Investigation of the selection and use of "other" personal protective equipment to prevent mucous membrane exposure in nurses: A cross-sectional study.

Abstract

Selection and use of personal protective equipment (PPE) to prevent non-percutaneous body fluid exposure (NP BFE) is determined by a clinical assessment of risk. The aim of this study was to explore the selection and use of PPE, particularly masks and eye protection to prevent NP BFE, by nurses. This quantitative single-site two-phased study was guided by the Health Belief Model (HBM). Phase 1 was a retrospective electronic database audit of body fluid exposure surveillance data. Phase 2 included a cross-sectional survey. The highest incidence of reported NP BFE to non-intact skin and mucous membranes during the study period were identified in the emergency department (ED) at 51.3% (20/39), intensive care unit (ICU) at 30.8% (12/39), operating theatre (OT) with 12.9% (5/39), and inpatient renal ward with 5.1% (2/39). Reported PPE use during NP BFE was: 0% face shields or masks, 10% gown/apron, and 15% goggles. Survey results related to Prevention of mucocutaneous exposures were similar across all high-risk units, though ED nurses reported poorer compliance with the use of PPE to prevent exposure. Risk assessment for prevention of NP BFE was reported, yet there was a lack of compliance. The ICU results indicated a positive safety culture in contrast to the ED. The findings are consistent with research identifying inadequate prevention of NP BFE, although nurses are aware of the importance of risk assessment. The HBM has the potential to increase understanding of the differences in nurses' perceptions of risk in safety culture.