Study: 80% of nurses don't adhere to infection prevention precautions

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More than 80% of ambulatory care nurses — the type of nurses who might visit a senior living community to provide care for residents — do not adhere to all of the standard precautions for infection prevention, potentially putting themselves and those for whom they care at risk, according to a newly published study. The research was published in the January issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology.

The study authors, from Northwell Health (formerly North Shore Long Island Jewish Health System), asked 116 ambulatory care nurses to self-report their adherence to nine standard precautions as well as behavioral factors influencing adherence (see box). Only 17.4% said they adhered to all of the precautions.

The highest rate of adherence was reported with glove-wearing (92%), followed by face mask-wearing (70%). Only 63% of participants reported that they always wash hands after removing gloves, and 82% reported that they always wash hands after providing care. And because adherence was self-reported, it might be overestimated, according to the researchers.

Standard precautions are the minimum infection control practices that should be used in the care of all residents or patients at all times, whether or not they appear to be infectious. They are used to protect healthcare workers, patients and residents from the transmission of diseases that can be spread by contact with blood, body fluids, non-intact skin and mucous membranes.

Although the study did not include nurses working in independent or assisted living environments, corresponding author Donna Powers, DNP, RN, tells McKnight's Senior Living that the findings can be generalized across all settings. “Basically, it's applicable to anybody who has a risk of occupational exposure to blood or body fluids,” she says.

Senior living community owners and operators employing nurses or welcoming them into their communities to care for residents via contracted home healthcare services or another arrangement should ensure that all nurses have undergone compliance training to reinforce the risks associated with bloodborne pathogen exposure and the importance of adhering to all infection prevention precautions, Powers says.

Resident education can be helpful as well, she adds. “Well-educated consumers are going to be the best advocates for themselves,” Powers says.”You certainly can educate them so that if they see a lapse in behavior, they can address it with the healthcare worker.”

Nurses who care for relatively healthy people may underestimate their infection risk, Powers adds. “Nurses who work in the operating room or in trauma may know that a patient is infected. In the ambulatory setting, you can have patients who are infected and really not know it and look healthy,” she says. “So the staff needs to understand that everybody has to be treated as potentially infectious, because you don't always know.”

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