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Nurses and Standard/Universal Precautions: Analysis of Barriers Affecting Strict Compliance Open Access

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Nurses and Standard/Universal Precautions: Analysis of Barriers Affecting Strict Compliance Goals: This research aimed to identify potentially important risk factors and barriers for less than strict compliance with universal/standard precautions by nurses in health care settings. The study outcomes were compliance with the use of personal protective equipment (PPE), specifically gloves, eye shields and respiratory shields. The study also looked at possible novel predictors of compliance including: availability of various types of PPE including size, material, style, and certain patient characteristics including age, English as a second language, and nurses' perception of the patient's potential risk status.Methods: Members of the Massachusetts Nurses Association (MNA) were surveyed in 2009, utilizing both previously validated questions and questions developed specifically for this research. Analysis was completed using SAS V 9.1.Results: While there was a low response rate (n=95) the MNA respondents are similar demographically to respondents in previous surveys. Compliance was not universal, even when PPE were available. Study results supported previously identified barriers to compliance including lack of training, workplace safety climate, and availability of PPE. Lack of availability of PPE was negatively associated with strict compliance. Higher scores for workplace safety climate, increased age, and longer nursing work experience were positively associated with compliance. The surveyed nurses also reported variation in compliance based on patient characteristics: pediatric patients (up to age 18), older adults (age 65+), those perceived to be low risk and those who spoke English as a second language. Discussion: Variation in compliance by patient demographics indicated that nurses employ personal assessment of risk regarding whether to wear PPE. Lack of gloves in appropriate sizes was negatively associated with strict compliance. Lack of training in universal/standard precautions was a surprising finding, with more than half the respondents receiving 30 minutes or less in annual training. Higher workplace safety climate was positively associated with additional training and compliance with eye shield and respiratory shield compliance.

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