Implementation Of Standard Precautions Research Articles

Individual Factors Related to Compliance with Standard Wisdom Implementation in Nurses at Rsud Dr. Rasidin Padang

Background: It is difficult to control the behavior of health workers implementing standard precautions when providing services to patients which results in infection rates in hospitals being difficult to make zero percent. This can be detrimental to the hospital and the client. Reducing this problem requires efforts by the hospital to increase the compliance of health workers, especially nurses in implementing standard precautions. Objective: This study is to identify individual factors associated with standard precautions in nurses at RSUD dr. Rasidin Padang. Method: This type of research is descriptive analytic with a cross sectional approach. The sample amounted to 45 nurses in the ICU, CVCU, NICU who were taken by total sampling. Data were collected using a questionnaire, data were analyzed univariate and bivariate. Results: The results showed that almost all nurses were compliant in implementing standard precautions, almost all nurses aged 20-35 were female, had a Ners education and had training. There is a significant relationship between attitude factors, nurse motivation with compliance with the implementation of standard precautions (p <0.05) while there is no significant relationship between factors of education level, age, gender, training with compliance with the implementation of standard precautions in nurses with (p <0.05). Conclusion: It is necessary to supervise the obligation to implement standard precautions by nurses and there is an agenda for training on standard precautions on an ongoing basis.

Relationship of Patient Safety Culture to Compliance with the Implementation of Standard Precautions by Nurses in the Inpatition of Royal Prima Hospital Medan

Patient safety is a system that makes patient care safer, including risk assessment, identification and management of patient risks, incident reporting and analysis, the ability to learn from incidents and follow up, as well as implementing solutions to minimize risks and prevent injuries caused by errors. The consequences of carrying out an action or not taking an action that should be taken. This type of research is quantitative research with an analytical descriptive design. The level of compliance with the application of universal precautions shows that the majority of respondents are compliant in implementing universal precautions with a total of 73 respondents (58.4%) and for respondents whose level of Compliance with the Implementation of Universal Precautions is not 52 people (41.6%).

Clinical and occupational health management of healthcare workers living with chronic hepatitis B: UK policy and international comparisons.

Hepatitis B virus (HBV) is a highly infectious bloodborne virus, which remains endemic in large geographic areas and represents a major global healthcare challenge. HBV transmission from healthcare workers, who perform exposure prone procedures (EPP), to patients is a recognized transmission risk, which varies widely globally. Although the risk is small in developed countries, it increases significantly in high-prevalent, low-resource countries, representing a major challenge to these healthcare systems and underlining the necessity for robust guidance to be in place. The HBV landscape has evolved as a result of global vaccination programs, implementation of standard precautions and the advent of new generation antiviral agents (3rd generation nucleos(t)ide analogues). In light of the progress in the field, the UK Advisory Panel for Healthcare Workers Infected with Bloodborne Viruses (UKAP) recently issued updated guidance, which essentially removes past barriers, restricting healthcare workers from performing EPPs solely on the basis of HBV DNA level, regardless of hepatitis B 'e' antigen and/or treatment status. Although the current recommendations remain conservative compared to those of other developed healthcare systems, UK practice is now in line with other high-income countries, while ensuring patient safety remains paramount, without unduly restricting HCWs from clinical practice. The current article presents the latest UKAP guidance, considers its implications for HCWs and compares it with the guidance from major international scientific societies and governing bodies.

Blood and body fluids exposure of healthcare workers in a university hospital of Palermo, Italy: a fourteen years long surveillance.

