Respect des «précautions standards» par le personnel infirmier d'un centre hospitalo-universitaire de l'ouest algérien

Abstract

Health care workers are exposed daily to blood borne injury and infection with a high risk of hepatitis B or C and human immunodeficiency virus (HIV) transmission. In the 1980s, the US Centers for Disease Control and Prevention (CDC) developed a set of protocols and guidelines known as standard precautions (SP) to prevent accidental transmission of pathogens. The SP should be followed for each intervention or delivery of care in order to protect health care workers from risks associated with contact with blood and other biological liquids. A survey was conducted in a Western Algerian university hospital to assess nurses' adherence to SP practices. A questionnaire was administered to 450 nurses in the hospital workplace setting. A field survey was also conducted in order to take into account the means and support available to the nurses in these hospital departments, namely to determine availability of hand washing and drying facilities. A total of 133 nurses, 81 women and 52 men, participated in the survey. Personal and professional data, hand-washing frequency, glove wearing practices were collected as data. A large majority (95%) of nurses reported washing their hands after removing their gloves, and 69% of them reported washing their hands between two patients. Male nurses wear gloves more often than females (respectively 77% and 53%). Sharp instruments were correctly disposed of in a puncture-resistant container more of the time. Recapping needles has been reported by two-thirds of survey respondents. Lack of liquid soap and alcohol-based washing solution were noted as major deficiencies as well as the lack of means to properly dry hands in many health care wards. Lack of SP adherence is primarily due to the lack of awareness and knowledge as well as insufficient supply of equipment and materials for good hand hygiene maintenance. This study highlights the urgent need to implement a programme to improve SP adherence among nurses and to increase the supply of hand washing and drying materials. Greater adherence to SP practices will also reduce the risk of occupational exposure to blood borne injury and infection.