Compliance With Universal Precautions in Correctional Health Care Facilities

• Published in: Journal of occupational and environmental medicine 1999-03, Vol.41 (3), p.181-189
• Main Authors: Gershon, Robyn R.M., Karkashian, Christine D., Vlahov, David, Kummer, Leslie, Kasting, Christine, Green-McKenzie, Judith, Escamilla-Cejudo, Jose A., Kendig, Newton, Swetz, Anthony, Martin, Linda
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cross-Sectional Studies; Demography; Female; Guideline Adherence - statistics & numerical data; Health facilities; Health Facilities - statistics & numerical data; Humans; Logistic Models; Male; Maryland; Medical sciences; Middle Aged; Miscellaneous; Occupational medicine; ORIGINAL ARTICLES; Prisons - statistics & numerical data; Public health. Hygiene-occupational medicine; Risk Factors; Safety - statistics & numerical data; Studies; Surveys and Questionnaires; Universal Precautions - statistics & numerical data
• ISSN: 1076-2752; 1536-5948
• DOI: 10.1097/00043764-199903000-00007

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 a compliance scak. 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 (ie, 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.