Healthcare workers are habitually in direct contact with patients, possible carriers of infectious diseases and with potentially infectious biological materials; therefore, the implementation of standard precautions and good working practices represent an intervention strongly recommended by the Centers for Disease Control and Prevention, and required by Italian law, for the prevention of professional cut wounds. The study focused on assessing the exposure frequency and factors related to biological injuries among healthcare workers in a teaching hospital in Palermo, Italy. We performed a 14-years retrospective descriptive analysis on blood and body fluids exposures in healthcare workers, documented by questionnaires administered at the time of injury and by data collected during the follow-up period. The questionnaire included questions concerning personal data (age, sex), job position (role, employment contract, ward), biological exposure (type of exposure, devices used and circumstance of blood and body fluids exposure), precautions adopted (personal protecting equipment, safety devices) and vaccination status. A total amount of 899 healthcare workers was investigated. The incidence rate per 100 beds was 10.7. Frequency of exposure to blood and body fluids among healthcare workers was 35.3% in nurses, 31.7% in physicians, 17.6% in students. The mean age of injured healthcare workers was 36 years. The most common blood and body fluids exposures were represented by needlestick injury (76.2%), splash and spill (15.0%) and sharp (8.3%). 585 out of 685 percutaneous exposures were caused by needles (syringe, peripheral venous catheter, butterfly needles, etc.) and occurred mainly to nurses (N=224, 38.3%), physicians (N=184, 31.4% of whom resident physicians=122, 20.1% and hospital doctors=62, 10.6%), students (N=96, 16.4%) and auxiliary personnel (N=77, 13.1%). No seroconversion among exposed healthcare workers was recorded in the whole survey period. Twenty-four healthcare workers (2.6%) received post-exposure prophylaxis against Hepatitis B Virus. To our knowledge, this is the first long-term survey on blood and body fluids exposure in Southern Italy. Nurses are the most commonly affected group by biological injuries. Resident physicians and students follow the nurses probably due to a lack of training and experience about biological risk. These last two groups, however, seem to have more awareness of blood and body fluids exposures to which they are susceptible during their training cycle; in fact, they mostly use personal protective equipment compared to other healthcare workers. The blood and body fluids exposures are a preventable and a major occupational hazard in healthcare. This focus highlights the need for interventions to enhance the occupational safety of workers and students.

Common Perceptions of Standard Precautions and Bloodborne Diseases among School Nurse Teachers in Japan

Objective: To elucidate the common perceptions of standard precautions and bloodborne diseases, as represented by hepatitis B virus (HBV) and C virus (HCV) infections, among school nurse teachers in Japan. Material and methods: We conducted a questionnaire survey targeting school nurse teachers who were employed at public elementary or junior high schools. The questionnaire had 2 categories: awareness and implementation of standard precautions in the school setting and the other was awareness and provision for bloodborne diseases. Results: A total of 63 school nurse teachers were enrolled in the study. Almost all (96.8%) the school nurse teachers had sufficient knowledge of standard precautions and bloodborne diseases according to the responses. When attending students with a common cold or gastroenteritis, all respondents washed their hands thoroughly, and most of them (92.3% and 89.7%, respectively) wore a facemask. They wore gloves more frequently when attending students with gastroenteritis than when attending those with a common cold. Thirty-one (49.2%) had examinations for HBV and 21 (33.9%) for HCV. Only 11 respondents (18.3%) received an HBV vaccination. Discussion: This study shows that the actual usage of measures for infection prevention and control (IPC) remained incomplete, partly because of the insufficient personal protective equipment in the schools. The appropriate implementation of IPC in the school environment should be done as soon as possible. As school nurse teachers continue to address many pathological agents, they should strictly use standard precautions whenever attending to students. Further investigations in these areas are required.

Do we Isolate Patients or Bugs? Challenging Isolation Precautions

Isolation of patients with multidrug-resistant organisms (MRGN) has been recommended since years. Recent evidence suggests no benefit by this isolation procedure. Furthermore, isolation precautions may have potential negative effects on patient well-being and may increase therapeutic error.Rather than blocking patients up in a room, implementing and continuous education about standard precautions as hand washing and contact awareness may decrease spread of MRGN and other resistant bacteria. In this context, evidence about mechanism of resistance transfer between bacteria is still expanding. Education about these mechanisms inside and outside the body may help to corroborate the appreciation about implementation of standard precautions. In addition, the awareness of antibiotic stewardship in this context has to be underlined. Prevention of spreading bacteria is not done by isolation in room. In fact, it is a multifactorial continuous cycle of planning, teaching, surveillance and transfer of knowledge. Combination of education, compliance to standard precautions and continuous education may be a big step forward in fighting MRGN transmission and progression.

