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Personal Healthcare Worker (HCW) and Work-Site Characteristics That Affect HCWs' Use of Respiratory-Infection Control Measures in Ambulatory Healthcare Settings

Published online by Cambridge University Press:  02 January 2015

Wayne Turnberg*
Affiliation:
Washington State Department of Health, Seattle, Washington
William Daniell
Affiliation:
School of Public Health and Community Medicine, Seattle, Washington
Jude Van Buren
Affiliation:
Washington State Department of Health, Seattle, Washington
Noah Seixas
Affiliation:
School of Public Health and Community Medicine, Seattle, Washington School of Nursing, Seattle, Washington
Edward Lipkin
Affiliation:
Department of Medicine, Seattle, Washington
Jeffery Duchin
Affiliation:
University of Washington, and Public Health–Seattle and King County, Seattle, Washington
*
Washington State Department of Health, 5146 47th Ave., NE, Seattle, WA 98105-2925 (wayne.turnberg@doh.wa.gov)

Abstract

Objectives.

To identify healthcare worker (HCW) and work-site characteristics associated with HCWs' reported use of recommended respiratory-infection control practices in primary and emergency care settings.

Design.

A cross-sectional study using a self-administered questionnaire for HCWs during the summer and fall of 2005.

Setting.

Primary and emergency care clinics at 5 medical centers in King County, Seattle, Washington.

Results.

Nurse professionals who reported receiving training (odds ratio [OR], 2.5 [confidence interval {CI}, 1.1–5.9]; P = .029), instructional feedback from supervisors (OR, 3.0 [CI, 1.5–5.9]; P = .002), and management support for implementing safe work practices had a higher odds of also reporting adherence to recommended respiratory precautions, compared with nurses who did not. Training was the only important determinant for adherence to respiratory precaution measures among medical practitioners (OR, 5.5 [CI, 1.2–25.8]; P = .031). The reported rate of adherence to hand hygiene practices was higher among nurse professionals who were male (OR, 2.2 [CI, 1.0–4.9]; P = .045), had infants, small children, or older adults living at home (OR, 2.2 [CI, 1.2–3.9]; P = .007), reported cleanliness and orderliness of the establishment where they worked (OR, 2.0 [CI, 1.1–3.5]; P = .019), had received respiratory-infection control training (OR, 3.2 [CI, 1.8–6.0]; P<.001), and reported fears about catching a dangerous respiratory infection at work (OR, 2.3 [CI, 1.2–4.5]; P= .011).

Conclusion.

