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style="font-size: 12pt / line-height: 115% / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / ">This study has reveled the levels of knowledge and compliance towards Universal Precautions and examined the factors that are influential in having a positive and negative effect on their adoption by healthcare practitioners in practice. Despite acceptable knowledge regarding the potential for infection and mechanisms to prevent these infections, this study has found out that health care workers are not as compliant with universal precautions as they need to be. The findings that compliance correlated directly with knowledge, with in-service training and with availability of protective equipment, provide important indications for future interventions. Therefore a regular on job refreshing training program on Universal Precautions, a written guideline and reminder poster on Universal Precautions and personal protective equipment need to be made available for all health care providers in every department of the hospital for better compliance. <span style="">&nbsp / </span><span style="">&nbsp / </span><span style="">&nbsp / </span><o:p></o:p></span></p> <p>&nbsp / </p>

<p>Background: Health care workers, more specifically, nursing students are at increased risk of occupational injury and exposure to blood borne pathogens. Compliance with universal precautions (UP) will minimise risk or transmission of HIV and HBV (Hepatitis B virus) according to the Department of Health of South Africa. Aim: The aim of this study was to investigate the knowledge and practice of universal precautions amongst nursing students and their fear of occupational exposure to blood borne pathogens. Rationale: The rationale for the study was to investigate what the students&rsquo / knowledge and practice of UP were, to see if this could be a possible contributing factor to occupational exposure. Research design: The study was a quantitative, cross sectional survey using a questionnaire that included one open ended question. Participants: The participants for the study were the undergraduate nursing students in year levels two to four (n = 253) who and were selected by means of stratified random sampling. Procedures: A questionnaire was administered to the participants by the researcher. Analysis of the data collected was done through statistical package for social sciences (SPSS 16.0) and content analysis. Results: The researcher established that there is indeed a lack of knowledge regarding UP and that the students&rsquo / self reported practice of UP is poor. No statistically significant correlation between knowledge and practice of UP were found. There is underreporting of occupational exposures to staff at the School of Nursing. The majority of students reported a moderate to severe fear for occupational exposures and contributing factors raised by them are reality in the clinical facilities.</p>

Background Hospital-acquired infections are significant cause of morbidity and mortality among hospitalized patients worldwide. Healthcare workers during job are exposed to blood borne pathogens through contact with infected body parts, blood and body fluids. World health organization (WHO) estimated that globally about 2.5% of HIV and 40% of hepatitis viral infected cases are among health workers due to exposures. The most important mechanism of spread of these pathogens is through contaminated hands of the healthcare workers. Standard precautions measures are essential to prevent and control healthcare associated infection among healthcare workers and patients. In developing countries despite the development of detailed guideline for infection control the knowledge of standard precautions is low and not properly applied. The aim of this study is to assess the knowledge and practice of health care workers regarding standard precautions and hand hygiene to infectious disease control.  Aim The aim of this study was to assess the knowledge and practice of health care workers regarding hand wash and standard precautions to control infectious diseases in BMCH. In addition create awareness among participants and encourage them to practice regularly hand hygiene and standard precautions to control or reduce nosocomial infections in health care facilities Methods The study design is cross-sectional evaluation of healthcare worker knowledge and practices about standard precautions and hand hygiene for infectious disease control. A questionnaire administered to health care workers (doctors and nurses). The questionnaire was divided in two parts and the first part concerns demographic information, asking knowledge and practice. The second part asked opinions about risk and prevention of HAIs. The questionnaire was developed with consultation of other studies of the same kind. It has been pre tested and is finalized for survey. The ethical approval was given by hospital superintendent and informs consent from all study participants. Statistic analysis was done on Excel and statistical software SPSS version 20. Data was described in numbers, percentages and Chi Square test done for association among categorical variables, significant level was considered P= &lt;0.05. Results Two hundred questionnaires were distributed to HCWs in BMCH and 169 completely fill questionnaire were returned. The male gender respondents were 42% and female respondents were 58%. The basic questions about knowledge of hand hygiene and standard precautions were answered well in both categories; about 73% were with sufficient knowledge. The practice of hand hygiene and standard precautions was not satisfactory among both categories; about 47% found with good practice. Differences found in sub groups, young age none trained doctors and nurses answered wrong and shown lack of knowledge. This study found an association of age, profession and job experience with knowledge and practice regarding hand hygiene and standard precautions. Open handed questions described well the major issue regarding HAIs and participants emphasized on risk and prevention methods.  Conclusions The respondents were HCWs (doctors and nurses) of both sex and this study found that majority of HCWs have good knowledge and practice about control of HAIs but difference were found in age groups, sex and profession. Above half of the HCWs were not trained for infection control in health facilities, thus getting training of infection control is important but more important is implementation of it during practice.