P1456PREVALENCE OF HEPATITIS B CORE ANTIBODY AND OCCULT INFECTION AMONG HAEMODIALYSIS PATIENTS

Abstract Background and Aims Haemodialysis (HD) patients are highly susceptible to blood borne virus infections and prevention strategies include surveillance, segregation, vaccination and strict implementation of standard precautions. As per new guidelines it is mandatory for all HD patients to be tested for hepatitis B core antibody at the beginning of renal replacement therapy. In the present study we sought to determine the prevalence of core antibody positivity and occult HBV infection as evidenced by viraemia in hepatitis B surface antigen (HBsAg) negative patients on maintenance haemodialysis. Method All HD patients (aged≥ 18 years) who were dialyzing in 2019 were included in this cross-sectional study. Retrospective data based on one-off screening for hepatitis B core antibody total (anti-HBc) for all HBsAg negative patients (study population) carried out between May and Oct 2019 was used for analysis. Information was gathered on HBsAg, anti-HBc antibody, surface antibody (anti-HBs) and Hepatitis B virus (HBV) DNA. All anti-HBc antibody positive patients were tested for HBV DNA using quantitative PCR assay. Patients were classified as immune (anti-HBs >10 IU/L) and non-immune (anti-HBs ≤10 IU/L) based on surface antibody levels. Demographic data were compared using Chi square test for categorical variables and Independent T test/Mann Whitney U test for continuous variables between the patients with and without HBV core antibody. Baseline characteristics were compared between the immune and non-immune groups using Chi square test and Independent T test/Mann Whitney U test as appropriate. Results A total of 3704 HBsAg negative HD patients (mean age 63.5±11.3 years, 56.1% male, 57.7% Chinese, 65.4% diabetic and mean vintage of 5.8±5.4 years) were included in the study after exclusion of 147 patients (3.8%) who had chronic HBV infection from the entire HD cohort of 3851 patients. 895 (24.2%) showed evidence of past HBV infection (anti-HBc positive but HBsAg negative) with only 3 (0.1%) patients having detectable HBV DNA. The HBV core antibody positive patients were predominantly elderly, Chinese, males and with high medical dependency compared to the patients without HBV core antibodies (p<0.001). There were no statistically significant differences in diabetic status and dialysis vintage between the patients with and without HBV core antibody. 3202 (86.4%) patients were immune following vaccination (anti-HBs >10 IU/L). The non-immune patients (13.5%) were more likely to be diabetic, with high medical dependency and lower vintage compared to immune patients (p<0.001). Age, race and gender did not differ significantly between the immune and non-immune patients. Conclusion The prevalence of hepatitis B core antibody positivity was 24.2% in our large racially diverse haemodialysis cohort but the presence of occult HBV was low (0.1%). Elderly Chinese males with high comorbidity and poor functional status were more likely to have evidence of past HBV infection. Occult HBV infection has implications in policy development for the prevention of HBV infection in dialysis centres.

Hubungan Pengetahuan dan Sikap dengan Tindakan Mahasiswa Program Profesi Dokter Gigi RSGMP Universitas Andalas Terhadap Pengendalian Infeksi

Background: In dentistry, level of risk on cross infection can be said very high. This is due to the teeth treatment, the operator may have direct contact with saliva and patient’s blood. The implementation of standard precautions is very important in clinical practice because in addition to it must be obeyed, it can avoid the operator and the patient to the cross infection. The purpose: To determine the relationship between knowledge and attitudes with the practices toward infection control of clinical student in dentistry. Methods: This type research analytical observasional by cross sectional study approach. The number of respondents were 61 clinical student of dentistry. The sampling technique by simple random sampling. The data collection done by providing questionnaire concerning knowledge and attitudes to clinical student of dentistry and practice observations toward infection control. Statictical analysis use chi-square. Results: There is significant relationship between the knowledge with the practices toward infection control with p=0.0005 and significant relationship between the attitudes with the practices toward infection control with p=0.023. Conclusion: High knowledge and positive attitude will be followed by good practice of control infection.

