Standard Precautions Research Articles

Background: Dextrocardia is a rare congenital anomaly in which the heart is positioned in the right hemithorax, often accompanied by complex structural abnormalities involving the cardiac chambers and great vessels. In oncology, this condition poses therapeutic challenges, particularly regarding cardiotoxicity risk. A thorough anatomical evaluation is essential to ensure the safety of invasive procedures and systemic cancer therapies. Research Questions: This case report explores how congenital cardiac anatomical variations influence clinical decision-making and cardio-oncology monitoring strategies. Approach: We describe a 35-year-old woman with left-sided invasive ductal carcinoma (HER2-, ER/PR+, Ki-67: 10%) and complex congenital heart disease: dextrocardia, congenitally corrected transposition of the great arteries, pulmonary stenosis, and ventricular septal defect. Pre-treatment evaluation included chest X-ray (Fig.1a), ECG (Fig. 1b), transthoracic echocardiography (Fig. 2), and cardiac MRI (Fig. 3). She underwent mastectomy, radiotherapy, and six cycles of docetaxel/cyclophosphamide chemotherapy. Cardiac function was monitored with serial echocardiograms and cardiac biomarkers (troponin, NT-proBNP). The patient developed heart failure with preserved ejection fraction (HFpEF) during chemotherapy. Clinical management with a loop diuretic and ACE inhibitor led to symptom resolution and clinical stabilization. The patient remained hemodynamically stable, with no drop in left ventricular ejection fraction. Discussion: Docetaxel and cyclophosphamide can be safely administered in dextrocardia, provided standard precautions are observed along with attention to altered cardiac anatomy. In cases with associated congenital heart disease, detailed cardiac imaging is crucial prior to chemotherapy. Serial monitoring with cardiac biomarkers allows early detection of cardiotoxicity. Interestingly, in this patient, dextrocardia led to reduced cardiac exposure during left-sided breast radiotherapy, possibly affording additional protection against radiation-induced myocardial fibrosis, coronary artery disease, and late cardiotoxicity. Conclusion: This case highlights the value of personalized oncology care in patients with congenital heart defects. While dextrocardia does not inherently preclude chemotherapy with agents such as docetaxel and cyclophosphamide, detailed imaging and vigilant clinical and laboratory monitoring are essential to optimize treatment safety and efficacy.

Knowledge, attitude, and challenges about standard safety precautions and vaccination among health care professionals: A cross-sectional study.

Background: Standard precautions are essential in preventing healthcare-associated infections, yet compliance among nursing students often varies. Assessing their knowledge and practices is crucial for guiding educational and institutional interventions. Objective: This study aimed to evaluate the knowledge and compliance with standard precautions among nursing students. Methods: A cross-sectional study was conducted at the Lahore School of Nursing among 58 fifth-semester BSN students, selected from a population of 76 using Slovin’s formula and convenient sampling. Data were collected using a validated questionnaire adapted from Getachew study which included 19rekated to knowledge and 17 Likert-scale items on compliance. Knowledge and compliance were categorized into levels, and data were analysed using SPSS version 22. Descriptive statistics summarized participant characteristics, while Pearson’s correlation tested the association between knowledge and compliance (p ≤ 0.05). Results: The findings revealed that overall knowledge of standard precautions was relatively high, though gaps existed in specific areas such as nosocomial infections and hand hygiene. Compliance levels varied, with students demonstrating stronger adherence in some practices than others. A positive correlation was observed between knowledge and compliance, indicating that greater knowledge was associated with better adherence to standard precautions. Conclusion: While nursing students showed good knowledge of standard precautions, compliance required strengthening, particularly in critical areas. Educational interventions focusing on practical demonstrations, continuous reinforcement, and role modelling by educators are recommended to improve adherence and ensure patient and nurse safety.

Background: Needle stick injuries (NSIs) are a major occupational hazard among healthcare workers, leading to potential transmission of blood-borne infections such as hepatitis B, hepatitis C, and HIV. Awareness and knowledge regarding prevention and management of NSIs are essential for ensuring workplace safety and infection control. Objective: To assess the level of knowledge regarding needle stick injuries among healthcare workers. Materials and Methods: This cross-sectional descriptive study was conducted among healthcare personnel using a structured, pretested questionnaire. Participants were evaluated on their knowledge about causes, risks, preventive measures, and post-exposure management of NSIs. The collected data were analyzed and presented as frequency and percentage distributions. Results: Out of the total respondents, 93 (62%) demonstrated good knowledge regarding needle stick injuries, 50 (33.3%) had average knowledge, while 7 (4.66%) showed poor knowledge. The findings indicate that although a majority possess adequate awareness, a substantial proportion still lack comprehensive understanding, highlighting the need for regular training and reinforcement programs. Conclusion: The study revealed that while most healthcare workers had good knowledge about NSIs, a significant number exhibited only moderate or poor understanding. Continuous education, awareness campaigns, and strict adherence to standard precautions are necessary to minimize occupational risk and enhance safety in healthcare settings.