There is an increase in HIV/AIDS and other blood borne diseases. Health care workers are often exposed to blood and body fluids and thus prone to blood borne infections. Preventative measures can be taken to prevent health workers from contracting these diseases. However, health care workers need to stringently apply these measures. Universal precautions against blood borne infections include diligent hygiene practices, such as hand washing and drying, appropriate handling and disposal of sharp objects, prevention of needle stick or sharp injuries, appropriate handling of patient care equipment and soiled linen, environmental cleaning and spills management, appropriate handling of waste as well as protective clothing such as gloves, gowns, aprons, masks and protective eyewear. This study is aimed at investigating compliance with universal precautions in operating theatres in Northern KwaZulu–Natal as well as perceptions of registered nurses working in these operating theatres regarding factors influencing compliance in order to contribute to measures to limit the risk of infection to patients and health care workers. A sequential explanatory design, mixed–method (quantitative and qualitative) was used to explore the use of universal precautions in operating theatres in the Northern Kwa–Zulu Natal. In the first phase, the sample consisted of practices in operating theatres of six hospitals and one regional hospital in area 3 of Kwa–Zulu Natal. The adapted structured checklist based on an established document developed by the MASA Committee for Science and Education (1995) was pilot tested. The collected data was statistically analysed and interpreted with the help of a statistician using SPSS. The results of Phase 1 were used as a base for the Phase 2 questions. Three focus group interviews were conducted with professional nurses who were observed during Phase 1 at the selected hospitals. Findings from quantitative data show that although health care workers take precautions to prevent infections, they do not attain full compliance to universal precautions. The qualitative data indicated that the reasons for non–compliance amongst others were the lack of knowledge of universal precautions, communication factors, resources, including maintenance of equipment, lack of supplies and shortage of human resources and attitudes of health care workers. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

There is an increase in HIV/AIDS and other blood borne diseases. Health care workers are often exposed to blood and body fluids and thus prone to blood borne infections. Preventative measures can be taken to prevent health workers from contracting these diseases. However, health care workers need to stringently apply these measures. Universal precautions against blood borne infections include diligent hygiene practices, such as hand washing and drying, appropriate handling and disposal of sharp objects, prevention of needle stick or sharp injuries, appropriate handling of patient care equipment and soiled linen, environmental cleaning and spills management, appropriate handling of waste as well as protective clothing such as gloves, gowns, aprons, masks and protective eyewear. This study is aimed at investigating compliance with universal precautions in operating theatres in Northern KwaZulu–Natal as well as perceptions of registered nurses working in these operating theatres regarding factors influencing compliance in order to contribute to measures to limit the risk of infection to patients and health care workers. A sequential explanatory design, mixed–method (quantitative and qualitative) was used to explore the use of universal precautions in operating theatres in the Northern Kwa–Zulu Natal. In the first phase, the sample consisted of practices in operating theatres of six hospitals and one regional hospital in area 3 of Kwa–Zulu Natal. The adapted structured checklist based on an established document developed by the MASA Committee for Science and Education (1995) was pilot tested. The collected data was statistically analysed and interpreted with the help of a statistician using SPSS. The results of Phase 1 were used as a base for the Phase 2 questions. Three focus group interviews were conducted with professional nurses who were observed during Phase 1 at the selected hospitals. Findings from quantitative data show that although health care workers take precautions to prevent infections, they do not attain full compliance to universal precautions. The qualitative data indicated that the reasons for non–compliance amongst others were the lack of knowledge of universal precautions, communication factors, resources, including maintenance of equipment, lack of supplies and shortage of human resources and attitudes of health care workers. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

