title: Continued non-compliance with the American College of Surgeons recommendations to decrease infectious exposure in the operating room: why?
abstract: BACKGROUND
  The American College of Surgeons (ACS) Statement on Sharps Safety recommends the use of double gloving (DG), hands-free zone (HFZ), and blunt-tip suture needles (BTSN) in the operating room to decrease needlestick injuries. Despite this endorsement, compliance is low. This survey determined the perceptions, attitudes, and barriers to compliance with these guidelines.
  
  
  METHODS
  A survey using a voluntary convenience sample of surgical staff members in which queries related to understanding of the ACS recommendations were posed. A total of 107 of the 324 surveys were completed and returned, for a response rate of 33%. Most respondents were residents (64%) or attending surgeons (29%).
  
  
  RESULTS
  Respondents were most familiar with recommendations for DG (58% of residents and 68% of attendings) and HFZ (61% for both groups) but less so for BTSN (48% of residents and 52% of attendings). More than 50% of the staff believed that DG decreased the risk of needlesticks, yet fewer than half used DG more than 75% of the time. Half believed that HFZ protected from sticks, yet fewer than 10% used it at least 75% of the time. Fewer than 50% believed that BTSN minimizes the risk of injury, with fewer than 10% of respondents using them at least 75% of the time. Reasons for non-compliance included decreased tactile sensation with DG, lack of training with HFZ, and lack of availability of BTSN.
  
  
  CONCLUSIONS
  To improve compliance with the ACS recommendations, institutions must improve awareness of the guidelines and the benefits associated with compliance and remove barriers to their incorporation into standard practice.
authors: Department of Internal Medicine, Division of Infectious Diseases, Virginia Commonwealth University, Richmond, Virginia 23298-0019, USA.
authors: Christina M
authors: CM
authors: Welc
authors: Ali
authors: A
authors: Nassiry
authors: Kara
authors: K
authors: Elam
authors: Kakotan
authors: K
authors: Sanogo
authors: Wilhelm
authors: W
authors: Zuelzer
authors: Therese
authors: T
authors: Duane
authors: Michael P
authors: MP
authors: Stevens
authors: Michael
authors: M
authors: Edmond
authors: Gonzalo
authors: G
authors: Bearman
mesh_terms: D005932:Gloves, Surgical; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000592:standards* / Q000706:statistics & numerical data*; D016602:Needlestick Injuries / Q000517:prevention & control; D009873:Operating Rooms / Q000592:standards* / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000592:standards* / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000517:prevention & control; D011795:Surveys and Questionnaires