EFFECT OF EDUCATION ON THE USE OF UNIVERSAL PRECAUTIONS IN A UNIVERSITY HOSPITAL EMERGENCY DEPARTMENT

Study objectives: To determine if an educational program would improve both knowledge and practice of universal precautions by nursing personnel. Design: Participants were given a 14-question test and observed for their practice of universal precautions during routine IV catheter placement or phlebotomy and trauma care before and six months after an education in-service. Setting: University hospital emergency department. Type of participants: Nursing personnel. Interventions: One-hour lecture addressing the occupational risk of human immunodeficiency virus (HIV) infection and the recommended use of universal precautions. Measurements and main results: The mean overall correct response rates to the questionnaire before and after the in-service were 70% and 73%, respectively (P = NS). The pattern of incorrect responses suggested that the perceived risks of HIV transmission are underestimated, particularly among healthy-appearing patients. For care of critical trauma patients, there were significant increases between the frequency rates before and after the in-service of glove and protective eyewear use (66.7% vs 87.7%, P < .025; 0.0% vs 17.3%, P < .05, respectively). The frequency rates of glove use for IV placement or phlebotomy in noncritical patients and of gown use for trauma patient care also increased (52.6% vs 65.2% and 25% vs 39.5%, respectively); however, these changes were not statistically significant. Conclusion: An intensive educational program was associated with a modest increase in the compliance of ED nursing personnel with universal precautions and had no long-term effect on their general knowledge of HIV risk. The practice of universal precautions is still far from universal in this ED. © 1990 American College of Emergency Physicians.