BackgroundInfection prevention and control (IPC) safety culture is recognized as a crucial factor in improving healthcare workers’ (HCWs) compliance with IPC measures. Despite its importance, evidence regarding the influence of IPC safety culture on compliance remains limited and warrants further investigation.MethodsA cross-sectional study was conducted from March 27 to April 3, 2025, using an online questionnaire to examine the association between IPC safety culture and HCWs’ compliance with IPC measures across more than 200 healthcare institutions, including 12 tertiary hospitals, in Haizhu District, Guangzhou, Guangdong Province, China. IPC safety culture was assessed using the Infection Control Culture Scale, while compliance with IPC measures was measured with the Compliance with Standard Precautions Scale, both utilizing five-point Likert scales. Student’s t test assessed differences between groups, and linear correlation analyses examined relationships between IPC safety culture dimensions and compliance scores. Multivariate logistic regression was used to identify factors associated with HCWs’ compliance to IP measures.ResultsA total of 1,600 questionnaires were distributed, of which 1,471 were valid (91.94%). HCWs aged over 30 years, with more than 5 years of work experience, and holding a Master’s degree or higher had higher IPC safety culture scores compared with their counterparts (p < 0.05). Similarly, HCWs aged over 30 years, with more than 5 years of experience, a Master’s degree or higher, and possessing clinical teaching qualifications demonstrated higher compliance with IPC measures compared with their counterparts (p < 0.05). Linear correlation analysis showed that basic IPC competence was strongly correlated with all dimensions of IPC compliance (r = 0.70, 0.63, 0.62, 0.63, 0.64, and 0.58, p < 0.001). Hospital management climate, departmental team cooperation, organizational learning and continuous improvement, and reporting frequency of hospital-acquired infections (HAIs) adverse events were weakly to moderately correlated with IPC compliance (p < 0.001). Based on a median score of 4.95 (IQR 4.77–5.00), 840 participants (57.10%) were classified as having good compliance, and 631 (42.90%) as poor compliance. Multivariate logistic regression indicated that clinical instructor status (OR = 1.60, 95% CI: 1.46–1.79), basic IPC competence (OR = 1.87, 95% CI: 1.73–1.99), hospital management climate (OR = 1.50, 95% CI: 1.08–2.10), reporting frequency of HAIs adverse events (OR = 1.36, 95% CI: 1.19–1.54), and organizational learning and continuous improvement (OR = 3.59, 95% CI: 2.68–4.80) as independent predictors of IPC compliance.ConclusionIPC safety culture significantly affects HCWs’ adherence to IPC measures. Enhancing basic IPC competence, hospital management support, organizational learning, reporting practices, and targeted interventions for clinical instructors can improve compliance and help prevent HAIs.

Background: Needle stick injuries (NSIs) remain a leading cause of occupational exposure to bloodborne infections among healthcare personnel, particularly nurses. In developing healthcare systems, inadequate adherence to standard precautions and insufficient training amplify the risk of hepatitis B, hepatitis C, and HIV transmission. Objective: To evaluate the effect of implementing standardized protocols on the knowledge and practices of nursing students regarding NSI prevention and management. Methods: A quasi-experimental study was conducted among forty final-year nursing students at a private tertiary hospital in Lahore, Pakistan. Participants underwent a structured training intervention based on World Health Organization guidelines. Data were collected using pre- and post-intervention questionnaires assessing knowledge and practice domains and analyzed using paired-sample t-tests with a 95% confidence interval. Results: Mean post-test scores increased significantly by 39.6 points compared with pre-test values (t = −25.08, p &lt; 0.001). Knowledge regarding safe disposal, double-gloving, post-exposure prophylaxis, and disease transmission improved from baseline levels of 14–37% to ≥92.5% across all variables. Conclusion: The implementation of standardized NSI training substantially enhanced nursing students’ knowledge and safety practices. Integrating such interventions into nursing curricula can effectively reduce occupational exposure risk.

