Michalsen A, Delclos G L, Felknor S A, Davidson A L, Johnson P C, Vesley D, Murphy L R, Kelen G D, Gershon R R
Southwest Center for Occupational and Environmental Health, University of Texas School of Public Health, Houston 77225-0186, USA.
J Occup Environ Med. 1997 Feb;39(2):130-7. doi: 10.1097/00043764-199702000-00010.
This study characterized and assessed self-reported levels of compliance with universal precautions (UP) among hospital-based physicians, and determined significant factors associated with both compliance and noncompliance. The physicians (n = 322) were a subgroup of a larger study population of hospital-based health care workers recruited from three geographically distinct locations (n = 1746), and were surveyed using a detailed confidential questionnaire that assessed personal, work-related, and organizational factors. Compliance with UP was measured through 11 items that examined how often physicians followed specific recommended work practices. Compliance was found to vary among the 11 items: they were high for certain activities (eg, glove use, 94%; disposal of sharps, 92%) and low for others (eg, wearing protective clothing, 55%; not recapping needles, 56%). Compliance with all items was low (31% to 38%). Stepwise logistic regression revealed that noncompliant physicians were likely to be age 37 or older, to report high work stress, and to perceive a conflict of interest between providing patient care and protecting themselves. Compliant physicians were more likely to be knowledgeable and to have been trained in universal precautions, to perceive protective measures as being effective, and to perceive an organizational commitment to safety.
本研究对医院医生自我报告的通用预防措施（UP）遵守水平进行了特征描述和评估，并确定了与遵守和不遵守相关的重要因素。这些医生（n = 322）是从三个地理位置不同的地点招募的更大规模医院医护人员研究群体的一个子组（n = 1746），并使用一份详细的保密问卷进行了调查，该问卷评估了个人、工作相关和组织因素。通过11个项目来衡量对UP的遵守情况，这些项目考察了医生遵循特定推荐工作规范的频率。结果发现，11个项目的遵守情况各不相同：某些活动的遵守率较高（例如，戴手套，94%；锐器处理，92%），而其他活动的遵守率较低（例如，穿防护服，55%；不回套针头，56%）。所有项目的总体遵守率较低（31%至38%）。逐步逻辑回归显示，不遵守规定的医生可能年龄在37岁及以上，报告工作压力大，并且认为在提供患者护理和保护自己之间存在利益冲突。遵守规定的医生更有可能知识渊博，接受过通用预防措施方面的培训，认为保护措施有效，并且认为组织对安全有承诺。
