Compliance With Universal Precautions in Correctional Health Care Facilities

Abstract

There were three main objectives of this cross-sectional study of Maryland State correctional health care workers. The first was to evaluate compliance with work practices designed to minimize exposure to blood and body fluids; the second, to identify correlates of compliance with universal precautions (UPs); and the third was to determine the relationship, if any, between compliance and exposures. Of 216 responding health care workers, 34% reported overall compliance across all 15 items on a compliance scale. Rates for specific items were particularly low for use of certain types of personal protective equipment, such as protective eyewear (53.5%), face mask (47.2%) and protective clothing (33.9%). Compliance rates were highest for glove use (93.2%) waste disposal (89.8%), and sharps disposal (80.8%). Compliance rates were generally not associated with demographic factors, except for age; younger workers were more likely to be compliant with safe work practices than were older workers (P < 0.05). Compliance was positively associated with several work-related variables, including perceived safety climate (i.e., management's commitment to infection control and the overall safety program) and job satisfaction, and was found to be inversely associated with security-related work constraints, job/task factors, adverse working conditions, workplace discrimination, and perceived work stress. Bloodborne exposures were not uncommon; 13.8% of all respondents had at least one bloodborne exposure within the previous 6 months, and compliance was inversely related to blood and body fluid exposures. This study identified several potentially modifiable correlates of compliance, including factors unique to the correctional setting. Infection-control interventional strategies specifically tailored to these health care workers may therefore be most effective in reducing the risk of bloodborne exposures.

Non-Hospital Based Registered Nurses and the Risk of Bloodborne Pathogen Exposure

“…This finding is not surprising given the frequency of clinical procedures performed by non-hospital RNs that involves needles and other sharps. Other types of exposures, such as splashes to eyes, were also similar to published results for hospital workers and exceeded rates published for correctional healthcare workers 22,24) . Similarly, the risk factors for exposure to blood/body fluids in this population have also been noted for RNs in the hospital setting including lack of compliance, poor safety climate, etc.…”

HBV, HCV, and HIV infection prevalence among prison staff in the light of occupational risk factors

“…Współczynnik skaleczeń dla personelu medycznego zatrudnionego w tych jednostkach i mającego bezpośredni kontakt z pacjentami wynosił 42 na 100 osobolat [17]. W innym badaniu tych samych autorów, przeprowadzonym w tej samej grupie zawodowej w 28 placówkach penitencjarnych w stanie Maryland, wykazano, że 14% personelu uległo ekspozycji zawodowej [18]. W niniejszym badaniu wśród 5 przedstawicieli zawodów medycznych (lekarz, lekarz dentysta, pielęgniarki) 3 osoby uległy zakłuciu w trakcie całej pracy zawodowej, w tym 1 osoba 3-krotnie w roku poprzedzającym badanie.…”

“…W cytowanym wyżej badaniu Gershon i wsp. wykazano, że podczas gdy rękawice ochronne regularnie stosowało 93% badanych pracowników ochrony zdrowia zatrudnionych w więziennictwie, to jedynie 54% badanych używało ochronę oczu [18]. Młodsi pracownicy stosowali środki ochronne istotnie częściej niż starsi.…”

“…w USA odsetek szczepionych przeciwko HBV pracowników więziennego personelu medycznego wynosił 64-72% [17,18], a w badaniu włas-nym 4 osoby z 5 należących do personelu medycznego zgłosiły zaszczepienie. Niepokoi jednak, że osoba, która nie poddała się szczepieniu, podała w ankiecie 2 ekspozycje zawodowe na krew, a w 1 przypadku status osadzonego był znany jako HBV-dodatni.…”

Health hazard evaluation report: HETA #2006-0357-3041, Denver Sheriff's Department, Denver, Colorado.

“…They have also reported skin and mucous membrane exposures to blood and body fluids. 3,4 The Centers for Disease Control and Prevention (CDC) recommends that measures to prevent occupational exposures to infectious agents be integrated into correctional facilities' infection control plans according to Occupational Safety and Health Administration (OSHA) requirements.…”