A number of HCW and work-site characteristics associated with HCWs' use of recommended respiratory-infection control measures have been identified. These potentially influential characteristics should be considered as targets or guides for further investigation, which should include the evaluation of intervention strategies.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1. Public Health Agency of Canada. Learning from SARS—Renewal of public health in Canada. A report of the National Advisory Committee on SARS and Public Health October 2003. Available at: http://www.phac-aspc.gc.ca/publicat/sars-sras/naylor/index-eng.php. Accessed September 17, 2004.Google Scholar
2. Centers for Disease Control and Prevention. Public Health Guidelines for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS), version 2/3; May 3, 2005. Supplement I: Infection Control in Healthcare, Home, and Community Settings. Available at: http://www.cdc.gov/NCIDOD/SARS/guidance/index.htm. Accessed October 21, 2007.Google Scholar
3.Centers for Disease Control and Prevention (CDC). Influenza (Flu). Fact Sheet: Respiratory Hygiene/Cough Etiquette in Healthcare Settings. November 4, 2004. Available at: http://www.cdc.gov/flu/professionals/pdf/resphygiene.pdf. Accessed August 14, 2007.Google Scholar
4.Gershon, RR, Vlahov, D, Felknor, SA, et al. Compliance with universal precautions among health care workers at three regional hospitals. Am J Infect Control 1995;23:225236.Google Scholar
5.Larson, E, Early, E, Cloonan, P, Sugrue, S, Parides, M. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 2000;26:1422.CrossRefGoogle ScholarPubMed
6.McCoy, KD, Beekmann, SE, Ferguson, KJ, et al. Monitoring adherence to standard precautions. Am J Infect Control 2001;29:2431.CrossRefGoogle ScholarPubMed
7.Michalsen, A, Delclos, D, George, L, et al. Compliance with universal precautions among physicians. J Occup Environ Med 1997;39:130137.CrossRefGoogle ScholarPubMed
8.Pittet, D. Compliance with hand disinfection and its impact on hospital-acquired infections. J Hosp Infect 2001;48(Suppl A):S40S46.CrossRefGoogle ScholarPubMed
9.Sax, H, Perneger, T, Hugonnet, S, Herrault, P, Chraiti, M, Pittet, D. Knowledge of standard and isolation precautions in a large teaching hospital. Infect Control Hosp Epidemiol 2005;26:298304.Google Scholar
10.Stein, AD, Makarawo, TP, Ahmad, MF. A survey of doctors' and nurses' knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals. J Hosp Infect 2003;54:6873.CrossRefGoogle ScholarPubMed
11.Gershon, RR, Karkashian, CD, Grosch, JW, et al. Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. Am J Infect Control 2000;28:211221.Google Scholar
12.Osborne, S. Influences on compliance with standard precautions among operating room nurses. Am J Infect Control 2003;31:415423.CrossRefGoogle ScholarPubMed
13.Pittet, D. Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerg Infect Dis 2001;7:234238.Google Scholar
14.Vaughn, T, McCoy, K, Beekmann, S, Woolson, R, Tomer, J, Doebbeling, B. Factors promoting consistent adherence to safe needle precautions among hospital workers. Infect Control Hosp Epidemiol 2004;25:548555.Google Scholar
15.Williams, C, Campbell, S, Henry, K, Collier, P. Variables influencing worker compliance with universal precautions in the emergency department. Am J Infect Control 1994;22:138148.Google Scholar
16.Yassi, A, Lockhart, K, Copes, R, et al. Determinants of healthcare workers' compliance with infection control procedures. Healthc Q 2007;10:4452.Google Scholar
17.Grosch, JW, Gershon, RR, Murphy, LR, DeJoy, DM. Safety climate dimensions associated with occupational exposure to blood-borne pathogens in nurses. Am J Ind Med 1999;1:S122S124.3.0.CO;2-L>CrossRefGoogle Scholar
18.Yassi, A, Moore, D, FitzGerald, M, Bigelow, P, Hon, C, Bryce, E. Research gaps in protecting healthcare workers from SARS and other respiratory pathogens: an interdisciplinary, multi-stakeholder, evidence-based approach. J Occup Environ Med 2005;47:4150.CrossRefGoogle ScholarPubMed
19.Turnberg, WL. Use of respiratory infection control recommendations among healthcare workers in primary care and emergency department settings [dissertation]. Seattle, Washington: University of Washington;2006.Google Scholar
20.Turnberg, W, Daniell, W, Seixas, N, et al. Appraisal of recommended respiratory infection control practices in primary care and emergency department settings. Am J Infect Control 2008;36:268275.Google Scholar
21.Garner, JS; Hospital Infection Control Practices Advisory Committee. CDC. Division of Healthcare Quality Promotion (DHQP). Issues in healthcare settings. Guideline for isolation precautions in hospitals. Updated February 18, 1997. Available at: http://www.premierinc.com/quality-safety/tools-services/safety/topics/guidelines/downloads/05_Isolation-HICPAC-96-97.doc. Accessed November 23, 2008.Google Scholar
22.Boyce, JM, Pittet, D; Healthcare Infection Control Practices Advisory Committee; HICPAC/SHEA/APOC/IDSA Hand Hygiene Task Force. Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APOC/IDSA Hand Hygiene Task Force. MMWR Recomm Rep 2002;51(RR-16):145.Google Scholar
23.Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L; Healthcare Infection Control Practices Advisory Committee. Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings 2007. Available at: http://www.cdc.gov/ncidod/dhqp/gl_isolation.html. Accessed August 14, 2007.Google Scholar
24. Centers for Disease Control and Prevention. Guidelines and recommendations: interim guidance for the use of masks to control influenza transmission; 2005. Available at: http://www.cdc.gov/flu/professionals/infectioncontrol/maskguidance.htm. Accessed September 30, 2006.Google Scholar
25.Pett, M, Lackey, N, Sullivan, J. Making Sense of Factor Analysis. Thousand Oaks, California: Sage Publications; 2003.Google Scholar
26.DeVellis, R. Scale Development: Theory and Applications. 2nd ed. Applied Social Research Methods Series. Volume 26. Thousand Oaks, California: Sage Publications; 2003.Google Scholar
27.Lau, T, Yang, X, Leung, P, et al. SARS in three categories of hospital workers, Hong Kong. Emerg Infect Dis 2004;10:13991404.Google Scholar
28.Novoa, A, Pi-Sunyer, T, Sala, M, Molins, E, Castells, X. Evaluation of hand hygiene adherence in a tertiary hospital. Am J Infect Control 2007;35:676683.CrossRefGoogle ScholarPubMed
29.O'Boyle, CA, Henly, SJ, Larson, E. Understanding adherence to hand hygiene recommendations: the theory of planned behavior. Am J Infect Control 2001;29:352360.Google Scholar
30.Jenner, E, Fletcher, B, Watson, P, Jones, F, Miller, L, Scott, G. Discrepancy between self-reported and observed hand hygiene behaviour in healthcare professionals. J Hosp Infect 2006;63:418422.CrossRefGoogle ScholarPubMed
31.Kretzer, EK, Larons, EL. Behavioral interventions to improve infection control practices. Am J Infect Control 1998;26:245253.Google Scholar