Assessment of Infection Control Practices in Bolan Medical Complex and Sandeman Provincial Hospital of Quetta, Balochistan, Pakistan

Pakistan has a double burden of disease, with more than 40% of the population suffering from infectious diseases. Therefore, in order to lower the risk of dangerous, avoidable infections among patients and healthcare staff, effective hospital infection control programmes are crucial from both an economic and a therapeutic standpoint. The goal of the study was to locate any gaps in current infection control and preventive procedures. The two teaching hospitals Bolan Medical Complex and Sandeman Provincial Hospital in Quetta were the sites of this cross-sectional investigation. In the SAMPLE, 161 people participated. The Statistical Package for Social Sciences (SPSS) version 16.0 was used to analyse the data, which was gathered via data sheets and questionnaires. The findings revealed that the Infection Control Committee (ICC) member's view of health-associated infections (HAIs) was ultimately determined to be inconsequential (P=0.6), and their perception that the staff education level may be a contributing factor was also shown to be unimportant (P=0.1). The operation theatre, labour room, lab and blood bank, OPD, and wards at BMC were evaluated in reference to the steps taken there for infection control and prevention, and the results were observed 30, 25, 15,14, and 15 accordingly. It was shown that the primary reason for the poor results was the negative perception of the ICC towards infection control and prevention. Therefore, it is necessary to alter how ICC is seen.

Knowledge of and adherence to standard precautions in a hemodialysis unit: a cross-sectional study

Abstract BACKGROUND: Standard precautions (SPs) are recommended safety measures for healthcare professionals to follow, with a view to preventing healthcare-related infections (HCRIs) and for their own protection. Inadequate adherence to these measures can lead to occurrences of occupational accidents and HCRIs. OBJECTIVES: To ascertain the knowledge of and adherence to SP measures among the nursing staff of a hemodialysis service and the relationship of these variables to occurrences of work accidents with biological material. DESIGN AND SETTING: Descriptive cross-sectional and correlational study with a quantitative approach developed in a hemodialysis clinic in Minas Gerais. METHODS: Data were collected through sociodemographic questionnaires and questionnaires on knowledge of and adherence to SPs. RESULTS: 29 professionals participated in the study. It is noteworthy that all of them had already participated in training related to SPs. However, no relationship was identified between knowledge of (15.17 points) and adherence to (71.86 points) SPs. In addition, inferential analysis showed that there was a relationship between suffering a work accident with biological material and the sociodemographic data and knowledge of and adherence to standard precautions. CONCLUSION: Knowledge of the SPs that had been established did not mean mastery of the subject. Despite positive results regarding adherence, factors requiring improvement were observed. It was possible to infer the characteristics that gave rise to greater risk of occurrences of accidents at work. Thus, this study showed the importance of assessing knowledge of and adherence to SP, in order to optimize and direct continuing education towards resolving occupational exposure.

Status of water, sanitation, and hygiene and standard precautions in healthcare facilities and its relevance to COVID-19 in Afghanistan

BACKGROUND@#To protect the health and safety of healthcare workers (HCWs), it is essential to ensure the provision of sustainable water, sanitation, and hygiene (WASH) services and standard precautions in healthcare facilities (HCF). The objectives of this short communication were 1) to assess the availability of WASH services and standard precautions in HCFs in seven provinces in Afghanistan before the COVID-19 pandemic, and 2) to elucidate the relevance of these patterns with the number of reported HCW infections from COVID-19 in the mentioned provinces.@*METHODS@#We analyzed secondary data from the 2018-19 Afghanistan Service Provision Assessment survey, which included 142 public and private HCFs in seven major provinces in Afghanistan. Data on COVID-19 cases were obtained from the Afghanistan Ministry of Public Health Data Warehouse. Weighted prevalence of WASH services and standard precautions were calculated using frequencies and percentages. ArcGIS maps were used to visualize the distribution of COVID-19 cases, and scatter plots were created to visualize the relevance of WASH services and standard precautions to COVID-19 cases in provinces.@*RESULTS@#Of the 142 facilities surveyed, about 97% had improved water sources, and over 94% had improved toilet for clients. Overall, HCFs had limited availability of hygiene services and standard precautions, which was lower in private than public facilities. More than half of the facilities had safe final disposal and appropriate storage of sharps and medical waste. Of the seven provinces, Herat province had the highest cumulative COVID-19 case rate among HCWs per 100,000 population and reported lower availability of WASH services and standard precautions in HCFs compared to other provinces.@*CONCLUSION@#Our findings show disparities in the availability of WASH services and standard precautions in public and private facilities. Private facilities had a lower availability of hygiene services and standard precautions than public facilities. Provinces with higher availability of WASH services and standard precautions in HCFs had a lower cumulative COVID-19 case rate among HCWs per 100,000 population. Pre-pandemic preparation of adequate WASH services and standard precautions in HCFs could be potentially important in combating infectious disease emergence.

