Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-12-01T01:21:02.587Z Has data issue: false hasContentIssue false
  • English
  • Français

Infection Control Practices Among Correctional Healthcare Workers: Effect of Management Attitudes and Availability of Protective Equipment and Engineering Controls

Published online by Cambridge University Press:  02 January 2015

Judith Green-McKenzie ,
Robyn R.M. Gershon  and
Christine Karkashian
Judith Green-McKenzie
Affiliation:
Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland
Robyn R.M. Gershon*
Affiliation:
Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland
Christine Karkashian
Affiliation:
Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland
*
600 West 186th St, 5th Floor, New York, NY 10032
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To determine the relation of the availability of personal protective equipment (PPE) and engineering controls to infection control (IC) practices in a prison healthcare setting, and to explore the effect on IC practices of a perceived organizational commitment to safety.

Design:

Cross-sectional survey.

Setting:

The study population was drawn from the 28 regional Correctional Health Care Workers Facilities in Maryland.

Participants:

All full-time Maryland correctional healthcare workers (HCWs) were surveyed, and 225 (64%) of the 350 responded.

Method:

A confidential, self-administered questionnaire was mailed to all correctional HCWs employed in the 28 Maryland Correctional Health Care Facilities. The questionnaire was analyzed psychometrically and validated through extensive pilot testing. It included items on three major constructs: IC practices, safety climate (defined as the perception of organizational commitment to safety), and availability of IC equipment and supplies.

Results:

A strong correlation was found between the availability of PPE and IC practices. Similarly, a strong correlation was found between IC practices and the presence of engineering controls. In addition, an equally strong association was seen between the adoption of IC practices and employee perception of management commitment to safety. Those employees who perceived a high level of management support for safety were more than twice as likely to adhere to recommended IC practices. IC practices were significantly more likely to be followed if PPE was always readily available. Similarly, IC practices were more likely to be followed if engineering controls were provided.

Conclusion:

