Implementation Of Universal Precautions Research Articles

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%).

Implementation of Universal Precautions for Health Workers in the City Health Services in Indonesia

Background: The most health problem in Indonesia for health services is infectious diseases. So the need to implement Universal Precautions is one of the efforts to prevent infection in health facilities. Aim : This study aims to implementation of universal precautions for health workers in the city health services. This study uses a quantitative design that is observational, with a cross-sectional study design. Methods: The sample in this study was the total number of health personnel in health services as many as 108 people consisting of a hospital as many as 89 nurses, a public health center with 9 nurses, and a clinic as many as 10 nurses. The instrument used in the application of universal precautions is through observation, using a monitoring sheet. Results: The result proportion of the not application of universal precautions at the level of hospital health services is 83.3%. The results showed that the higher the level of health care, the higher the average application of universal precautions. The application of universal precautions at the health service level has the same level of service in handling patients, and there are still nurses who do not use APD aprons. Conclusion: The health service conducts training and the head of the room directs the nurse about universal vigilance when the shift changes, so that the nurse can apply universal precautions according to the standard operating procedures (SOP).

Factors Related to Nurse Compliance in The Implementation of Universal Precaution in The Inpatient Room One of Private Hospital in Yogyakarta

Transmission of nosocomial infections from person to person must be prevented by always maintaining hand hygiene after carrying out inspection activities and interaction activities in hospitals, one of them by doing hand hygiene. Awareness of the importance of hand hygiene in health workers is needed in efforts to prevent nosocomial infections. The hand hygiene compliance rate obtained at One of Private Hospital in Yogyakarta is 80%. Awareness of the importance of the implementation of hand hygiene does not yet exist or has not emerged in the nurse itself, while it is very important in addition to protecting himself from the transmission of infection and can reduce the risk and spread of nosocomial infections in the hospital. This study uses an observational analytic method with a cross-sectional design. The sampling technique uses proportional random sampling, with the number of samples studied as many as 89 people. The research data were analyzed using the chi-square test. The p-value of 0.040 (p 0.05) indicates that there is a relationship between knowledge and nurse compliance in the implementation of hand hygiene. A p-value of 1.00 (p 0.05) indicates that there is no relationship between attitude and nurse compliance in the implementation of hand hygiene. P-value of 0.425 (p 0.05) indicates that there is no relationship between motivation and nurse compliance in the implementation of hand hygiene

Factors related to the implementation of universal precautions by nurses in the inpatient unit (IRINA F) Prof. Dr. R. D. Kandou Central General Hospital Manado

Nosocomial infection is an infection acquired when someone had ever been in a hospital or other health care facility. The high incidence rates of nosocomial infections indicate low quality of health services in the hospital. In this regard so that the implementation of universal precautions is an action to control against infections by health workers to reduce the infection transmission risk. The aim of this study is to determine factors related to the implementation of universal precautions by nurses in the inpatient unit (IRINA F) Prof. Dr. R. D. Kandou Central General Hospital Manado.Quantitative research design was employed with analytical survey method and by using cross sectional study approach. The study was conducted in the inpatient unit (IRINA F) Prof. Dr. R. D. Kandou Central General Hospital Manado since September – December 2016. Total sampling technique employed to obtain 65 people. Data was collected through validated questionnaires.The result shows a significant relationship between knowledge and the implementation of universal precautions (p < 0,005), but there is no significant relationship between the availability of facilities and motivation with the implementation of universal precautions (p=0,271 and 0.338, respectively). Multiple logistic regression showing that knowledge is the most predominant factor regarding the implementation of universal precautions by nurses.Overall, it can be concluded that there is a significant relationship between knowledge with the implementation of universal precautions by nurses. Thus, various efforts to improve the knowledge of nurses regarding with the implementation of universal precautions are necessary in preventing nosocomial infection.Â

Practice and its determinants of universal precaution among nursing staff in a tertiary hospital of Manipur