HAMBATAN PERAWAT DALAM PELAKSANAAN STANDARD PRECAUTIONS DI INSTALASI GAWAT DARURAT RSUD SUMEDANG

Standard precautions is an action to prevent infection in any cases of medical treatment toward patients. However, some studies have shown that the implementation of standard precautions has not been optimal due to the barriers perceived by nurses. This study aimed to identify the barriers perceived by nurses in the implementation of standard precautions. Descriptive-quantitative method was used with cross-sectional approach in 37 nurses in General Hospital Emergency Department by using total sampling technique. The data were collected by using questionnaires consisting of 48 statements, including five action of standard precautions (hand hygiene, use of PPEs, safe injection, environmental disinfection, and respiratory hygiene practices/ethics of cough and sneezing) and have been through the content and face validity test. The data were analyzed by using frequency distribution and presented in percentage. The results showed that there were some barriers perceived by nurses on standard precautions action. The most perceived barriers are limited PPEs equipment (45.9%), equipment that irritates the skin on hand hygiene (37.8%), increased number of patients in environmental disinfection (32.4%), limited support and supervision in the implementations of standard precautions for safe injection (16.2%), and equipment limitations on respiratory hygiene practices/ethics of cough and sneezing (10.8%). Based on this research, the hospital should strengthen the function properly and regularly to overcome some equipment, seek hand hygiene equipment containing emollient/moisturizers and alcohol type hand rub n-propanol to overcome skin irritation, and pay attention to the study of the ratio of nurses and patients to safe working practices. In addition, the hospital should create a practice program, socialize rewards or penalties to improve it in standard precautions.

HUBUNGAN PENGETAHUAN DAN SIKAP DENGAN TINDAKAN MAHASISWA PROGRAM PROFESI DOKTER GIGI RSGMP UNIVERSITAS ANDALAS TERHADAP PENGENDALIAN INFEKSI

Background : In dentistry, level of risk on cross infection can be said very high. This is due to the teeth treatment, the operator may have direct contact with saliva and patient’s blood. The implementation of standard precautions is very important in clinical practice because in addition to it must be obeyed, it can avoid the operator and the patient to the cross infection.
 The purpose : To determine the relationship between knowledge and attitudes with the practices toward infection control of clinical student in dentistry.
 Methods : This type research analytical observasional by cross sectional study approach. The number of respondents were 61 clinical student of dentistry. The sampling technique by simple random sampling. The data collection done by providing questionnaire concerning knowledge and attitudes to clinical student of dentistry and practice observations toward infection control. Statictical analysis use chi-square.
 Results : There is significant relationship between the knowledge with the practices toward infection control with p=0.0005 and significant relationship between the attitudes with the practices toward infection control with p=0.023
 Conclusion : High knowledge and positive attitude will be followed by good practice of control infection. 
 Keyword : Cross infection, Knowledege, Attitude, Practice, Standard precautions

The Influence of Health Workers’ Knowledge, Attitude and Compliance on the Implementation of Standard Precautions in Preventions of Hospital-Acquired Infections at PKU Muhammadiyah Bantul Hospital

Prevention of infection is a form of efforts to maintain patient safety in health services in hospitals. However, the large number of health workers with low knowledge, inappropriate attitudes and non-adherence in the implementation of standard precautions makes increase the number of infections acquired in hospitals. Analytical observational research with cross-sectional design. Knowing the knowledge, attitudes and compliance to 99 health workers consisting of nurses and midwives in the application of standard precautions in the inpatient room, intensive care unit and delivery room of PKU Muhammadiyah Bantul Hospital during July to August 2017. Data analysis using multiple logistic regression. There are three things that are assessed in the application of standard precautions namely knowledge, attitude and compliance. All aspects were assessed to have an effect on the implementation of standard precautions in PKU Muhammadiyah Bantul Hospital. Attitude is the most influential with p value 0,038 and OR value is 3,701. From the analysis, it is known that the percentage of all variables is 36.8% toward the implementation of standard precautions. Knowledge, Attitudes and Compliance has an effect of 36.8% on the application of standard precautions with the attitude having the greatest influence.

