Is evidence guiding practice? Reported versus observed adherence to contact precautions: a pilot study

Am J Infect Control. 2013 Nov;41(11):965-70. doi: 10.1016/j.ajic.2013.05.005. Epub 2013 Jul 25.

Abstract

Background: Hospital-acquired infections are a major patient safety issue. We examined staff members' knowledge, attitudes, reported and observed adherence to guidelines, and perceptions of barriers to use of contact precautions.

Methods: A survey and nonparticipant observation study was used to examine knowledge, attitudes, perceptions, and actual behavior of staff on 3 medical/surgical units at a 600-bed Magnet-designated academic medical center (MDAMC) and a 110-bed community medical center (CMC) in the southeastern United States.

Results: Correct knowledge answers ranged from 75% (CMC) to 100% (MDAMC). CMC participants were less likely to perceive time as a barrier (5% vs 25%; P = .050); more MDAMC participants were motivated by supervisors' recognition (87% vs 33%; P = .001). No statistically significant differences existed between groups on reported behaviors. Upon observation, fewer CMC participants demonstrated 4 of 5 evidence-based contact precaution behaviors compared with MDMC participants (P < .001). Hand hygiene before glove application was similarly low at both sites.

Conclusions: Despite a decade of focus on improving patient safety, low adherence to evidence-based practice guidelines for implementation of contact precautions remains. Ongoing efforts are needed both at the system and practitioner level to improve practice adherence.

Keywords: Adherence; Attitudes; Health care-associated infections; Infection control; Practices.

MeSH terms

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Attitude of Health Personnel*
  • Cross Infection / prevention & control*
  • Female
  • Guideline Adherence*
  • Health Personnel*
  • Humans
  • Infection Control / methods*
  • Male
  • Middle Aged
  • Professional Competence*
  • Southeastern United States