Background: Health workers are at higher risk of infection with blood-borne viruses including human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. Successful implementation of universal precaution can effectively control these infections in health-care setting. Objective: To assess the practice of universal precautions among nurses and factors influencing its use in a tertiary-health center of Manipur. Materials and Methods: A cross-sectional study was conducted among the nursing staffs in a tertiary health-care center of Manipur from October 2011 to September 2013. Respondents were purposively selected, and data were collected using structured questionnaire. Descriptive statistics such as percentage was used to describe the findings. Result: Total respondents were 446 nurses. Response rate was 98%. Only 24% of the nurses always used gloves whenever contact with blood and body fluid was likely. Five in 100 nurses never washed hands after removing gloves. One-third of the nurses never used gown, 22% of the nurses never used mask, 69.3% never used goggles when blood and body fluid splash was likely. Seven in 10 of the respondents always recapped needles immediately after use. Majority of the respondents used sharp and liquid proof container as a method of disposal of sharp materials after removing needle (61.2%). But, three in 100 nurses mixed sharps with general waste, and around 2% of them threw sharps in open pail. Reasons behind not practicing universal precaution were work stress (10.3%), time constraint (28%), lack of supply of personal protective equipment (67%), lack of display of guidelines (2.5%), and emergency situations (4%). Conclusion: Practice of universal precaution was not satisfactory. Training of the health-care workers, proper equipment supply, posters displaying guidelines, and proper hospital policy of patient load management would significantly help both quantitatively and qualitatively for effective implementation of universal precaution in this premier health-care institution of Manipur.

Knowledge and practice of universal precautions among nursing staff at a tertiary care hospital in South Gujarat, India

Background: Health care providers are at an increased risk of exposure to various infections like HIV, Hepatitis B, Hepatitis C etc. These infections are prevented if proper universal precautions are observed by health care providers consistently in their day to day clinical work. In study we have explored knowledge and practice of universal precautions among nursing staff. Methods: A cross sectional study carried out among staff nurses in December 2013. Self-administered semi structured proforma was used for data collection. Information regarding knowledge and practice of universal precautions was collected. Results: Out of 88 participants interviewed, almost all of them reported of having awareness about universal precautions and personal protective equipments. Only 44.3% nurses mentioned all the correct measures for universal precautions. 89.77% nurses were aware about health hazards of needle stick injury but only 67.05% correctly reported about how needle stick injury can be prevented. 38.64% nurses had experienced needle stick injury while working and most of them (79.41%) followed proper guidelines. Conclusions: correct knowledge regarding universal precautions among nursing staff is still not of satisfactory level and training at repeated interval needs to be given to ensure correct knowledge as well as implementation of universal precautions.

Addressing HIV stigma in protected medical settings

ABSTRACTPrevious studies suggest that the implementation of universal precaution (UP) plays a role in reducing HIV stigma. In this study we investigate the efficacy of a stigma reduction intervention on UP compliance and explore whether UP compliance could potentially influence HIV stigma reduction in medical settings. A randomized controlled intervention trial was conducted in two provinces of China with 1760 healthcare service providers recruited from 40 county-level hospitals. Longitudinal analyses included data collection at baseline, 6-, and 12-month follow-up assessments. Using a hierarchical modeling approach, we estimated the intervention effect for each provider's UP compliance and its potential mediating role on HIV stigma with the bootstrapping method. A significant intervention effect on UP compliance was observed at both the 6- and 12-month follow-up assessments. The intervention effect on provider avoidance intent was partially mediated by the provider's own UP compliance at the two follow-up points. This study provides evidence that UP compliance should be part of HIV stigma reduction programs, especially in resource-restrained countries. Findings suggest that a protected work environment may be necessary but not sufficient to address HIV stigma in medical settings.

Sickle Cell Trait Screening of Collegiate Athletes: Ethical Reasons for Program Reform.

The National Collegiate Athletic Association (NCAA) requires all student-athletes have their sickle cell trait (SCT) status confirmed prior to athletic participation. The NCAA approved the screening program in 2010 for institutions participating in Division I athletics and extended it in subsequent years to institutions at Division II and III levels. Ethical concerns about the controversial policy focus on its mandatory nature and potential impact on student-athletes, particularly through stigmatization of and discrimination against those with SCT. Organizations, such as the American Society of Hematology (ASH), oppose the imposition of SCT testing and instead recommend universal precautions that would protect the entire student-athlete population without revealing student-athletes' SCT statuses. This paper discusses these issues and offers recommendations, including genetic counseling, which would improve the current SCT screening program. It argues that implementation of universal precautions would ensure that the most ethically sound practices are afforded to every student-athlete.