Transmission of blood-borne pathogens in US dental health care settings: 2016 update

BackgroundDuring the past decade, investigators have reported transmissions of blood-borne pathogens (BBPs) in dental settings. In this article, the authors describe these transmissions and examine the lapses in infection prevention on the basis of available information. MethodsThe authors reviewed the literature from 2003 through 2015 to identify reports of the transmission of BBPs in dental settings and related lapses in infection prevention efforts, as well as to identify reports of known or suspected health care–associated BBP infections submitted by state health departments to the Centers for Disease Control and Prevention. ResultsThe authors identified 3 published reports whose investigators described the transmission of hepatitis B virus and hepatitis C virus. In 2 of these reports, the investigators described single-transmission events (from 1 patient to another) in outpatient oral surgery practices. The authors of the third report described the possible transmission of hepatitis B virus to 3 patients and 2 dental health care personnel in a large temporary dental clinic. The authors identified lapses in infection prevention practices that occurred during 2 of the investigations; however, the investigators were not always able to link a specific lapse to a transmission event. Examples of lapses included the failure to heat-sterilize handpieces between patients, a lack of training for volunteers on BBPs, and the use of a combination of unsafe injection practices. ConclusionsThe authors found that reports describing the transmission of BBPs in dental settings since 2003 were rare. Failure to adhere to Centers for Disease Control and Prevention recommendations for infection control in dental settings likely led to disease transmission in these cases. Practical ImplicationsThe existence of these reports emphasizes the need to improve dental health care personnel's understanding of the basic principles and implementation of standard precautions through the use of checklists, policies, and practices.

Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions - United States, 2016.

Zika virus transmission was detected in the Region of the Americas (Americas) in Brazil in May 2015, and as of March 21, 2016, local mosquito-borne transmission of Zika virus had been reported in 32 countries and territories in the Americas, including Puerto Rico and the U.S. Virgin Islands.* Most persons infected with Zika virus have a mild illness or are asymptomatic. However, increasing evidence supports a link between Zika virus infection during pregnancy and adverse pregnancy and birth outcomes (1), and a possible association between recent Zika virus infection and Guillain-Barré syndrome has been reported (2). Although Zika virus is primarily transmitted through the bite of Aedes species of mosquitoes, sexual transmission also has been documented (3). Zika virus RNA has been detected in a number of body fluids, including blood, urine, saliva, and amniotic fluid (3-5), and whereas transmission associated with occupational exposure to these body fluids is theoretically possible, it has not been documented. Although there are no reports of transmission of Zika virus from infected patients to health care personnel or other patients, minimizing exposures to body fluids is important to reduce the possibility of such transmission. CDC recommends Standard Precautions in all health care settings to protect both health care personnel and patients from infection with Zika virus as well as from blood-borne pathogens (e.g., human immunodeficiency virus [HIV] and hepatitis C virus [HCV]) (6). Because of the potential for exposure to large volumes of body fluids during the labor and delivery process and the sometimes unpredictable and fast-paced nature of obstetrical care, the use of Standard Precautions in these settings is essential to prevent possible transmission of Zika virus from patients to health care personnel.

Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016

Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016

Barriers to standard precautions adherence in a dental school in Iran: A qualitative study

Setting up good infection control practices in educational institutions is crucial in shaping future health professionals. The implementation of standard precautions (SPs) in Iranian dental schools has not been explored qualitatively to identify barriers to good practice. Twelve focus group discussions and 8 semistructured interviews were conducted with students, residents, and staff members (n=83) of the Shiraz University of Medical Sciences Dental School. The interview guide addressed performance, subjective norms, and behavioral control domains of SP-related behaviors. Thematic analysis was performed manually to identify barriers to SP practices. Proximal factors of poor SP adherence were a lack of knowledge and technical difficulties. These factors were compounded by intermediate factors in the work environment: lack of facilities, heavy workload, patient expectations, interprofessional conflicts, and lack of good role models. Two underlying distal factors were financial issues and unsupportive organizational culture. The social constructionism theory was useful in analyzing the situation and suggesting an educational approach as part of the solution. Complex and intertwined barriers of SP adherence were found in this dental school. A social construction approach may assist in addressing these problems by shifting the culture through education to construct a contextual new knowledge. Further research in medical sociology of SP practices would be useful.

Health care-associated hepatitis C virus infection.

