followed by eye protection (45.0%), gowns (49.6%) and gloves (73.7%). A questionnaire administered following the study period revealed that the most common reasons given for not adhering to UP was lack of time to put on protective materials (47%), and interference in performance of procedures (33%). CONCLUSION: HCWs in this setting are not taking adequate precautions. Other strategies for implementing Universal Precautions need to be developed.
Publication Types:
Keywords:
- Allied Health Personnel
- Emergency Service, Hospital
- Gloves, Protective
- HIV-1
- Health Personnel
- Hospital Departments
- Humans
- Masks
- Protective Clothing
- Trauma Centers
- Universal Precautions
- injuries
Other ID:
UI: 102175989
From Meeting Abstracts