Powers Donna, Armellino Donna, Dolansky Mary, Fitzpatrick Joyce
Kransoff Quality Management Institute, North Shore Long Island Jewish Health System, New York, NY.
Infection Prevention, North Shore Long Island Jewish Health System, New York, NY.
Am J Infect Control. 2016 Jan 1;44(1):4-7. doi: 10.1016/j.ajic.2015.10.001.
Exposure to blood and bodily fluids represents a significant occupational risk for nurses. The most effective means of preventing bloodborne pathogen transmission is through adherence to Standard Precautions (SP). Despite published guidelines on infection control and negative health consequences of noncompliance, significant issues remain around compliance with SP to protect nurses from bloodborne infectious diseases, including hepatitis B virus, hepatitis C virus (HCV), and HIV.
A descriptive correlational study was conducted that measured self-reported compliance with SP, knowledge of HCV, and perceived susceptibility and severity of HCV plus perceived benefits and barriers to SP use. Relationships between the variables were examined. Registered nurses (N = 231) working in ambulatory settings were surveyed.
Fewer than one-fifth (17.4%) of respondents reported compliance with all 9 SP items. Mean score for correct responses to the HCV knowledge test was 81%. There was a significant relationship between susceptibility of HCV and compliance and between barriers to SP use and compliance.
This study explored reasons why nurses fail to adopt behaviors that protect them and used the Health Belief Model for the theoretical framework. It concentrated on SP and HCV because more than 5 million people in the United States and 200 million worldwide are infected with HCV, making it 1 of the greatest public health threats faced in this century. Understanding reasons for noncompliance will help determine a strategy for improving behavior and programs that target the aspects that were less than satisfactory to improve overall compliance. It is critical to examine factors that influence compliance to encourage those that will lead to total compliance and eliminate those that prevent it.
接触血液和体液对护士来说是一项重大的职业风险。预防血源性病原体传播的最有效方法是遵守标准预防措施（SP）。尽管已发布关于感染控制和不遵守规定的负面健康后果的指南，但在遵守SP以保护护士免受血源感染性疾病（包括乙型肝炎病毒、丙型肝炎病毒（HCV）和艾滋病毒）方面，仍存在重大问题。
进行了一项描述性相关性研究，该研究测量了自我报告的对SP的遵守情况、对HCV的了解程度、对HCV易感性和严重性的感知以及对使用SP的益处和障碍的感知。研究了变量之间的关系。对在门诊环境中工作的注册护士（N = 231）进行了调查。
不到五分之一（17.4%）的受访者报告遵守了所有9项SP项目。HCV知识测试正确回答的平均分数为81%。HCV易感性与遵守情况之间以及使用SP的障碍与遵守情况之间存在显著关系。
本研究探讨了护士未能采取保护自身行为的原因，并使用健康信念模型作为理论框架。它专注于SP和HCV，因为在美国有超过500万人，在全球有2亿人感染了HCV，使其成为本世纪面临的最大公共卫生威胁之一。了解不遵守规定的原因将有助于确定改善行为的策略以及针对那些不尽人意的方面的项目，以提高总体遵守情况。审视影响遵守情况的因素至关重要，以鼓励那些能导致完全遵守的因素，并消除那些阻碍遵守的因素。
