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Noncompliance With Universal Precautions and the Associated Risk of Mucocutaneous Blood Exposure Among Danish Physicians

Published online by Cambridge University Press:  02 January 2015

Suzanne Nelsing ,
Thyge Lynghøj Nielsen  and
Jens Ole Nielsen
Suzanne Nelsing*
Affiliation:
Department of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark
Thyge Lynghøj Nielsen
Affiliation:
Department of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark
Jens Ole Nielsen
Affiliation:
Department of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark
*
Department of Infectious Diseases 144, Hvidovre University Hospital, Kettegaard allé, 30, 2650 Hvidovre, Denmark
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Abstract

Objective:

To study the compliance, and reasons for noncompliance, with Universal Precautions and the associated circumstances of mucocutaneous blood exposure (MCE) among Danish physicians.

Design:

A nationwide questionnaire survey.

Setting:

All Danish hospitals.

Participants:

All hospital-employed physicians.

Results:

Of 9,384 questionnaires, 6,256 (67%) were returned, and 6,005 were eligible for analysis. Only 35% of respondents were compliant with the basic principle of Universal Precautions. Compliance with specific barriers in the preceding week among “surgeons and pathologists” and “other physicians” was as follows: gloves, 63.0% and 23.4%; masks, 55.2% and 17.6%; and protective eyewear, 11.5% and 4.0%, respectively. Common arguments for non-compliance were “interferes with working skills,” “forget,” “wear spectacles,” “not available,” “too much trouble to get,” or “gloves do not fit.”

Detailed descriptions of 741 MCEs were obtained. Blood splashes in the eyes (n=320) was the most common MCE in surgical specialties and pathology, whereas blood on the hands (n=290) was most common in other specialties. In 20% of MCEs of the eyes, the exposure occurred despite the use of spectacles. An estimated 84% to 98% of MCEs potentially would have been preventable had appropriate barriers been worn. More than one half of MCEs were preventable by two interventions only: compulsory use of protective eyewear during operations and use of gloves during insertion of peripheral intravenous catheters.

Conclusion:

Compliance with Universal Precautions is unacceptably low, as reflected by the circumstances of MCE. Increased efforts to ensure education in Universal Precautions, easy accessibility of protective barriers, and improved design of the barriers are necessary to improve compliance and reduce the risk of MCE.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 10 , October 1997 , pp. 692 - 698
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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