Hepatitis C Virus (HCV) is emerging as one of the major health problems in Bangladesh. Worldwide, there are roughly 71 million people who are chronically infected. Prevalence of HCV infection in Bangladesh is 0.88%. Chronic HCV carriers have the potential of transmitting HCV parenterally in the hospital setting; thus, health care workers (HCWs) are at risk of contracting HCV, with the most likely exposure being via a needle stick injury (NSI). As there is no effective vaccine till today, personal protection, safe transfusion of blood and blood products, safe disposal of Hospital bio-waste and use of disposable or auto-disabled syringes would be the best preventive option for a country like Bangladesh. This study aimed to investigate the knowledge, attitudes and practices regarding hepatitis C virus among health care workers in Mymensingh Medical College Hospital (MMCH). This cross-sectional observational study was conducted among 239 health care workers (79 Doctors, 100 Nurses, 50 Lab technicians and 10 Porters) from July 2019 to December 2019. Data were collected by structured questionnaire. The overall response rate was 85.0%. For knowledge about hepatitis C virus physicians were the most knowledgeable while porters are least knowledgeable group. Males who were over 40 years old and had working history of more than 10 years were most likely to show positive attitude towards hepatitis C. Physicians have more positive attitude than other groups. Those who received training had more positive attitude than others. In this study about half of participant took training about standard precaution. Though about fifty percent participant knows about protective measures but not all of them used it. Measures taken against blood borne viruses specially against hepatitis C virus are not satisfactory among the health care staffs of MMCH, Bangladesh. Therefore, a guideline should be put in place and implemented by the government and private health care authorities.

Febrile neutropenia is a medical emergency requiring rapid and rigorous management considering the risk of severe infection. Febrile neutropenia is a frequent complication in patients receiving chemotherapy. Initial assessment is vital in order to decide the follow-up (outpatient treatment, conventional care or intensive care unit) and to initiate adapted antibiotic therapy as soon as possible. Depending on the infectious syndrome (clinically documented, microbiologically documented or undocumented), antibiotic therapy should be adapted or discontinued, considering the recovery from aplasia and absence of fever. Antifungal agents are not systematically used and its use should be discussed according to the context. G-CSF should be used prophylactically, and is not an adjunct to antibiotic therapy for febrile neutropenia. Granulocyte transfusions are exceptionnally indicated and its use should be discussed on a case-by-case basis. Standard precautions are adequate for the majority of patients, with the exception of specific situations.

The updated AORN "Guideline for transmission-based precautions" provides perioperative nurses with evidence-based guidance on preparing for emerging and persistent infectious threats and outlines strategies to reduce the risk of transmission in the surgical setting. This article provides an overview of the guideline and discusses recommendations for personal protective equipment; implementing standard, contact, droplet, and airborne precautions; infective airborne particle risk assessment; transporting patients with confirmed or suspected infectious disease; and preparing for emerging infectious diseases. A scenario illustrates the application of these practices during the transport of a patient on airborne precautions. Perioperative nurses should review the guideline in its entirety and apply the recommendations to support infection prevention; protect patients and personnel; and ensure safe, evidence-based care across all surgical settings.

ObjectivesThis study tested a serial mediation model, based on Social Cognitive Theory (SCT), to explore how patient safety climate is associated with nurses' compliance via infection prevention climate (IPC) and standard precautions attitude.MethodsA cross-sectional survey was conducted among 913 registered nurses from 34 hospitals in China using validated instruments. Data were analyzed using PROCESS macro (Model 6) with 5,000 bootstrap samples, adjusting for age, gender, education, professional title, hospital level, and infection control training frequency.ResultsPatient safety climate had a significant total effect on compliance (βPSC → COMP(total) = 0.551, p < 0.001), but the direct effect became non-significant after including mediators (βPSC → COMP = −0.034, p = 0.378), indicating full mediation. This suggests that patient safety climate was not directly associated with compliance but exerted its influence entirely through infection prevention climate and attitudes, highlighting an indirect yet substantial pathway. All three indirect paths were significant: via infection prevention climate alone (βPSC → IPC → COMP = 0.138), via attitude alone (βPSC → ATT → COMP = 0.102), and via both in sequence [βPSC → IPC → ATT → COMP = 0.346, 95% CI (0.272, 0.426)], with the sequential pathway explaining 59.0% of the total indirect effect. In practical terms, attitude showed the strongest predictive power, with a standardized coefficient of βATT → COMP = 0.666, indicating a clinically meaningful impact on compliance behavior.ConclusionPatient safety climate indirectly enhances compliance through departmental climate and individual attitudes. Interventions targeting both organizational climate and individual beliefs may strengthen compliance with standard precautions in clinical practice.

