Substantial Improvement in Compliance With Universal Precautions in an Emergency Department Following Institution of Policy

Gabor D Kelen, Gary B. Green, David A. Hexter, Dewitt C. Fortenberry, Eric Taylor, Deborah H. Fleetwood, Keith T. Sivertson

Research output: Contribution to journalArticle

Abstract

Seven months following the introduction of an institutional policy mandating compliance with universal precautions (UPs), we observed 127 health care workers performing 1421 interventions on 155 critically ill and injured patients in an emergency department setting in July 1989. Results were compared with a similar study undertaken exactly 1 year previously when UPs were considered as guidelines only. Overall adherence to UPs improved from 44.0% to 72.7% from 1 year to the next. Adherence to UPs improved from 19.5% to 55.7% during interventions on patients with profuse bleeding and from 16.7% to 54.5% during performance of major procedures. Compliance improved from 47.9% to 81.0% for emergency departmentbased health care workers (residents, attending physicians, nurses, x-ray film technicians). Prehospital care providers, a group not accountable to the institution, remained particularly noncompliant with only 13% adherence. We conclude that mandating UPs as policy with a monitoring component is effective in ensuring a reasonable level of adherence. However, given current barrier technology, achieving appropriate levels of compliance during unscheduled visits by patients requiring immediate attention and rapid intervention remains a challenge.

Original languageEnglish (US)
Pages (from-to)2051-2056
Number of pages6
JournalArchives of Internal Medicine
Volume151
Issue number10
DOIs
StatePublished - 1991

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Universal Precautions
Hospital Emergency Service
Organizational Policy
Delivery of Health Care
Guideline Adherence
Motion Pictures
Critical Illness
Compliance
Emergencies
Nurses
X-Rays
Guidelines
Hemorrhage
Technology
Physicians

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Substantial Improvement in Compliance With Universal Precautions in an Emergency Department Following Institution of Policy. / Kelen, Gabor D; Green, Gary B.; Hexter, David A.; Fortenberry, Dewitt C.; Taylor, Eric; Fleetwood, Deborah H.; Sivertson, Keith T.

In: Archives of Internal Medicine, Vol. 151, No. 10, 1991, p. 2051-2056.

Research output: Contribution to journalArticle

Kelen, Gabor D ; Green, Gary B. ; Hexter, David A. ; Fortenberry, Dewitt C. ; Taylor, Eric ; Fleetwood, Deborah H. ; Sivertson, Keith T. / Substantial Improvement in Compliance With Universal Precautions in an Emergency Department Following Institution of Policy. In: Archives of Internal Medicine. 1991 ; Vol. 151, No. 10. pp. 2051-2056.
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