NURSES INFECTION-CONTROL PRACTICE - HAND DECONTAMINATION, THE USE OF GLOVES AND SHARP INSTRUMENTS

Infection is an acknowledged hospital problem. Micro-organisms are dis seminated mainly via hands but there is evidence that hand decontamina tion, the most important means of prevention, is performed too seldom, and not always after activities likely to result in heavy contaminati on. Nurses themselves are exposed to risks of infection, chiefly throu gh contact with blood and body fluids, yet it has also been reported t hat gloves are not always worn during contact with patients' secretion s and that the handling and disposal of sharp instruments may be perfo rmed unsafely. The study reported in this paper documents nursing beha viour in relation to hand decontamination, the use of gloves and sharp s, taking into consideration a number of variables which could influen ce practice: availability of the expertise afforded by an infection-co ntrol nurse, clinical setting, nursing workload, knowledge and the res ources available to control infection. Hands were decontaminated after 28.78% of patient contacts. Hands were decontaminated after 49.85% of activities likely to result in heavy contamination. Performance was r elated to nursing workload and the availability of hand decontaminatin g agents, especially when the nurses became busy. Use of gloves when t hey were available also proved good, with little evidence of wasteful use. The handling and disposal of sharps were commendable for most sub jects but a few grossly unsafe incidents were nevertheless witnessed, apparently not associated with any of the variables examined.