Hand hygiene is one of the most significant components of standard infection control precautions. This study aimed to assess local hand hygiene technique and the effectiveness of an instructional video plus adding a seventh step to the Ayliffe technique. Adherence of practitioners to the six-step Ayliffe technique and its effectiveness were assessed using a lotion that shows areas not cleansed adequately under ultraviolet light. This was followed by a short instructional video plus an added step to improve cleansing of the dorsal hand. Technique was re-evaluated immediately and 3-4 weeks later. 43% of participants correctly performed all six steps of the Ayliffe technique during the initial assessment; this rose to 97% after watching the video. A majority (59%) of participants initially missed the dorsal hands, which improved to 13% at the third assessment. An instructional video is an effective tool for improving hand hygiene technique. Adding the seventh step to the Ayliffe technique improves coverage of the dorsal hand so will increase the effectiveness of hand hygiene protocols.

Background:During the coronavirus disease 2019 (COVID-19) pandemic, strict infection prevention and control (IPC) measures were implemented in healthcare settings.Aim:To evaluate the effect of enhanced IPC practices implemented during the COVID-19 pandemic on the prevalence of hospital-acquired infections (HAIs) in a Tunisian university hospital.Methods:A multimodal IPC strategy was implemented from March to September 2020 at Sahloul University Hospital, Sousse, Tunisia. This strategy included promoting hand hygiene (HH), enhancing adherence to standard precautions and universal masking. We compared the prevalence of HAIs and compliance with IPC practices before the pandemic (pre-intervention phase) and during the pandemic (post-intervention phase).Results:A total of 306 patients were surveyed in 2019 and 228 in 2021. The prevalence of HAIs increased slightly from 9.4% to 10.08% (p = 0.814). HH compliance improved significantly from 38.3% to 51.6% and sharp waste sorting compliance rose from 60.3% to 77.6%. The use of personal protective equipment also increased, with FFP2 respirator consumption increasing nearly 247-fold.Conclusions:This study found no significant change in HAI prevalence despite the implementation of enhanced IPC strategies. However, the small sample size was a major limitation that may have reduced the statistical power to detect meaningful differences. Larger-scale studies are needed to confirm these findings and better assess the impact of IPC strategies in this context.Trial registration:Not applicable.

Aseptic technique forms a component of standard precautions and is a foundational concept in nursing practice. The application of that standard appears to vary between context and nurse. The variation of principles and application between facilities and individuals may reflect the current disparity in evidence-based literature. The purpose of this scoping review is to map the current literature and to seek clarification of key concepts and definitions of asepsis and aseptic technique in relation to clinical nursing. A systematic search was conducted in alignment with Joanna Briggs Institute guidelines and PRISMA-ScR for scoping reviews. Electronic databases Medline and CINAHL were searched using a combination of Medical Subject Headings (MeSH) and free-text terms. Studies published between January 1st, 2004 and 31st, December 2024 were included. Studies were screened in Covidence. One reviewer screened the titles and abstracts, with a second checking a random sample. Two reviewers conducted full text reviews. Data extraction was undertaken using a pre-specified database. A total of 2812 studies were initially identified, with 31 articles included in the review following the screening and full-text review. Half of the included papers originated from three countries, the UK (N = 6), USA (N = 5), and Australia (N = 4). Many papers do not define asepsis or aseptic technique, and there are notable variations in the terminology used to apply aseptic technique. This scoping review highlights the variation in the definitions, principles, and application of aseptic technique in clinical nursing settings across evidence-based literature. It will inform a larger planned program of research.

A systematic review of knowledge assessment instruments for isolation precautions among health care personnel.

Standard precautions perception and practice among health workers in the obstetrics-gynecology department of a referral hospital in Cameroon

Oncology nurses' compliance with standard precautions: a multi-method study.

