Jeffe D B, Mutha S, Kim L E, Evanoff B A, L'Ecuyer P B, Fraser V J
Washington University School of Medicine, St Louis, MO, USA.
Infect Control Hosp Epidemiol. 1998 Oct;19(10):767-71. doi: 10.1086/647721.
To investigate differences in second-, third-, and fourth-year medical students' knowledge of bloodborne pathogen exposure risks, as well as their attitudes toward, and intentions to comply with, Universal Precautions (UP).
Cross-sectional survey.
Surveys about students' knowledge, attitudes, and intentions to comply with UP were completed by 111 second-year (preclinical), 80 third-year, and 60 fourth-year medical students at Washington University School of Medicine in the spring of 1996.
Preclinical students knew more than clinical students about the efficacy of hepatitis B vaccine, use of antiretroviral therapy after occupational exposure to human immunodeficiency virus, and nonvaccinated healthcare workers' risk of infection from needlestick injuries (P<.001). Students' perceived risk of occupational exposure to bloodborne pathogens and attitudes toward hepatitis B vaccine did not differ, but preclinical students agreed more strongly that they should double glove for all invasive procedures with sharps (P<.001). Clinical students agreed more strongly with reporting only high-risk needlestick injuries (P=.057) and with rationalizations against using UP (P=.008). Preclinical students more frequently reported contemplating or preparing to comply with double gloving, wearing protective eyewear, reporting all exposures, and safely disposing of sharps, whereas students with clinical experience were more likely to report compliance. Clinical students also were more likely to report having "no plans" to practice the first three of these precautions (P<.001).
Differences in knowledge, attitudes, and intentions to comply with UP between students with and without clinical experience may have important implications for the timing and content of interventions designed to improve compliance with UP.
调查二、三、四年级医学生对血源性病原体暴露风险的认知差异，以及他们对通用防护措施（UP）的态度和遵守意愿。
横断面调查。
1996年春季，华盛顿大学医学院的111名二年级（临床前）、80名三年级和60名四年级医学生完成了关于学生对通用防护措施的知识、态度及遵守意愿的调查。
临床前学生在乙肝疫苗的效力、职业暴露于人类免疫缺陷病毒后使用抗逆转录病毒疗法以及未接种疫苗的医护人员因针刺伤而感染的风险方面，比临床学生了解得更多（P<0.001）。学生们对职业暴露于血源性病原体的感知风险以及对乙肝疫苗的态度没有差异，但临床前学生更强烈地认同在所有使用锐器的侵入性操作中都应戴双层手套（P<0.001）。临床学生更强烈地认同仅报告高风险针刺伤（P=0.057）以及对不采用通用防护措施的辩解（P=0.008）。临床前学生更频繁地报告考虑或准备遵守戴双层手套、佩戴防护眼镜、报告所有暴露情况以及安全处理锐器的措施，而有临床经验的学生更有可能报告已经遵守。临床学生也更有可能报告“没有计划”实施前三项防护措施（P<0.001）。
有临床经验和无临床经验的学生在通用防护措施的知识、态度和遵守意愿方面存在差异，这可能对旨在提高通用防护措施遵守率的干预措施的时机和内容具有重要意义。