These findings suggest that ready availability of PPE and the presence of engineering controls are crucial to help ensure their use in this high-risk environment. This is especially important because correctional HCWs are potentially at risk of exposure to bloodborne pathogens such as human immunodeficiency virus and hepatitis B and C viruses. Commitment to safety was found to be highly associated with the adoption of safe work practices. There is an inherent conflict of “custody versus care” in this setting; hence, it is especially important that we understand and appreciate the relation between safety climate and IC practices. Interventions designed to improve safety climate, as well as availability of necessary IC supplies and equipment, will most likely prove effective in improving employee compliance with IC practices in this healthcare setting.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 9 , September 2001 , pp. 555 - 559
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.US Bureau of the Census. Statistical Abstract of the United States: 1993. 113th ed. Washington, DC: US Bureau of the Census; 1993.Google Scholar
2.Sekscenski, E. The Health Services Industry in the United States: Trends in Employment From 1970-1983 With Projections to 1995. Washington, DC: Department for Professional Employees AFL-CIO; 1984. Publication 84-5.Google Scholar
3.US Department of Justice. Bureau of Justice Statistics National Update 1992;11:10–11.Google Scholar
4.Vlahov, D. HIV-1 in the correctional setting. NIDA Res Monogr 1992;118:51–61.Google Scholar
5.Hankins, C, Gendron, S, Handley, M, Richard, C, Tung, MT, O'Shaughnessy, M. HIV infection among women in prison: an assessment of risk factors using a nominal methodology. Am J Public Health 1994;84:1637–1640.CrossRefGoogle Scholar
6.Vlahov, D, Lee, H, Canavaggio, M, Canner, C, Burczak, J, Saah, A. Antibody to human T-lymphotropic virus type I/II (HTLV-I/II) among male inmates entering Maryland prisons. J Acquir Immune Defic Syndr 1990;3:531–535.Google Scholar
7.Anda, R, Perlman, S, D'Alessio, D, Davis, J, Dodson, V. Hepatitis B in Wisconsin male prisoners. Am J Public Health 1985;75:1182–1185.Google Scholar
8.Decker, M, Vaughn, W, Brodie, J, Hutcheson, R, Schaffner, W. Seroepidemiology of hepatitis B Tennessee prisoners. J Infect Dis 1984;150:450–459.Google Scholar
9.Kendig, N, Stough, T, Austin, P, Kummer, L, Swetz, A, Vlahov, D. Profile of HIV seropositive inmates diagnosed in a state correctional system by various testing strategies. Public Health Rep 1994;109:755–760.Google Scholar
10.Marcus, R. Hospital Infections Program, Centers for Disease Control and Prevention. Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. N Engl J Med 1988;319:1118–1123.Google Scholar
11.McCray, E. Hospital Infections Program, Centers for Disease Control and Prevention. Occupational risk of the acquired immunodeficiency syndrome among health care workers. N Engl J Med 1986;314;1127–1132.Google Scholar
12.Henderson, D, Fahey, B, Willy, M, Schmitt, JM, Carey, K, Koziol, DE, et al. Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures: a prospective evaluation. Ann Intern Med 1990;113:740–746.Google Scholar
13.Sepkowitz, K. Occupationally acquired infections in health care workers Part II. Ann Intern Med 1996;125:917–834.Google Scholar
14.Collins, C, Kennedy, D. Microbiological hazards of occupational needle-stick and “sharps” injuries. J Appl Bacterid 1987;62:385–432.Google ScholarPubMed
15.Moran, GJ. Emergency department management of blood and body fluid exposures. Ann Emerg Med 2000;35:47–62.Google Scholar
16.Osborn, EHS, Papadakis, MA, Gerberding, JL. Occupational exposures to body fluids among medical students: a seven-year longitudinal study. Ann Intern Med 1999;130:45–51.CrossRefGoogle ScholarPubMed
17.Cardo, DM, Bell, DM. Bloodborne pathogen transmission in healthcare workers: risks and prevention strategies. Infect Dis Clin North Am 1997;11:341–356.Google Scholar
18.Gershon, RM, Kharkashian, D, Vlahov, D, Kummer, L, Kasting, C, Green-McKenzie, J, et al. Compliance with Universal Precautions in correctional health care facilities. J Occup Environ Med 1999;41:181–189.Google Scholar
19.Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens—OSHA. Final rule. Fed Regist 1991 Dec 6;56(235):64004–64182.Google Scholar
20.Green-McKenzie, J, Gershon, RM, Kharkashian, C. Correlates of compliance with infection control practices among correctional health care workers. 85th Annual American Occupational Health Conference (AOHC); May 18, 2000; Philadelphia, PA Abstract.Google Scholar
21.Hersey, C, Martin, L. Use of infection control guidelines by workers in healthcare facilities to prevent occupational transmission of HBV and HIV: results from a national survey. Infect Control Hosp Epidemiol 1994;15:243–252.Google Scholar
22.Gershon, R, Vlahov, D, Felknor, S, Vesley, D, Johnson, P, Delclos, G, et al. Compliance with Universal Precautions among health care workers at three regional hospitals. Am J Infect Control 1995;23:225–234.Google Scholar
23.Gershon, R, Karkashian, C, Vlavhov, D, Grimes, M, Spannhake, E. Correlates of infection control practices in dentists. J Occup Environ Med. In press.Google Scholar
24.Dejoy, DM, Murphy, LR, Gershon, RMM. Safety climate in health care settings. In: Bittner, AC, ed. Advances in Industrial Ergonomics and Safety VII. London, UK: Taylor and Francis; 1995:923–929.Google Scholar
25.Dejoy, D, Gershon, R, Murphy, L, Wilson, M. A work-systems analysis of compliance with Universal Precautions among health care workers. Health Education Quarterly 1996;23:159–174.Google Scholar
26.Michalsen, A, Declos, GL, Felknor, SA, Davidson, AL, Johnson, PC, Vesley, D, et al. Compliance with Universal Precautions among physicians. J Occup Environ Med 1997;39:130–137.Google Scholar
27.Likert, R, Gardner, M. A technique for the measurement of attitudes. Archives of Psychology 1932:140.Google Scholar
28.Cronbach, LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951;16:297–334.Google Scholar