Organizational safety culture/climate and worker compliance with hazardous drug guidelines: lessons from the blood-borne pathogen experience.
BACKGROUND
The health risks posed to health care workers (HCW) handling antineoplastic and other hazardous drugs (HDs) are well established. However, despite nearly 20 years of professional practice standards, compliance with safe handling procedures is poor.


METHODS
We present documentation of undercompliance with recommended safety procedures for HDs. Then, we examine a similar problem, HCW compliance with blood-borne pathogen universal precautions (UP) and its partial solution tied to the strength of a facility's safety culture. Lessons learned here may be applicable to the HD issue.


RESULTS
It is proposed that analyzing a facility's safety culture may enlarge our understanding of the barriers contributing to HD under-compliance and suggest strategies to improve it.


CONCLUSIONS
The Safety Culture paradigm offers many targets for intervention to enhance and promote worker compliance with safe HD handling practices thus mitigating internal exposure.
McDiarmid
Melissa A
MA
Occupational Health Program, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mmcdiarm@medicine.umaryland.edu
Condon
Marian
M
D017848:Blood-Borne Pathogens; D006282:Health Personnel; D006801:Humans; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011481:Protective Clothing / Q000706:statistics & numerical data*; D012449:Safety / Q000592:standards*; D014481:United States; D014489:United States Occupational Safety and Health Administration / Q000592:standards*