Infusing standard precautions for infection control in occupational therapy telehealth with children

@#The COVID-19 pandemic has caused a profound effect on the health and well-being of individuals worldwide. In the Philippines, the withstanding quarantine protocols have affected the occupational therapy practice, which has adopted a telehealth strategy. Filipino occupational therapists (OTs) working with children have to infuse concepts of standard precautions of infection control to prevent infection and transmission in their virtual sessions. This innovative practice has been delivered through telehealth services. This case report highlights the importance of family collaboration, activity analysis, evidence utilization, and infusing standard precautions in children’s daily occupations. OTs should consider these “new approaches” in the “new normal” and beyond.

Standard precautions: Awareness, practice, and adherence among obstetrics and gynecology resident doctors of a tertiary care hospital

Background: Infection control occupies a unique position in the field of patient safety since it is universally relevant to health care workers and patients at every single health-care encounter. Most of the healthcare-associated infections are preventable. Through this study, the awareness, practices, and adherence to standard precautions among the resident doctors were sought. Objectives: The objectives of this study were as follows: (1) To determine the level of awareness, practices, and adherence to standard precautions for infection control among resident doctors and (2) to determine factors affecting infection control. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, an observational study was conducted among the resident doctors in the post-natal care ward (PNC) of a tertiary care hospital. Data collection was done using direct observations, a structured validated interview schedule, and discussions with 21 resident doctors working in the PNC. Results: About 71% of the study population had received a training in standard precautions. Specific infection control protocol as suggested in standard precautions was followed for infection control by 76% of the population. Hepatitis B vaccination coverage with three doses of the vaccine is only 66.6% in the study population. Good awareness in standard precautions considering all five elements together was seen in 57% of respondents. Good practice of standard precautions was seen in 52% of doctors. When the individual elements were considered separately, good practice was seen the least for waste disposal. Most respondents had good practice in hand hygiene and cough hygiene. Conclusion: Deficient adherence to standard precautions among health-care providers warrants new induction and monitoring strategies.

Factors Affecting Compliance with Standard Precautions among Healthcare Workers in Public Hospitals Abuja, Nigeria

Background:Health care workers are at risk of various occupational hazards such as blood borne and other pathogens infections in the hospital in the course of carrying out their duties. This study aims to assess the factors affecting compliance with standard precautions (SP)s among Health care workers in primary, secondary and tertiary hospitals in NigeriaMethods: A cross-sectional survey of 332 health care workers involved in clinical practices from 19 Government health facilities in North central Nigeria. A multi-staged sampling technique was used and data collected using a semi-structured self-administered questionnaire and analysed using Epi-info 7 and associations tested using chi square test and logistic regression. Level of significance was set at 5% Results:Of 332 participants interviewed, knowledge was above average in 274 (82.6%) of the respondents out of which 141 (42.5%) had good knowledge and 133 (40.1%) had fair knowledge. Majority of the respondents (76.2%) were compliant with SPs. Factors significantly affecting health care worker’s compliance type of health facility (p=0.022) and years of practice (p=0.044). Conclusion: Health care workers in primary health facilities were less likely to be compliant with standard precautions than those in tertiary health facilities. Training on infection prevention and control, was recommended.

