COMPLIANCE WITH UNIVERSAL PRECAUTIONS AMONG HEALTH-CARE WORKERS AT 3 REGIONAL HOSPITALS

Objective: To assess and characterize self-reported levels of complian ce with universal precautions among hospital-based health care workers and to determine correlates of compliance. Design: Confidential quest ionnaire survey of 1716 hospital-based health care workers. Participan ts: participants were recruited from three geographically distinct hos pitals. A stratified convenience sample of physicians, nurses, technic ians, and phlebotomists working in emergency, surgery, critical care, and laboratory departments was selected from employment lists to recei ve the survey instrument. All participants had direct contact with eit her patients or patient specimens. Results: For this study, overall co mpliance was defined as ''always'' or ''often'' adhering to the desire d protective behavior. Eleven different items composed the overall com pliance scale. Compliance rates varied among the 11 items, from extrem ely high for certain activities (e.g., glove use, 97%; disposal of sha rps, 95%) to low for others (e.g., wearing protective outer clothing, 62%; wearing eye protection, 63%). Compliance was strongly correlated with several key factors: (1) perceived organizational commitment to s afety, (2) perceived conflict of interest between workers' need to pro tect themselves and their need to provide medical care to patients; (3 ) risk-taking personality; (4) perception of risk; (5) knowledge regar ding routes of HIV transmission; and (6) training In universal precaut ions. Compliance rates were associated with some demographic character istics: female workers had higher overall compliance scores than did m ale workers (25% of female and 19% of male respondents circled ''alway s'' or ''often'' on each of the 11 items, p < 0.05); and overall compl iance scores were highest for nurses, intermediate for technicians, an d lowest for physicians. Overall compliance scores were higher for the mid-Atlantic respondents (28%) than for those from the Southwest (20% ) or Midwest (20%, p = 0.001). Conclusions: This study supports earlie r findings regarding several compliance correlates (perception of risk , knowledge of universal precautions), but it also identifies importan t new variables, such as the organizational safety climate and perceiv ed conflict of interest. Several modifiable variables were identified, and intervention programs that address as many of these factors as po ssible will probably succeed in facilitating employee compliance.