Hepatitis C Virus Infection Trends in Italy

In previous issue of Hepatitis Monthly, La Torre G et al. from Sapienza University and the Catholic University of the Sacred Heart located in Rome, Italy, have published their findings on the incidence of hepatitis C virus (HCV) infections in Italy [1]. In the Italian general population, they estimate that the overall trend, and also the trends in gender and different age groups, has decreased significantly over the period from 1996 to 2006, with an overall significant decrease in incidence from 2.02 to 0.55 per 100,000. The incidence rates were estimated using the data from the system for acute viral hepatitis in Italy (SEIEVA) and population data from ISTAT. A marked decrease in incidence was observed in all age groups. A similar rate of decrease was observed in the 25-64-year-old and the greater than 65-year-old age groups. A more pronounced decrease was observed in the 15-24-year-old age group, whereas a low decrease was observed in the 0-14-year-old age group, primarily because of the existing low incidence in 1996 [1]. In the male population, which had a significantly higher incidence rate than the female population in 1996, the decrease was more marked with a clear trend of diminishing gender differences in HCV incidence in 2006, and with a lower (but probably not significant) incidence rate in males aged 0-14 years (0.05 vs. 0.15/100,000). The estimated decrease in the overall annual incidence was -12.5%. This study shows an encouraging favorable trend toward a low incidence of HCV in Italy, and it confirms previous findings in this country [2][3]. The trend described in this study is similar to the trends observed in Canada [4], Western Europe [4], and the USA [5][6][7]; however, contrary trends have been observed in Eastern Europe and Russia [4], and also among adolescents and young adults in some states of the USA [8][9][10] and in US population groups [11]. Estimation of the incidence of HCV infection remains difficult; reporting systems can underestimate the incidence of HCV infection despite well-established surveillance systems, such as that in Italy. Regular population-based surveys should be conducted to confirm these findings. The notable decrease in the incidence rate seen in the last 2 decades in Italy is mainly attributed to the improvement in the safety of blood supplies and blood products, use of safe injection practices, and implementation of universal precautions in medical settings. Intravenous drug use, other parenteral exposure i.e. ear piercing, tattooing), surgery, hospitalization, and dental treatment remain common risk factors among patients with HCV infection, particularly in resource-limited settings. Therefore, there is still no room for complacency. The public health agenda warrants maintaining surveillance, prevention, and control of HCV infection. The joint-point regression method used in this study may help to assess the impact of public health policies to meet the challenges posed by HCV infection and disease and to foster new public health strategies. However, it must be kept in mind that infectious disease epidemics rarely follow linear trends over time.

Blood Exposure at the 2010 International Federation of Football Association World Cup: Time for Universal Adaptation of Universal Precautions

Injuries involving blood exposure are relatively common in football. The goal of this observational study was to assess the use of universal precautions at the 2010 International Federation of Football Association (FIFA) World Cup. Observational descriptive study of more than 4000 minutes of FIFA World Cup football. Televised matches of football in the 2010 FIFA World Cup in the Republic of South Africa. Injuries with visible blood that were attended to by health care providers were recorded. Number of injuries with visible blood in which gloves were used by responders. Twenty-two significant bloody injuries were noted in more than 4000 minutes of play observed. In none of these cases were universal precautions implemented. This brief report shows the need for better implementation of universal precautions in football and other team sports.

Hepatitis B and the surgeon

Hepatitis B virus is the most transmissible virus and is very resistant to heat and chemicals, because of its unique structure. Blood has the maximum concentration of the virus among all the body fluids and the risk of transmission is related to the presence of HBeAg and the Hepatitis B virus DNA level in the blood. In India, about 1-10% of the healthcare workers are HBsAg positive. Healthcare workers, especially surgeons, and laboratory technicians are at a high risk of developing Hepatitis B infection. Transmission from Hepatitis B positive surgeons to patients has been well-documented. However, the risk of transmission from a patient to a surgeon is higher - about 30% - following a needle stick injury from an HBeAg positive individual. In India, there is low awareness among healthcare personnel about Hepatitis B vaccination and its related issues, and there is no health policy in this regard. In relation to the healthcare workers, there is an urgent need to formulate guidelines on HBsAg testing, hepatitis B vaccination, restriction of exposure-prone procedures that have to be performed, the extent to which their serological status can be revealed to patients, implementation of universal precautions, and post-exposure prophylaxis.

