Factors associated with occupational exposure and compliance with universal precautions in an urban school district

Universal precautions

The purpose of this literature review is to consider key themes from empirical research relating to the knowledge and compliance of universal precautions amongst healthcare practitioners. Utilising international studies, strategies to improve universal precautions are analysed. The review identifies areas of limited knowledge, synthesises existing research and suggests aspects of universal precautions that need to be studied further.

A literature search of studies listed in the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database was conducted from 1990–2003, using a number of key words. Review, analysis and synthesis of selected studies were performed.

The findings of this review showed that universal precautions are considered an effective means of protecting patients and staff and controlling infection. The consensus from this body of evidence is that, globally, knowledge of universal precautions is inadequate and compliance low. Studies from many countries have shown that specific intervention strategies, such as education, are influential in improving knowledge and compliance.

This review concludes that it is imperative that future research examines how the attitudes and beliefs of practitioners can be influenced and changed to reenforce adherence to universal precautions within the clinical practice setting. There remains a lack of evidence on the long-term benefits of practice interventions to improve compliance, and what specific barriers are influential in affecting how healthcare practitioners adopt universal precautions more effectively in their practice.

Review of personal protection equipment used in practice

Standard precautions offer a consistent approach to infection control that does not rely on knowledge or suspicion of infection, and contributes to staff and patient safety by reducing the risk of exposure to potentially infectious material. One of the cornerstones of standard precautions is the appropriate use of personal protective equipment (PPE) whenever contact with blood or body fluids is anticipated. However, evidence suggests that compliance with standard precautions including correct use of PPE is inadequate. Demographic and epidemiological changes in the U.K., and the drive to provide more complex patient care outside acute hospitals may lead to increased infection risks for both patients and community healthcare workers. This review examines the importance and use of PPE by community nurses and discusses the implications for practice of poor compliance with standard precautions. Recommendations for practice will be made aimed at improving compliance with this important element of standard precautions.