Standard precautions (SP) are the basis of infection prevention and include a set
of common sense infection control practices that prevent transmission of diseases
that can be acquired by contact with blood, body fluids, non-intact skin, and mucous
membranes. Standard Precautions require that the risk for exposure be assessed and
appropriate precautions be applied based on risk (e.g. hand hygiene, personal protective
equipment, sharps safety, disinfection, respiratory etiquette). Observations and anecdotal
evidence led us to believe there was a lack of understanding of standard precautions
among healthcare personnel.
A survey was conducted at a large health system to assess knowledge and practices
related to specific elements of standard precautions.
There were over 3000 respondents that included healthcare workers from inpatient (41%),
outpatient (37%) and both settings (22%). Nurses comprised the majority of respondents
(54%) and others included physicians (9%), respiratory therapists, as well as physical
and occupational therapists. The vast majority (96%) of respondents agreed SP were
required in the care of all patients, but a large proportion (34%) interpreted that
to mean SP always involves wearing gloves and over one-fifth (22.5%) thought PPE was
always required. Hand hygiene and sharps safety were identified as the most understood
elements of SP. Whereas, respiratory etiquette and cleaning and disinfection were
reported as the least understood elements, with PPE, waste disposal and linen handling
also being reported as inadequately understood components of SP.
In an era of increasing drug resistance, fewer antibiotics, SP are our best defense
against the spread of infections in the health care setting. Our survey showed that
there is room for improvement in healthcare workers understanding of the elements
of SP. We plan to use the survey to craft a targeted education campaign on improving
understanding of and adherence to SP.