Implementation of Universal Precautions during Norovirus Outbreak at One County Long Term Care Facility

ISSUE: Noroviruses are very common: they account for 93% of nonbacterial gastroenteritis reported to the Centers for Disease Control and Prevention (CDC) for which a cause is identified. Outbreaks in long-term care facilities are not uncommon. In one recent two-year period, 80% of norovirus outbreaks were in skilled nursing facilities. Taking specific steps to prevent the virus from being transmitted from person to person can control outbreaks. CONTROL OF AN OUTBREAK OF VIRAL GASTROENTERITIS 1. Interrupt person-to-person transmission; 2.

KNOWLEDGE, ATTITUDES AND PRACTICES OF CLEANING STAFF REGARDING HEPATITIS B VIRUS

Abstract Background : Hepatitis B virus (HBV) is endemic in human population. It is estimated that 400 million people are infected with HBV in the world. Healthcare workers face with the risk of HBV infection during their work. Despite the increase of the disease, lack of knowledge regarding the mode of transmission and methods of prevention including immunization is still a threat. Purpose: The aim of this descriptive study was to assess knowledge, attitudes and practice of cleaning staff at Labafinejad Hospital regarding prevention of HBV. Methods: A questionnaire and a checklist of observation were used for data collection. The questionnaire consisted of 4 parts: 1) 18 questions regarding demographic characteristics; 2) 32 questions on knowledge, route of transmission and prevention of HBV infection; 3) 18 questions on attitude and 4) 4 question s regarding practice. It was validated and made reliable by content and test-retest methods (r=0.87). The questionnaire was distributed among 100 cleaning staff. Results: Finding showed that 75% of samples was male and 25% female. Knowledge score on universal precautions was moderate, attitude was good and practice was moderate. The results also showed that their attitude and practice were significantly correlated (P=0.009), practice had a significant correlation with age and sex (P=0.03). However, Furthermore, there was a significant correlation between knowledge with attitude, (P=0.35) and knowledge with practice (P=0.12). Conclusion: It can be concluded that cleaners had positive attitude toward HBV and implementation of universal precautions. On the other hand, cleaners had moderate knowledge and practice with regard to the mode of transmission. Therefore, performing comprehensive educational programs for cleaning staff regarding universal precautions seems necessary. Key words: HBV, Knowledge, Attitude, Practice.

Effect of Isolation Measures on the Incidence and Prevalence of Hepatitis C Virus Infection in Hemodialysis

Background: Nosocomial transmission of hepatitis C virus (HCV) in hemodialysis (HD) units is well established. In units with a high prevalence of HCV infection, the implementation of universal precautionary measures may not suffice in order to decrease the incidence and prevalence of HCV. In this setting strict isolation practices can be useful in order to achieve this goal. Methods: The incidence and prevalence of HCV infection amongst all HD and peritoneal dialysis (PD) patients from the province of Albacete, Spain, have been studied from 1992 to 2003.Through the 1993–1995 period chronic HD patients were treated either in a room exclusively for HCV– patients or in a room shared by HCV+ and HCV– patients. Complete separation of HCV+ and HCV– patients was implemented in 1995. Acute patients have been separated since 1992. The implementation of universal precautions was applied throughout the period. Results: There has not been a single seroconversion in the rooms where only HCV– patients were dialyzed during the 11 years of follow-up. There were two seroconversions in the rooms shared for 3 years by both HCV+ and HCV– patients. In 1995 the prevalence of HCV+ cases in HD and PD was 21.6 and 23.2%, respectively. Since then it has decreased steadily and in parallel for both therapies, and the current prevalence is 6.8% in HD and 5.7% in PD. Conclusions: In HD units with a high prevalence of HCV+ patients, strict isolation in combination with implementation of universal prevention measures can eliminate nosocomial transmission and obtain a long-term reduction in prevalence.

