Compliance with universal precautions in correctional health care facilities.
There were three main objectives of this cross-sectional study of Maryland State correctional health care workers. The first was to evaluate compliance with work practices designed to minimize exposure to blood and body fluids; the second, to identify correlates of compliance with universal precautions (UPs); and the third was to determine the relationship, if any, between compliance and exposures. Of 216 responding health care workers, 34% reported overall compliance across all 15 items on a compliance scale. Rates for specific items were particularly low for use of certain types of personal protective equipment, such as protective eyewear (53.5%), face mask (47.2%) and protective clothing (33.9%). Compliance rates were highest for glove use (93.2%) waste disposal (89.8%), and sharps disposal (80.8%). Compliance rates were generally not associated with demographic factors, except for age; younger workers were more likely to be compliant with safe work practices than were older workers (P < 0.05). Compliance was positively associated with several work-related variables, including perceived safety climate (i.e., management's commitment to infection control and the overall safety program) and job satisfaction, and was found to be inversely associated with security-related work constraints, job/task factors, adverse working conditions, workplace discrimination, and perceived work stress. Bloodborne exposures were not uncommon; 13.8% of all respondents had at least one bloodborne exposure within the previous 6 months, and compliance was inversely related to blood and body fluid exposures. This study identified several potentially modifiable correlates of compliance, including factors unique to the correctional setting. Infection-control interventional strategies specifically tailored to these health care workers may therefore be most effective in reducing the risk of bloodborne exposures.
Gershon
R R
RR
Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, Md. 21205, USA.
Karkashian
C D
CD
Vlahov
D
D
Kummer
L
L
Kasting
C
C
Green-McKenzie
J
J
Escamilla-Cejudo
J A
JA
Kendig
N
N
Swetz
A
A
Martin
L
L
D000328:Adult; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008396:Maryland; D008875:Middle Aged; D011330:Prisons / Q000706:statistics & numerical data; D012307:Risk Factors; D012449:Safety / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016635:Universal Precautions / Q000706:statistics & numerical data