This thesis deals with the law applicable to targeting during an armed conflict — in particular, the law concerning military objectives and the rule of proportionality. The law concerning military objectives is further considered in the context of a UN sanctioned military operation.Using the law applicable to Australia as the frame of reference (particularly Additional Protocol I of 1977), the existing treaty law, relevant case law, and the extensive commentary available is analysed. Separate chapters deal with the law concerning human targets, non-human targets, and currently controversial targets (along with effects based operations). Further chapters deal with precautions in attack and proportionality.The law of targeting in the context of United Nations operations is addressed; and in particular, how a United Nations Security Council mandate might affect what objectives are lawful targets.Finally, I put forward a process by which responsibility for individual components of a targeting decision can be analysed. This will allow for the determination of legal responsibility for discrete steps in a targeting decision. This should prove particularly useful in two situations. First, it will enable military commanders to appreciate what needs to be considered in each targeting decision and thereby ensure that somebody is assigned responsibility for each discrete step. Second, in the event of an investigation into an alleged targeting mishap, it will be possible to identify who had, or at least should have had, responsibility for discrete aspects of the overall targeting decision.

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 1994. / Richard M. Grimes. (ADVISOR) Includes bibliographical references (leaves 112-118).

Introdução: A propagação das infecções em serviços de saúde pode ocorrer devido ao não cumprimento das precauções padrão e precauções específicas por parte dos profissionais da assistência a saúde, indivíduos e visitantes. Estudos demonstraram baixa adesão às medidas de precaução pelos profissionais da assistência a saúde, o que pode ter relação com os aspectos do comportamento humano, como a falsa percepção de um risco invisível e a subestimação do compromisso individual nas taxas de infecções relacionadas à assistência a saúde. Com relação aos indivíduos e familiares a orientação inadequada, que se restringe apenas em dizer o que deve ou não ser feito pelo familiar e indivíduo, não esclarece o objetivo principal das precauções, fazendo com que a adesão aos procedimentos não ocorra ou ocorra de maneira inadequada. A partir da década de 1980, teóricos em saúde coletiva propuseram o conceito de vulnerabilidade para ser utilizado como quadro de referência para apoiar o manejo de agravos em saúde. No presente estudo, o conceito de vulnerabilidade foi utilizado como referencial teórico para a abordagem dos aspectos que envolvem o conhecimento e engajamento do indivíduo nas situações que requerem precauções específicas. Objetivo: elaborar e validar com especialistas um roteiro de orientação escrito sobre precauções específicas para indivíduos adultos, tendo como quadro de referência o conceito de vulnerabilidade. Métodos: trata-se de um estudo do tipo metodológico. O estudo foi aplicado em três fases sequenciais: a coleta de dados por meio de aplicação de um questionário dirigido aos indivíduos, a elaboração do roteiro de orientação aos profissionais de saúde e a validação desse material. O estudo foi desenvolvido em dois hospitais, sendo um deles universitário público de nível assistencial secundário e o outro um hospital geral privado com atendimento a convênios de saúde. Participaram do estudo indivíduos adultos que se encontravam em situação de precauções específicas para a transmissão de doenças durante a internação, no período do estudo. Foram convidados a participar como juízes na validação profissionais de saúde com conhecimento reconhecido na área de prevenção de transmissão de doenças ou na temática de vulnerabilidade. O Índice Validade de Conteúdo (IVC) de 0,75 foi utilizado como critério