A cross sectional study on adoption of standard precautions among sanitary workers, Tamil Nadu

Background: Hospital waste is a potential reservoir of pathogenic micro-organism and requires appropriate, safe handling. Sanitary workers entail to do waste collection, handling, storage and disposal. Hence they have higher chances of exposure to numerous risk factors. The objective of the study was to assess the adoption of ‘standard precautions’ among sanitary workers pertaining to hand hygiene, use of personal protective equipment (PPE), prevention of needle stick/sharp injuries, handling of soiled linen and finding out the reasons for non-adoption.Methods: A cross sectional study was done in two health care institutions in Chennai and Madurai, Tamil Nadu during January to May 2018. Institutional ethics committee approval was obtained. All sanitary workers willing to participate in the study were included. After getting informed consent, data was collected using structured questionnaire and analyzed with SPSS 20.0. Mean, frequency and percentages were calculated.Results: Sanitary workers included in the study were 118. The overall hand hygiene was satisfactory among 35.6%. Only 62.7% were using gloves while handling waste. 54(45.8%) had NSI in last one year. Immersing soiled linen in hot water was done only by 15 (12.7%) before washing with disinfectant and autoclaving.Conclusions: The adoption of ‘standard precautions’ among sanitary workers is inadequate due to lack of proper orientation

Assessment of the knowledge and practices regarding standard precaution among nursing staff at a tertiary care hospital of Raipur city, Chhattisgarh

Background: Nurses as healthcare providers obliged to protect herself and patients against infections. Therefore, nurses should have knowledge and strict adherence to standard precautions. Hence, this study was undertaken to assess the knowledge and practices of nursing staff regarding standard precautions. Aims and objectives of the study were to assess the knowledge of nursing staff regarding standard precaution and to observe the practices of nursing staff regarding standard precaution.Methods: This was a cross sectional study conducted among staff nurses working in Bhim Rao Ambedkar Memorial Hospital, Raipur, and Chhattisgarh, from January to March 2017 among 100 staff nurses. Pretested predesigned semi-structured questionnaires were used. Data collected were entered in Microsoft excel sheet. The statistical analysis was done by using epi info 7. Frequencies and percentage were presented for categorical variables.Results: The overall knowledge regarding standard precaution were excellent (>75% score) in 8% nurses. Good knowledge (50 to 75%) in 83% and average (25 to 50%) in 9%. The Practises regarding standard precautions among the nurses were good in 72%, excellent in 17% and average in 11%.Conclusions: Based on the findings of the present study, it can be concluded that in spite of having good knowledge regarding standard precaution among the nurses, practices were not to up to the mark.

Awareness on standard precautions among auxiliary nurse midwives in a subdivision of Purba Bardhaman district, West Bengal

Background: Due to their occupation, health workers are always at-risk of developing life-threatening infections. “Standard precautions” acts as a protective barrier against this. There is a lack of information about awareness on standard precaution among auxiliary nurse midwives (ANMs), the frontline health personnel working at Sub-centres. The aim of the study was to assess the current awareness on Standard precautions among ANMs.Methods: This descriptive study with cross-sectional design was conducted at sub centre level of Bardhaman Sadar North subdivision, Purba Bardhaman district, West Bengal. In this study, conducted between September-November 2017, three blocks were chosen from the seven blocks in the subdivision through simple random sampling. All ANMs working in these blocks were approached and data were collected on background characteristics and knowledge on key elements of Standard precautions using a pre-tested and pre-designed self-administered questionnaire. Items assessing standard precaution were scored one (for correct response) and zero (for incorrect/missed response). Maximum possible score was fourteen and minimum was zero. Statistical analysis used association of acceptability of knowledge with background characteristics were assessed using bivariate analysis and binary logistic regression.Results: Median (IQR) of the score obtained was 10 (9, 12). Out of total 138 subjects, 64.5% had acceptable knowledge (score ≥10) regarding standard precautions. Participants’ age had a statistically significant association with acceptable knowledge in the bivariate analysis; however, in the final model, only training status of the participants remained significant [AOR-0.304 (0.098-0.938)].Conclusions: It emphasized the importance of regular training on Standard precautions for ANMs.

