Blood exposure: factors promoting health care workers' compliance with guidelines in connection with risk.
BACKGROUND
Health care workers compliance with guidelines, universal precautions, in connection with tasks that could involve contact with patient's blood is unsatisfactory. In a previous paper, we identified different forces that undermine compliance. Socialization into infection control, routinization, stereotyping, perceptions of patients' wishes and the presence of competing values and norms are examples of such forces.


OBJECTIVE
The aim of this article is to describe and analyse different forces that promote adherence to universal precautions. Behavioural variations are seen as a consequence of differences between wards with regard to the safety culture. Safety culture is conceptualized as the outcome of a constant interplay between deactivating and reactivating forces. In this article the focus is on the latter.


METHODS
The grounded theory approach. Data were collected through interviews with nurses and assistant nurses.


RESULTS
The charge nurse, informal leaders, students, infection control nurses, type of work, availability of equipment, blood-exposure incidents and media-coverage of infectious diseases are described as potentially important for compliance. The properties these agents must possess in order to be influential are also described.


CONCLUSIONS
The outcome of an occupationally acquired infection can be fatal. Hence it is important that health care workers take protective measures. The results imply that mere information about safe practices alone is insufficient to achieve that goal. All factors of importance for compliance must be taken in to consideration in clinical work and in education.
Lymer
Ulla-Britt
UB
Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden. ulla-britt.lymer@hhj.hj.se
Richt
Bengt
B
Isaksson
Barbro
B
D001291:Attitude of Health Personnel; D017848:Blood-Borne Pathogens; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D019983:Guideline Adherence / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D017053:Infection Control / Q000592:standards*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D009728:Nursing Assistants / Q000193:education / Q000523:psychology*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control; D016273:Occupational Exposure / Q000517:prevention & control*; D016272:Occupational Health; D015279:Organizational Culture; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012951:Socialization; D013240:Stereotyping; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D016635:Universal Precautions