Fewer than 1 in 5 nurses comply with guidelines for standard precautions


Washington, January 20, 2016 – Only 17.4 percent of ambulatory care nurses reported compliance in all nine standard precautions for infection prevention, according to a study 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 (APIC).

Researchers from Northwell Health (formerly North Shore Long Island Jewish Health System) conducted a study of 116 ambulatory care nurses to measure self-reported compliance with standard precautions, knowledge of hepatitis C virus (HCV), and behavioral factors influencing compliance.

The highest rate of compliance was reported with always wearing gloves (92 percent), followed by always wearing a face mask (70 percent). Only 63 percent of participants reported that they always wash hands after removal of gloves and 82 percent reported that they always wash hands after provision of care.

The study also found knowledge of HCV was variable, with more than one in four (26 percent) erroneously believing that it is commonly spread through sexual contact, 14 percent incorrectly believing that HCV causes premature death, 12 percent not knowing HCV antibodies can be present without an infection, and 11 percent not knowing there are multiple HCV genotypes.

“Self-reported data might be an overestimate of actual compliance and that makes these results of particular concern for potential exposure to bloodborne diseases,” concluded the study authors. “Overall, the ambulatory care nurses chose to implement some behaviors and not others, and this behavior puts them at risk for acquiring a bloodborne infection.”

Standard precautions are the minimum infection control practices that should be used in the care of all patients at all times, whether or not they appear to be infectious. They are used to protect healthcare workers and patients from transmission of diseases that can be spread by contact with blood, body fluids, non-intact skin, and mucous membranes. The nurses surveyed in this study were assessed based on these nine precautions:

  1. I provide nursing care considering all patients as potentially contagious
  2. I wash my hands after the removal of gloves
  3. I avoid placing foreign objects on my hands
  4. I wear gloves when exposure of my hands to body fluids is anticipated
  5. I avoid needle recapping
  6. I avoid the disassembling of a used needle from a syringe
  7. I use a face mask when exposure to air-transmitted pathogens is anticipated
  8. I wash my hands after the provision of care
  9. I discard used sharp materials into sharps containers

Learn more on APIC’s Infection Prevention and You website.

AJIC: American Journal of Infection Control (www.ajicjournal.org) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.

APIC’s mission is to create a safer world through prevention of infection. The association’s more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at www.apic.org. Follow APIC on Twitter and Facebook. For consumer information, visit APIC’s Infection Prevention and You website.

Factors influencing nurse compliance with Standard Precautions” by Donna Powers, Donna Armellino, Mary Dolansky, and Joyce Fitzpatrick appears in the American Journal of Infection Control, Volume 44, Issue 1 (January 2016).


Donna Powers, DNP, RN (Corresponding Author)
Northwell Health (formerly North Shore Long Island Jewish Health System), New York, NY

Donna Armellino, DNP, RN
Infection Prevention
Northwell Health (formerly North Shore Long Island Jewish Health System), New York, NY

Mary Dolansky, PhD, RN
Frances Payne Bolton School of Nursing
Case Western Reserve University, Cleveland, OH

Joyce Fitzpatrick, PhD, RN
Frances Payne Bolton School of Nursing
Case Western Reserve University, Cleveland, OH

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