Knowledge and Attitudes of Workers from a Public Emergency Service in Relation to the Adoption of Standard Precautions

Background: The exposure of health professionals working in emergency services to risks related to their daily activities and non-adherence to universal precautions can predispose them to occupational accidents.

Objective: This study aimed to evaluate the adoption of precaution measures through the knowledge and attitude of a multiprofessional team in relation to standard precautions, occupational risks and infection control.

Methods: This cross-sectional study was carried out with 116 professionals from an Emergency Medical Service in Minas Gerais, Brazil. Data were collected between June and November 2006. Data were analyzed according to professional category, age, gender, time since graduation, time working at the facility and assigned unit. Chi-square test was used to compare categorical variables and logistic regression to evaluate potential association between adherence to standard precautions and categorical variables.

Results: Among the 116 participants, 15.5% were physicians, 7.8% nurses, 55.2% nursing technicians and auxiliaries and 21.5% were drivers. The majority (56.0%) were male; 57.1% graduated before 2000; 59.5% worked at the hospital for more than one year and 70.7% were assigned to the basic support unit. Results indicate that nurses and drivers presented the highest and lowest levels of knowledge in relation to standard precautions, respectively (Table 1). Non-adherence to precaution measures was 3.8 (CI 95%: 1.5–9.5) times more frequent among professionals older than 31 years and 6.7 (CI 95%: 1.8–24.8) times more frequent among workers from the basic support unit.

Conclusions: For the service to keep appropriate standards of care delivery to patients and prevent potential exposure to biological risks, discussion about used procedures and the need to develop occupational risk prevention programs should be encouraged among employees.

TablE 1: Distribution of answers related to knowledge in relation to standard precaution measures according to professional category

KNOWLEDGE	Physician N=18 %	Nurse N=9 %	Nursing tech/aux N=64 %	Driver N=25 %	p-value
Most important vehicle for microorganisms transmission	94.4	100.0	90.6	56.0	0.001*
Indication for using disposable gloves during emergency care	94.4	100.0	78.1	52.0	0.002
Importance of hand washing	88.9	77.8	84.4	52.0	0.006
Indication to hand hygiene  when delivering care to patient	72.2	88.9	89.1	68.0	0.064*
Risk of infection from blood contact with ocular mucosa	88.9	100.0	48.4	32.0	< 0.001
Potential infections that can be acquired through contact with body fluids and blood	88.9	77.8	68.8	64.0	0.287
Standard precautions for emergency care service	72.2	55.6	51.6	84.0	0.029
Appropriate packaging of waste produced in emergency care	66.7	77.8	78.1	92.0	0.233
Hepatitis B vaccine	100.0	88.9	85.9	76.0	0.129*
AVERAGE	15 (83.3)	8 (83.8)	48 (75.0)	16 (64.0)

*Fischer’s exact test