Improving Anesthesia Nurse Compliance with Universal Precautions Using Group Goals and Public Feedback

Abstract

Universal Precautions (UPs), procedures to reduce the likelihood of accidental exposure to blood-borne pathogens, were observed among seven Certified Nurse Anesthetists and one anesthesia technician during intravenous line procedures. After six weeks of baseline measures, nurses participated in training, goal setting, and feedback targeting hand sanitizing practices. Three weeks later immediate needle disposal was targeted. Hand sanitizing behaviors increased from a group baseline percentage of 24% to 65% during the intervention, and 52% during withdrawal. No significant increases in immediate needle disposal were found. Participants disposed of needles immediately 53% of the time during baseline, 58% during the intervention phase, and 45% during withdrawal. Nontargeted UP behaviors also increased as a result of the intervention: Recapping needles with onhand increased from 45% during baseline to 61% during the intervention phases; removing gloves from inside out increased from 61% to 93%; and wearing gloves when discarding waste increased from 31% to 52%. Auxiliary behaviors such as nurse and patient interactions remained consistently high throughout the study.

Key Words:

• Universal Precautions
• hand washing
• goal setting
• group feedback
• public feedback