Factors Promoting Consistent Adherence to Safe Needle Precautions Among Hospital Workers

• Published in: Infection control and hospital epidemiology Vol. 25; no. 7; pp. 548 - 555
• Main Authors: Vaughn, Thomas E., McCoy, Kimberly D., Beekmann, Susan E., Woolson, Robert F., Torner, James C., Doebbeling, Bradley N.
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ The University of Chicago Press 01-07-2004; Slack; Cambridge University Press
• Subjects: Biological and medical sciences; Blood; Epidemiology; Equipment Design; Guideline Adherence - statistics & numerical data; Health care; Health care industry; Health Care Surveys; Hospitals; Humans; Hypodermic needles; Infection control; Infection Control - standards; Infection Control - statistics & numerical data; Iowa; Logistic Models; Medical equipment; Medical personnel; Medical sciences; Medical syringes; Multivariate Analysis; Needles; Needlestick injuries; Needlestick Injuries - prevention & control; Occupational Diseases - prevention & control; Occupational Exposure - prevention & control; Occupational safety; Organizational Culture; Organizational Policy; Original Articles; Personnel, Hospital - statistics & numerical data; Physical trauma; Physicians; Polls & surveys; Protective equipment; Public health. Hygiene-occupational medicine; Safety Management - standards; Safety Management - statistics & numerical data; Teaching hospitals; Universal precautions; Iowa; Infection; Health staff; Adhesion; Public health; Needle
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/502438

To examine organizational factors and occupational characteristics associated with adherence to occupational safety guidelines recommending never recapping needles.
Mail surveys were conducted with healthcare workers (HCWs) and infection control professionals (ICPs).
The surveys were conducted at all non-federal general hospitals in Iowa, except one tertiary-care hospital. Survey data were linked to annual survey data of the American Hospital Association (AHA).
HCWs were sampled from statewide rosters of physicians, nurses, and laboratory workers in Iowa. Eligible HCWs worked in a setting and position in which they were likely to routinely handle needles. ICPs at all hospitals in the state were surveyed.
Ninety-nine ICPs responded (79% response rate). AHA data were available for all variables from 84 (85%) of the hospitals. Analyses were based on 1,454 HCWs who identified one of these hospitals as their primary hospital (70% response rate). Analyses were conducted using multiple logistic regression. Positive predictors of consistent adherence included infection control personnel hours per full-time-equivalent employee (odds ratio [OR], 1.03), frequency of standard precautions education (OR, 1.11), facilities providing personal protective equipment (OR, 1.82), facilities using needleless intravenous systems (OR, 1.42), and management support for safety (OR, 1.05). Negative predictors were use of "blood and body fluid precautions" isolation category (OR, 0.74) and increased job demands (OR, 0.90).
Healthcare organizations can improve staff safety by investing wisely in educational programs regarding approaches to minimize these risks, providing protective equipment, and eliminating the use of blood and body fluid precautions as an isolation policy.