Occupational Exposure to Potentially Infectious Biological Material Among Physicians, Dentists, and Nurses at a University

OBJECTIVE: The objective of this study was to evaluate the prevalence and incidence of accidents with biological material, the level of knowledge, and compliance to standard precautions (SPs) among dentists, physicians, nurses, and dental and medical students.METHODS: A closed cohort study with a prospective and retrospective component was conducted between August 2014 and September 2015. The participants were contacted in two moments during the follow-up period, during which a structured questionnaire divided into six sections was used; the interviews were conducted during the follow-up period (Month 6) and at the end of the observation period (Month 12).RESULTS: The global prevalence of accidents in the previous 12 months was 10.2%, with a difference between professionals and students (13.0% vs. 5.1%, respectively; p < 0.003). The incidence rate was 6.49 per 100 person/year, with difference between the groups (6.09 per 100 person/year in professionals and 7.26 per 100 person/year in students), type of specialization (hazard ratio, 3.27), and hours worked per week (hazard ratio, 2.27). The mean of compliance to SP was 31.99 (±3.85) points, with a median of 33 (30, 35) points against the expected 27.75 points. Adherence to SP was associated with the accident report (p < 0.020).CONCLUSION: We conclude that the proportion/incidence rate of accidents with biological material was high in relation to that in the literature, being higher in professionals and especially among physicians. The levels of knowledge and adherence to SP were good, with the best found in dentists and dental students.

Transmission and Prevention of Healthcare-Associated Infections / 대한내과학회지

To prevent the transmission of pathogens in hospitals, implementation of transmission-based precautions is essential, such as precautions to prevent airborne, droplet, and contact transmissions. However, it is impossible to identify all hidden asymptomatic carriers. Emphasis has therefore been placed on the use of standard precautions, including hand hygiene and cough etiquette. Recently, the possibility of the spread of imported emerging infectious diseases in medical institutions has also become an area of focus. Prevention of the spread of infections in hospitals should be a top priority to ensure the highest quality of care.

Survey of the knowledge, safety climate, and compliance with hospital infection standard precautions among dental hygienists / 대한구강보건학회지

OBJECTIVES: The aim of this study was to examine the knowledge, safety climate, and compliance with hospital standard precautions among dental hygienists, and investigate the influencing factors. METHODS: A biased sampling method was used. Using the modified questionnaire, data were collected from 146 dental hygienists working at dental hospitals, general hospitals, and University hospitals, during September to October 2015. Data were entered and analyzed using software SPSS 20.0. RESULTS: The knowledge, safety climate, and compliance score of the hygienists regarding hospital standard precautions, were high when evaluation was carried out during healthcare accreditation or its preparation. The most important factor affecting compliance with the hospital standard precautions was working experience. CONCLUSIONS: Knowledge, safety climate, and compliance with hospital infection standard precautions were all high, on certification by the healthcare accreditation system.

Factors Influencing Nursing Students' Performance on Standard Precautions of Infection Control

PURPOSE: The purpose of this study was to identify the factors that affect nursing students' performance on standard precaution of infection control. METHODS: For the analysis of the study results, mistakes and percentages, descriptive statistics, Pearson's coefficient, and multiple regression analysis were performed. RESULTS: Among the participants, 76.5% received hospital infection education, and 72.5% experienced an exposure to blood or body fluid, and the most of the exposures were occurred during the first semester of the third year. The knowledge score was 20.08±2.09, the awareness score was 4.63±.41, and the performance score was 4.34±.55. In the relationship between the standard precautions knowledge, awareness, and performance, the awareness and the performance were in positive correlations, while the factors that affected the performance level of the standard precautions were awareness and the school year (third year), which had 37.0% of the total exposures. CONCLUSION: In order to increase the performance level of the standard precautions among the nursing department students, after identifying the differences between school years and demands of the students, it is necessary to provide continuous and regular education of standard precautions.