The Effect of Two Models of Supervision on Selected Outcomes

To evaluate the effect of training in two different supervisory models on the supervision itself, the quality of care, and job satisfaction of nurses in different service settings in a district health service (DHS) in South Africa. As part of a larger health systems study, the results of supervision training were evaluated. The quantitative study was done in three health districts in South Africa. The modified matrix (MM) model of supervision was taught and implemented in District A, the Centre for Health and Social Studies (CHESS) model in District B, and the control was District C. Checklists based on direct observation and record reviews were used to measure quality of care (quality of hand-over between shifts, nursing records, management of chronic diseases, and implementation of universal precautions). Questionnaires were used to measure perception of supervision and patient satisfaction. Chi-square analysis was done. Supervision ratings before and after the interventions differed significantly in the total sample, but not by district. In the district with the MM model, care for people with chronic diseases improved significantly, but other measures did not. The supervision training had some influence, but more measures of effectiveness of supervision training are needed.

A Survey of the quality of nursing care in several health districts in South Africa.

BackgroundSouth Africa is currently focusing strongly on human resource development. The purpose of this study was to describe and compare the quality of nursing service and care in three health districts in the KwaZulu Natal Province. To identify deficiencies which could be addressed by education and training, it might be useful to measure the quality of care given by nurses.MethodsFrom March to August 2002 a survey was done in six hospitals and six clinics in three health districts of the KwaZulu-Natal province of South Africa. Five different aspects of care was evaluated; hand-over from one nursing shift to another, implementation of universal precautions, patient satisfaction, nursing records, management of chronic illnesses. All these aspects were evaluated using checklists based on record reviews or direct observation, except for patient satisfaction, which was evaluated by questionnaires.ResultsThe average scores on the different aspects varied from 11% (for nursing records) to 73% (for management of chronic diseases). Specific problems became evident. In one district three out of four hand-overs between shifts of nurses scored less than 50%. In all three districts the use of protective gear scored low (43%). While the average score for management of chronic illnesses were high at 73%, the blood pressures of only 23% was within the target range, and the blood sugar of only 38% of patients were controlled. Patient satisfaction averaged 72% across the three districts.ConclusionThe quality of care measurements identified specific training needs, but other management strategies are probably also indicated.

AWARENESS AND PRACTICE OF UNIVERSAL PRECAUTIONS BY HEALTH CARE WORKERS IN A TEACHING INSTITUTE

Health Care Workers (HCWs) face a grave risk of acquiring infection including HumanImmunodeficiency Virus (HIV) and Hepatitis B & C during the course of their work.A questionnaire based study was conducted amongst the 154 HCWs working in ateaching hospital to study Acquired Immunodeficiency Syndrome (AIDS) awareness,and to assess the knowledge, attitude, and practice in respect of application of universalprecautions. This study has shown that definite lacunae exist regarding awarenessand practice of universal precautions. Comprehensive in service educationalprogramme for HCWs regarding the implementation of universal precautions isrecommended.

Epidemiology of hepatitis B in Europe and worldwide.

Hepatitis B virus (HBV) infection is a major public health problem and cause of infectious disease mortality worldwide. Approximately 2 billion people one third of the world’s population have serologic evidence of past or present HBV infection, and 350 million people are chronically infected. Each year over 1 million people die from HBV-related chronic liver disease, including cirrhosis and hepatocellular carcinoma (HCC) (1). HCC is one of the most common cancers worldwide, and HBV is responsible for at least 75% of these cancers (2).

Disposable non-sterile gloves: a policy for appropriate usage.

Since the implementation of universal precautions, the use of disposable gloves has become part of everyday clinical practice. Guidance has been published to advise healthcare workers of the risks of latex allergies associated with the wearing of powdered latex gloves. The literature supports the use of gloves when contact with blood or body fluids is likely. However, an audit of glove usage indicated that practitioners were wearing gloves inappropriately, i.e. to wash patients (20%). The results of this study also demonstrated that a small percentage of staff (20%) were wearing vinyl gloves to deal with blood spillages and for venepuncture (13%) and cannulation (10%). A glove policy and a flow chart to assist staff in the selection of gloves were introduced. An educational programme for all hospital staff was commenced. These measures can assist healthcare workers in making an informed choice regarding glove usage.

Advances in the Molecular Diagnosis of Hepatitis C and Their Clinical Implications

Advances in the Molecular Diagnosis of Hepatitis C and Their Clinical Implications