Introduction: The COVID-19 pandemic has intensified the challenges of infection prevention in healthcare settings. Nursing professionals, particularly those working in critical care units, are at high risk of occupational exposure to biological hazards. Adherence to standard precautions (SP) is essential for infection control, yet compliance remains suboptimal. Methods: This descriptive, cross-sectional, multicenter study was conducted between September and October 2020 in two public hospitals in Brazil. Nursing professionals (n=384) working in critical care units participated. Data were collected using a structured questionnaire that assessed sociodemographic and professional characteristics and the Compliance with Standard Precautions Scale – Portuguese- Brazilian version (CSPS-PB). Bivariate analyses (Mann–Whitney U, Kruskal–Wallis, Chisquare tests) were performed, with a significance level of 5%. Results: The median SP adherence score was 15.2 (range: 15–20), reflecting a 65% compliance rate. Nursing technicians had the highest adherence (mean=15.44; SD=2.6), with older professionals also showing higher compliance (p&lt;0.002). The most frequently reported barriers to adherence were procedural urgency (35.4%), general discomfort (34.9%), and discomfort with specific personal protective equipment (32.2%). Training on SP was significantly associated with higher compliance scores (p=0.05). Discussion: Despite ongoing training efforts, SP adherence among nursing professionals was below recommended levels, posing risks to both staff and patients. Factors such as professional category, age, and participation in SP training influenced adherence. Organizational and behavioral barriers were prominent, underscoring the need for multifaceted interventions. Conclusion: Nursing professionals exhibited low adherence to standard precautions during the COVID-19 pandemic. Targeted educational strategies, institutional support, and behavior-focused interventions are urgently needed to enhance compliance and reduce occupational risks.

BackgroundTeaching standard precautions during undergraduate courses in health-related fields is essential for preventing healthcare-associated infections (HAI).PurposeTo analyze the effect of an educational intervention on nursing students’ knowledge of COVID-19, standard precautions (SP), transmission-based precautions, and compliance with SP, as well as the factors associated with knowledge.MethodsA quasi-experimental pre- and post-test study was conducted with 80 nursing students at a higher education institution in the state of São Paulo, Brazil. The group received an intervention using combined teaching methods, including an interactive lecture, a video presentation, and an instructor-led demonstration of donning and doffing personal protective equipment (PPE).ResultsRegarding knowledge, after the educational intervention, an increase in correct answers was observed in 14 questions related to COVID-19 and SP measures, with seven showing statistically significant differences. In terms of SP compliance, significant improvements were observed in the following aspects: using alcohol-based products for hand hygiene, proper disposal of sharps containers, discarding PPE in designated locations, protecting wounds or injuries with waterproof dressings before patient contact, wearing gowns/aprons when exposed to bodily fluids, and disposing of contaminated materials in white plastic bags. No factors were found to be associated with knowledge or participant characteristics regarding COVID-19 training.ConclusionsThe educational intervention proved to be an effective strategy for enhancing nursing students’ knowledge of COVID-19, SP measures, and compliance with SP.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12912-025-03672-y.

Challenges and Compliance in Practicing Standard Precautions: An Insight from Nurses in Ihiala, Nigeria

BackgroundDespite the significant morbidity and mortality caused by healthcare-associated infections worldwide, especially in low- and middle-income countries (LMICs), there is a lack of understanding of the readiness to apply standard precautions for infection prevention and control (IPC) in healthcare facilities across different LMICs.MethodsWe analysed nationally representative health system data from the Service Provision Assessment surveys for six selected LMICs – Afghanistan, the Democratic Republic of Congo, Haiti, Nepal, Senegal, and Bangladesh. We recorded seven tracer items of standard precautions into binary elements. We calculated a readiness index based on the World Health Organization’s Service Availability and Readiness Assessment manual. We utilised survey-weighted multivariable generalised estimating equations to identify factors associated with the readiness index.ResultsAmong 6054 healthcare facilities, 55% (95% confidence interval (CI) = 53.1, 56.5) of necessary standard precautions were available, ranging from 48.1% in the Democratic Republic of the Congo to 65% in Nepal. Readiness varied by service area, with the tuberculosis service area being the least prepared at 38% and the general outpatient service area being the most prepared at 66%. Facilities in Nepal and the urban regions showed higher readiness, with mean (x̄) differences of 16% (95% CI = 13.6, 17.9) and 3% (95% CI = 1.8, 4.9) compared to the Democratic Republic of the Congo and rural areas, respectively.ConclusionsWe revealed significant deficiencies in standard precautions within healthcare facilities across six LMICs, notably in rural areas. The findings underscore an urgent need for targeted interventions to improve IPC strategies, particularly in domains like tuberculosis care.