Investigating Compliance with Standard Precautions During Residency Physicians in Gynecology and Obstetrics

OBJECTIVES: Physician compliance with standard precautions is important in the specialty of gynecology and obstetrics because of the high frequency of invasive procedures. The current study investigated compliance with standard precautions among resident physicians working in gynecology and obstetrics. METHOD: A cross-sectional study was conducted among resident physicians in gynecology and obstetrics in their first (R1), second (R2) and third (R3) years of residency at a teaching hospital in a city in São Paulo. A structured questionnaire that included demographic and professional aspects and the Standard Precautions Adherence Scale were used to collect data. Statistical analysis was performed using IBM® SPSS version 20. Ethical aspects were considered. RESULTS: Fifty-eight resident physicians participated in the study. Of the enrolled participants, 27 (46.6%) were in R1, 12 (20.7%) were in R2 and 19 (32.8%) were in R3. The standard precautions compliance score was 4.1, which was classified as intermediate. There were no significant differences in the compliance scores of the resident physicians across the three years of residency (H=2.34, p=0.310). CONCLUSION: Compliance with standard precautions among resident physicians was intermediate. Preventive measures in clinical practice are not fully adopted in the specialty of gynecology and obstetrics. More important, many professionals claimed lack of sufficient training in standard precautions in the workplace. Such circumstances should draw the attention of hospital management with regard to occupational health risks.

Human immunodeficiency virus, hepatitis B virus and hepatitis C virus seroprevalence in critically ill emergency department patients at a Trauma Care Centre, India.

Introduction: Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the most common occupationally acquired infections amongst the healthcare workers (HCWs) with critically ill patients attending the emergency department being the most common source of occupationally acquired infections. Therefore, the present study was conducted at a 165 bedded level-1 trauma centre of India to ascertain the seroprevalence rate of HIV, HBV and HCV; and thus the risk associated with the occupational exposure in a busy emergency setting of the developing world. Methodology: A retrospective, 7 years study (2007-2013) was carried out at the JPNA Trauma Centre of the 2,500 bedded All India Institute of Medical Sciences, New Delhi. Records of all patients whose serum samples were sent to the laboratory for viral markers testing were obtained and those falling in the red area were included. Results: A total of 11,630 patients were received in the red area; and samples from 7,650 patients were sent for testing. Seropositivity of HIV, HBV and HCV in these samples was 0.28%, 3.4% and 0.9% respectively. The number of samples received was lesser than the total number of patients received in the red area. Conclusion: Adopting Standard Precautions (SP) can be used as an easy method to decrease the risk of occupationally acquired infections.

Factors influencing emergency staff′ compliance with standard precautions in the tertiary hospitals：a focus group qualitative study / 中国实用护理杂志

Objective To explore the factors influencing emergency staff′ compliance with standard precautions in the tertiary hospitals, in order to provide a theoretical basis for improving the standard precautions. Methods Using qualitative research method, eight focus groups were conducted with emergency staff in the tertiary hospitals in China from October to December in 2015. Interview data were imported into Nvivo10.0 qualitative analysis software, using content analysis method for its collation and analysis. Results Factors that affect the standard precautions compliance were grouped into five themes: availability and practicality of protective equipment, organizational climate, safety awareness, obstructive elements to the behavior, and trigger elements to the behavior. Conclusions Standard precautions compliance of emergency medical staff is affected by many factors, management departments should actively build a good professional environment and reinforce safety awareness of the emergency staff.