Hepatitis C virus (HCV) is a blood-borne pathogen that has a worldwide distribution and infects millions of people. Care-associated HCV infections represented a huge part of hepatitis C burden in the past via contaminated blood and unsafe injections and continue to be a serious problem of public health. The present review proposes a panorama of health care-associated HCV infections via the three mode of contamination that have been identified: (1) infected patient to non-infected patient; (2) infected patient to non-infected health care worker (HCW); and (3) infected HCW to non infected patient. For each condition, the circumstances of contamination are described together with the means to prevent them. As a whole, the more important risk is represented by unsafe practices regarding injections, notably with the improper use of multidose vials used for multiple patients. The questions of occupational exposures and infected HCWs are also discussed. In terms of prevention and surveillance, the main arm for combating care-associated HCV infections is the implementation of standard precautions in all the fields of cares, with training programs and audits to verify their good application. HCWs must be sensitized to the risk of blood-borne pathogens, notably by the use of safety devices for injections and good hygiene practices in the operating theatre and in all the invasive procedures. The providers performing exposed-prone procedures must monitor their HCV serology regularly in order to detect early any primary infection and to treat it without delay. With the need to stay vigilant because HCV infection is often a hidden risk, it can be hoped that the number of people infected by HCV via health care will decrease very significantly in the next years.

Programme stoprisk: all about standard precautions

CCLIN Sud-Est offers a programme of innovative actions supporting the implementation of standard precautions: StopRisk is a quality and security improvement initiative for healthcare establishments. The programme started in 2009 and will continue until 2012. It answers two priority themes defined by the national programme of nosocomial infection prevention 2009/2013: - promotion of a shared culture of quality and safety raising awareness and training of professionals. - detection and pre-emption of emerging pathogenic agents by reinforcing prevention of cross transmission, in particular observance of standard precautions.

Investigation and management of an outbreak of ocular adenovirus infections: a New Zealand experience

Nosocomial ocular infections are uncommon (Durand et al, 2004), though they do occur both as sporadic cases and as outbreaks. A common viral cause of these cases and outbreaks is adenovirus, which has also caused epidemics of keratoconjunctivitis. Adenovirus has been shown to remain viable on environmental surfaces for extended periods and thus can be transmitted by hospital equipment. Many patients presenting to ophthalmology clinics require contact with the specialised equipment used for examinations within the department. As with all hospital equipment and surfaces, thorough cleaning and disinfection is essential between patients. Following an unexpected increase in the number of adenovirus type 19 isolates from eye swabs taken from patients being seen on the second or subsequent appointment in the eye outpatient's department of the Canterbury District Health Board in New Zealand, the infection control service undertook a review of the area and practices, including the cleaning and disinfecting processes, within the department. As this was the first such outbreak within the organisation, the investigation included a literature review of ocular adenovirus infections and outbreaks worldwide. Recommendations made included an enhanced cleaning protocol for tonometer tips, better cleaning of the environment and improvements in the implementation of standard precautions by staff. Following the introduction of these changes, rates of adenoviral eye infections returned to pre-outbreak levels.

Update on latex allergy among health care personnel

Occupational exposure to natural rubber latex has sensitized 10% to 17% of health care personnel in Europe and the United States. The increased incidence of latex allergy is believed to be a direct result of the implementation of standard precautions. The purpose of this literature review is to examine latex allergy studies and discuss the emerging problem of latex allergy in health care personnel. Latex composition, prevalence, clinical manifestations, and populations at risk also are discussed.

Implementing standard precautions in the operating theatre: the role of the infection control liaison nurse

The appointment of an infection control liaison nurse (ICLN), particularly in specialised areas such as the operating theatre (OT), can make a significant contribution to the infection control program. That nurse's value can be demonstrated when specific changes to infection control practices are proposed. Following the introduction of standard precautions in a 560-bed adult teaching hospital, the OT ICLN identified that some nursing staff were not complying with the guidelines on standard precautions. A specific policy for OT staff was therefore formulated, and focused on OT procedures in relation to the appropriate use of protective clothing and prevention of sharps injuries. This paper describes the role of the ICLN in the implementation of standard precautions in the OT. A variety of strategies were used, including educational sessions, an infection control questionnaire and a role play. [AIC Aust Infect Control 1999; 4(1):7-11]