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How Standard Are Standard Precautions? Knowledge and Attitudes Towards Standard Precautions at an Academic Medical Center

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      Background

      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.

      Methods

      A survey was conducted at a large health system to assess knowledge and practices related to specific elements of standard precautions.

      Results

      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.

      Conclusions

      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.
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