THE INFLUENCE OF EMPLOYEE, JOB TASK, AND ORGANIZATIONAL-FACTORS ON ADHERENCE TO UNIVERSAL PRECAUTIONS AMONG NURSES

Universal precautions (UP) refer to recommended work practices designed to help prevent occupational exposure to HIV/AIDS and other blood-borne pathogens in health care settings. However, despite widespread dissemination of UP guidelines and subsequent government regulatory action, worker adherence remains less than satisfactory. The present study used hierarchical, multiple regression analysis to examine the relative influence of four sets of factors on worker adherence to UP: demographics, personal characteristics, job/task factors, and organization-level factors. Data were analyzed on a sample of 451 nurses employed at a large U.S. medical center. Consistent with the general hypothesis of the study, job/task and organization-level factors were the best predictors of adherence. Using the results from the study, a heuristic model of the adherence process is proposed that highlights the contributions of job hindrances and organizational safety climate to UP-related behavior. A three-pronged intervention strategy is also presented that emphasizes (1) the availability and accessibility of personal protective devices, (2) the reduction of UP-related job hindrances and barriers, and (3) improvements in safety performance feedback and related communications. Given the preliminary nature of this study, several recommendations for future research are also offered. Relevance to industry Efforts to enhance the use of personal protective equipment should extend beyond equipment availability and traditional motivational/enforcement activities. Worker adherence is likely to benefit from careful analysis of specific job requirements and the provision of a supportive organizational safety climate.