MedicalResearch.com Interview with:
Donna Powers, DNP, RN
Kransoff Quality Management Institute
North Shore Long Island Jewish Health System
New York, NY
Medical Research: What is the background for this study? What are the main findings?
Dr. Powers: Despite widely published, accessible guidelines on infection control and negative health consequences of noncompliance with the guidelines, significant issues remain around the use of Standard Precautions to protect nurses from bloodborne infectious diseases.
Only 17.4% of ambulatory nurses reported compliance with all nine standards. The nurses represented medicine, cardiology, dialysis, oncology, pre – surgical testing, radiation and urology practices. Compliance rates varied considerably and were highest for wearing gloves (92%) when exposure of hands to bodily fluids was anticipated, however only 63% reported washing hands after glove removal. 68% provided nursing care considering all patients as potentially contagious. 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.”
The study also found knowledge of HCV was variable. Although HCV is not efficiently transmitted by sexual activity, more than one in four nurses (26 %) believed that sexual transmission is a common way that HCV is spread. 14 percent believed incorrectly that most people with HCV will die prematurely because of the infection, 12 percent did not know that HCV antibodies can be present without an infection, and 11 percent did not know there are multiple HCV genotypes.
A statistically significant relationship was found between compliance and perception of susceptibility to HCV illness (P = .05) and between compliance and perception of barriers to use of Standard precautions (P=.005).
Medical Research: What should clinicians and patients take away from your report?
Dr. Powers: This issue is importance to nurses as they represent one of the largest group of workers in the healthcare system and their daily work puts them in direct contact with patients micro-organisms. Self-reported data might be an overestimate of actual compliance and that makes these results of particular concern for potential exposure to bloodborne diseases.
Understanding reasons for noncompliance will help determine a strategy for improving behavior and programs that target the aspects that were less than satisfactory to improve overall compliance. Stricter enforcement of policy must take place and nurse managers, educators, infection prevention staff must develop education and monitoring programs aimed at problem areas to increase the use of all Standard Precaution behaviors.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Powers: Gaps in knowledge regarding transmission, treatment and progression of HCV may affect nurses’ perception of risk and severity of illness. If a nurse engages in a recommended health action because he or she believes that a negative health condition can be avoided and the presence of illness poses at least a moderate threat to some aspect of his or her life, then adequate knowledge will provide a more realistic perception of the risk involved.
Factors influencing nurse compliance with Standard Precautions.
Powers, Donna et al.
American Journal of Infection Control , Volume 44 , Issue 1 , 4 – 7
Donna Powers, DNP, RN (2016). Most Nurses Skip Some Infection Control Measures