para validação dos tópicos desenvolvidos no instrumento de orientação. Resultados: foram entrevistados 39 indivíduos, em média sete dias após a instituição das precauções específicas. A maior parte estava em precaução para contato. Menos da metade sabia que necessitava de algum cuidado específico; dentre estes, menos da metade sabia como se transmitia seu agravo. O roteiro educacional foi desenvolvido de modo a proporcionar maior conhecimento nos aspectos usualmente negligenciados pelos profissionais e estimular o cuidado centrado na individualidade. Todos os itens tiveram um índice de validade de conteúdo acima de 75%. Conclusão: o roteiro educacional apresenta potencial para instrumentalizar os profissionais da assistência à saúde para a elaboração de ações educativas para indivíduos adultos em precauções específicas. Espera-se que este roteiro possa ser aplicado rotineiramente pelos profissionais nos serviços de saúde, visando a minimizar os efeitos indesejados decorrentes das situações de precauções específicas para transmissão de doenças. / Introduction: The spread of infections in health services may occur due to health care professionals, patients and visitors noncompliance with standard precautions and specific precautions. Studies have shown low adherence from health care professionals to precautionary measures, which may be related to aspects of human behavior, such as false perception of an invisible risk and underestimation of the individual commitment in reference to infections rates related to health care. With regard to patients and families, inadequate guidance - which is limited only to saying what the family member and patient should or should not do - does not clarify the main purpose of the precautions, hindering adherence to precautions or making them occur inappropriately. From the 1980s on, public health theorists proposed the concept of vulnerability to be used as a framework to support health hazard management. In this study, the concept of vulnerability will be used as a theoretical framework to address the aspects concerning the patients knowledge and engagement in situations that require specific precautions. Purpose: to develop and validate with experts a guidance reference in writing on specific precautions for adult patients, using the concept of vulnerability as a referential framework. Method: this is a methodological study design, which will be implemented in three sequential phases: data collection by means of a survey to patients, development of a guidance instrument and validation of this material. The study will be developed in two hospitals, one of them, a state university hospital of secondary care level and the other, a private general hospital covering health insurance plans. Patients participating in the study were adults under specific precautions concerning transmission of diseases during hospitalization at the time of the study. Health professionals with recognized expertise in diseases transmission prevention or on the topic of vulnerability were invited to participate as judges for validation. The Content Validity Index (CVI) of 0.75 was used as a criterion for validation of the topics developed in the guidance tool. Results: Thirty-nine patients were interviewed, on average seven days after the imposition of specific precautions. Most were under contact precautions. Less than half knew they needed some special care; among these, less than half knew how their hazard was transmitted. The educational guide was developed to provide more knowledge on the aspects usually neglected by professionals and to foster care centered on the patient\'s individuality. All items had a content validity index above 75%. Conclusion: the educational guide has the potential to enable health care professionals for the development of educational activities for adults under specific precautions. This guide is expected to be applied routinely by professionals in health services, in order to minimize the undesirable effects of the cases of specific precautions to disease transmission.