Motivos e consequências da baixa adesão às precauções padrão pela equipe de enfermagem / Razones y consecuencias de la baja adhesión a precauciones estándar para el equipo de enfermería / Reasons and consequences of low adherence to standard precautions by the nursing team

RESUMO As precauções padrão (PP) são recomendações para prevenir infecções e proteger os trabalhadores de saúde durante a prestação de cuidados. Porém, constata-se baixa adesão a estas recomendações. Objetivo Analisar os motivos e as consequências da baixa adesão às PP pela equipe de enfermagem. Método Revisão integrativa da literatura, busca em sete bases de dados, período de 2005 a 2014. Resultados 30 artigos foram selecionados para análise. Os motivos da baixa adesão evidenciados relacionam-se a práticas deficitárias de educação permanente, comportamentos de risco de trabalhadores, provisão de material e equipamentos de proteção inadequados e condições de trabalho inadequadas. As consequências são os acidentes e as doenças do trabalho. Os estudos de intervenção são escassos e limitam-se à educação dos profissionais. Conclusões A baixa adesão às PP está vinculada a aspectos individuais dos trabalhadores e às instituições empregadoras e formadoras. As estratégias de intervenção realizadas mostram-se pouco eficientes por focar apenas o trabalhador.

RESUMEN Las precauciones estándares (PE) son recomendaciones para prevenir infecciones y proteger a los trabajadores de la salud durante la prestación de cuidados, pero, se constata baja adhesión a estas recomendaciones. Objetivo analizar los motivos y consecuencias de la baja adhesión a las PE por el equipo de enfermería. Método revisión integradora de la literatura, busca en siete bases de datos, periodo de 2005 a 2014. Resultados 30 artículos fueron seleccionados para análisis. Los motivos de la baja adhesión evidenciados se relacionan a precarias prácticas de educación permanente, comportamientos de riesgo de trabajadores, inadecuada provisión de material y equipos de protección e inadecuadas condiciones de trabajo. Las consecuencias son los accidentes y las enfermedades del trabajo. Son escasos los estudios de intervención y se limitan a la educación de los profesionales. Conclusiones la baja adhesión a las PE se vincula a los aspectos individuales de los trabajadores, las instituciones empleadoras y formadoras. Las estrategias de intervención realizadas se muestran poco eficientes por enfocar solo al trabajador.

ABSTRACT Standard precautions (SP) are recommendations to prevent infection and protect health care workers during the provision of care, however, still exists low adherence to these recommendations. Objective To analyze the reasons and consequences of low adherence to standard precautions by the nursing staff. Method integrative literature review, search in seven databases, from 2005 to 2014. Results 30 articles were selected for analysis. The reasons for low adherence evidenced relate to deficient practices of lifelong learning, risk behaviors of workers, inadequate provision of equipment and protective equipment and inadequate working conditions. The consequences are accidents and occupational diseases. There are few intervention studies, which merely provide guidance to professionals. Conclusions The low adhesion to standard precautions is linked to individual aspects of workers, employers and educational institutions. Intervention strategies carried out have shown little efficient by only focusing on the worker.

Níveis de adesão às precauções-padrão entre profissionais médicos e de enfermagem de um hospital universitário / Compliance with standard-precautions among medical and nursing staff at a university hospital

As a primary intervention to prevent occupational exposures to bloodborne pathogens, compliance with standard precautions (SP) is extremely important to management occupational risks. The purpose of this study was to analyse self-reported levels of compliance with standard precautions among physicians and nurses. A sample of medical and nursing staff at a university hospital was asked how frequently they used the recomendations of SP. A Likert scale was used. Data were analysed by averagind scores of each scale item. The recomendations itens about "manipulation and discard of sharps objects", "washing hands after removing disposable gloves" and "using disposable gloves whenener there is a possibility of the contact with blood" raised high levels of compliance. The levels of compliance reported by nursing staff was significantly higher than medical staff to four SP recomendations. The findings offer evidence to involve physicians on organizacional tranning about standard precautions.

