Study: Most Ambulatory Care Nurses Don’t Comply With Precautions for Blood-Borne Pathogens

Only 17% adhere to all nine standard recommendations

A new study has raised concerns that ambulatory care nurses fail to comply with standard precautions intended to protect them from blood-borne pathogens, according to an article on the FierceHealthcare website.

Standard precautions are the minimum infection control practices that nurses must follow when caring for patients, whether or not the patients appear to be infectious. The protocols protect health care workers from diseases that can be spread by contact with blood, body fluids, nonintact skin, and mucous membranes.

The study evaluated nurses’ compliance with nine standard precautions:

  1. I provide nursing care considering all patients as potentially contagious.
  2. I wash my hands after the removal of gloves.
  3. I avoid placing foreign objects on my hands.
  4. I wear gloves when exposure of my hands to body fluids is anticipated.
  5. I avoid needle recapping.
  6. I avoid the disassembling of a used needle from a syringe.
  7. I use a face mask when exposure to air-transmitted pathogens is anticipated
  8. I wash my hands after the provision of care
  9. I discard used sharp materials into sharps containers

The new research, published in the January issue of the American Journal of Infection Control, found that only 17% of 116 ambulatory care nurses participating in the study complied with all nine standard precautions for preventing infection.

Most of the surveyed nurses (92%) said they always wear gloves, but only 63% said they always wash their hands after removing gloves, and only 82% said they always wash their hands after caring for patients.

Since the results were self-reported, they are likely to exaggerate actual compliance, the authors warned.

The study also evaluated the nurses’ knowledge of hepatitis C virus (HCV). The highest score attainable for knowledge was 17. The nurses’ mean score was 13.8 (81%; range, 8 to 17). The results showed that knowledge of HCV was variable. Although HCV is not efficiently transmitted by sexual activity, 26% of the respondents believed that sexual transmission is a common way that HCV is spread. Fourteen percent believed incorrectly that most people with HCV will die prematurely because of the infection; 12% did not know that people can have HCV antibodies without currently being infected with the virus; and 11% did not know that there are multiple HCV genotypes.

Failure to follow infection-control standards puts not only nurses at risk but their patients as well, according to the FierceHealthcare article. Authorities in Utah are still trying to track down more than 7,000 patients who had contact with a former nurse infected with HCV; several patients have tested positive.

Sources: FierceHealthcare; January 20, 2016; and AJIC; January 1, 2016.