As Precauções-Padrão (PP) são consideradas como as principais medidas de prevenção à exposição com material biológico potencialmente contaminado e a adesão as PP contribui significativamente para reduzir esses riscos. Este estudo teve como objetivo descrever e comparar os escores de adesão às PP de profissionais de enfermagem que atuavam nas unidades de internação de um hospital universitário. Trata-se de um estudo transversal, comparativo e quantitativo, realizado em um hospital de ensino do interior do estado de São Paulo, Brasil. A amostra de 290 sujeitos foi calculada e sorteada segundo um plano amostral estratificado (alfa =0,01; número de preditores = 3, sendo, tempo de exercício na profissão, carga horária semanal, categoria profissional, effect size = 0,08, poder 0,99). Critérios de inclusão: exercer no mínimo seis meses de trabalho na função de enfermeiro, técnico ou auxiliar de enfermagem na instituição; estar lotado na unidade selecionada para a realização do estudo; prestar assistência direta aos doentes. Critérios de exclusão: exercer exclusivamente atividades administrativas; estar em férias, licença-saúde ou afastamento. Utilizou-se um formulário contendo variáveis demográficas e a escala psicométrica de adesão às PP, desenvolvido por Gershon et al. (1995), traduzida e validada por Brevidelli e Cianciarullo (2009), no total de 13 ítens, cujas opções variam segundo uma escala Likert de cinco pontos. A coleta de dados foi realizada entre 01 de setembro de 2009 a 31 de março de 2010 e os profissionais abordados e entrevistados em seu próprio turno de trabalho. A análise dos dados foi efetuada por meio do software Social Package for Social Science (SPSS), versão 15.0. Participaram do estudo 256 profissionais de enfermagem, sendo 178 (69,5%) auxiliares de enfermagem, 27 (10,5%) técnicos e 51 (19,9%) enfermeiros. A confiabilidade da escala de adesão às PP, cujo resultado de 0,70, foi considerado satisfatório. Os resultados apontaram que 152 (59,4%) profissionais apresentaram escores médios altos para a adesão às PP, igual ou acima de 4,5; 98 (38,3%) escores intermediários, entre 3,5 a 4,49 e 06 (2,3%) baixos, ou seja, menores que 3,5. Verificou-se que 50 (19,5%) informaram ter menos de 05 anos na profissão, 83 (32,4%) entre 05 e 10 anos e a maioria, 123 (48,0%), mais que 10 anos na profissão. A análise dos escores de adesão às PP e tempo na profissão mostrou fraca correlação (r=0,629; p=0,395). A análise dos escores de adesão às PP dos profissionais de saúde segundo a carga horária semanal também apontou que houve fraca correlação (r = - 0,070; p = 0,266). Entre profissionais expostos ou não a material biológico não houve diferenças nos escores de adesão às PP. Os resultados apontaram alta e intermediária adesão às PP dos profissionais de enfermagem, entretanto, não houve diferenças estatisticamente significativas entre os escores segundo a categoria profissional, tempo na profissão, carga horária semanal ou setores de trabalho ou exposição prévia ao material biológico. / The Standard Precautions (SP) are considered as key measures for preventing exposure to potentially contaminated biological material adhesion to the PP and contributes significantly to reducing these risks. This study aimed to describe and compare the scores of adherence to the SP of nurses who worked in inpatient units of a university hospital. This is a cross-sectional, comparative and quantitative, carried out in a teaching hospital in the state of São Paulo, Brazil. The sample of 290 subjects was calculated and drawn in a plane stratified sample (alpha = 0.01, 3 = number of predictors, being, exercise time in the profession, weekly workload, professional category, effect size = 0.08; power 0.99). Inclusion criteria: exercise at least six months working in the role of nurse, technician or nursing assistant in the institution was packed in the unit selected for the study, provide direct care to patients. Exclusion criteria: exercise exclusive administrative activities; be on vacation, sick leave or removal. We used a form containing demographic and psychometric scale for adherence to the SP, developed by Gershon et al. (1995), translated and validated by Brevidelli and Cianciarullo (2009), totaling 13 items, whose options vary according to a five-point Likert scale. Data collection was conducted between September 1, 2009 to 31 March 2010 and discussed the pros and interviewed in their own shift. Data analysis was performed using the software Social Package for Social Sciences (SPSS) version 15.0. The study included 256 nurses, of which 178 (69.5%) nursing assistants, 27 (10.5%) technicians and 51 (19.9%) nurses. The reability scale adhesion to SP, which results of 0.70, was considered satisfactory. The results showed that 152 (59,4%) professionals had higher mean scores for adherence to SP equal to or above 4.5, 98 (38.3%) scores intermediate between 3.5 and 4.49 and 06 (2 3%) low , less than 3.5. It was found that 50 (19.5%) reported having less than 05 years in the profession, 83 (32.4%) between 05 and 10 years and the majority, 123 (48.0%), more than 10 years in the profession. The mean score for adherence to SP and length of service showed a weak correlation (r=0,629; p=0,395). Analysis of the scores of compliance with standard precautions for health professionals according to weekly working hours also pointed out that there was a weak correlation (r = - 0,070; p = 0,266). Among workers exposed to biological material or not there were differences in scores for adhesion to SP. The results showed high, intermediate, and high adhesion to SP nursing professionals, however, no significant statistically differences between scores by professional category, length of service, weekly or sectors of work or exhibition prior to the biological material.

Magister Public Health - MPH / This study has reveled the levels of knowledge and compliance towards Universal Precautions and examined the factors that are influential in having a positive and negative effect on their adoption by healthcare practitioners in practice. Despite acceptable knowledge regarding the potential for infection and mechanisms to prevent these infections, this study has found out that health care workers are not as compliant with universal precautions as they need to be. The findings that compliance correlated directly with knowledge, with in-service training and with availability of protective equipment, provide important indications for future interventions. Therefore a regular on job refreshing training program on Universal Precautions, a written guideline and reminder poster on Universal Precautions and personal protective equipment need to be made available for all health care providers in every department of the hospital for better compliance.