Como medida de prevenção primária da exposição ocupacional a material biológico, a adesão às precauções-padrão (PP) é de extrema importância para o controle dos riscos ocupacionais. O objetivo deste estudo foi analisar os índices de adesão relatados por profissionais médicos e de enfermagem. Uma amostra de profissionais médicos e de enfermagem, de um hospital universitário, foi questionada quanto à freqüência com que utilizava as PP. Foi utilizado um questionário com escala do tipo Likert.. Para análise dos dados, foram calculados os escores médios dos itens da escala. As recomendações relacionadas à “manipulação e descarte de OPC”, “lavagem de mãos após retirar luvas” e “uso de luvas quando houver possibilidade de contato com sangue” atingiram altos níveis de adesão. Os profissionais de enfermagem relataram níveis de adesão significativamente maiores do que os médicos a quatro recomendações das PP. Os resultados evidenciaram a necessidade de inclusão dos médicos no treinamento institucional sobre precauções-padrão.

Modelo explicativo da adesão às precauções-padrão: construção e aplicação / Construction and application of a model for explaining compliance with standard precautions

A exposição ocupacional a material biológico é uma das questões mais proeminentes na área da Saúde e Segurança Ocupacional, pois coloca o profissional de saúde em risco de adquirir infecções transmitidas por via sanguínea. Há mais de uma década, esforços têm sido dirigidos para incentivar as medidas preventivas, denominadas, inicialmente, precauções universais (PU) e, posteriormente, precauções-padrão (PP). Entretanto, universalmente estudos têm demonstrado níveis insatisfatórios de adesão às recomendações das PP. A revisão da literatura aponta para a análise dos fatores que interferem na tomada de decisão dos profissionais de saúde baseada em três dimensões: indivíduo, trabalho e organização. Fundamentados nessa premissa, desenvolvemos um modelo teórico explicativo da adesão às precauções-padrão para identificar a influência dos fatores individuais, relativos ao trabalho e organizacionais. A aplicação desse modelo em 270 profissionais médicos e de enfermagem de um hospital universitário revelou importantes diferenças entre os dois grupos profissionais: (1) os profissionais de enfermagem relataram níveis significativamente maiores de adesão às recomendações para "seguir as PP com todos os pacientes", "lavar as mãos após retirar luvas", "usar avental protetor", e ao conjunto de itens relacionados à manipulação e descarte de objetos perfurocortantes; (2) os profissionais de enfermagem relataram perceber mais intensamente os aspectos organizacionais de apoio a adoção das precauções-padrão; (3) os fatores individuais, relativos ao trabalho e organizacionais explicaram 38,5% do índice global de adesão; (4) o índice global de adesão foi explicado por pertencer ao grupo profissional de médicos; ter recebido treinamento em PP; perceber menos intensamente os obstáculos para seguir as PP; perceber mais intensamente a carga de trabalho, o feedback das práticas de segurança, e as ações gerenciais de apoio à segurança. ) Os resultados obtidos possibilitaram a discussão de um programa para o gerenciamento dos riscos ocupacionais relacionados à exposição a material biológico cujas diretrizes foram assim definidas: (1) educação para consciência; (2) controle de engenharia; (3) controle das práticas de trabalho.

The bloodborne pathogens exposure is a salient issue for Occupational Health and Safety so that it places health care workers on bloodborne infections risks. For almost two decades, efforts have been drived to encourage safety practices named, first, universal precautions, and after, standard precautions. However, studies have showed poor levels of compliance with these recommendations. The literature points out the factors that interfere in the health care workers decision-making which are centred on tree dimensions: individual, job/task, and organization. Based on this premise, we developed a theorethical model for explaining compliance with standard precautions and to identify the influence of individual, job-related, and organization factors. The application of this model on 270 heath care workers at a university hospital shows that: (1) nursing staff reported higher levels of compliance with some recommendations than physicians did; (2) nursing staff perceived strongly the organization support for adherence with PP than physincians did; (3) the individual, job-related and organization factors predicted 38,5% of general compliance level differences among individuals. The empirical investigation also shows that general compliance levels are explained by the following variables: being physician; having receveid PP training at university hospital; perceiveing less likely job hidrances for using PP, and perceiveing strongly workload, feedback of safety practices, management actions and commitment with safety. The conclusions of this research aid to organize a program to management bloodborne occupacional exposure whose directives was defined as: raising awareness through education; engineering control; and work practices control.