Another view to blood and body substance precaution: 1988-91

Occupational transmission of human immunodeficiency virus (HIV) in hospitals can be prevented with the use of 'blood and body substance precaution'. At the Royal Victoria Hospital, an infection control objective is to get employees automatically to use blood and body substance precaution with all patients--without relying on isolation signs. The concept of blood and body substance precaution was introduced in 1988 and simultaneously used with disease-specific signs. It was observed that disease-specific signs were mostly used to identify HIV-positive patients; this was verified under documented surveillance from July 7 to August 8, 1990, when 60 patients (14 HIV-positive and 46 whose HIV etiology was unknown) were observed. All 14 known HIV-positive patients were isolated with signs, while only four of 46 unknown HIV-positive patients (8.6%) had signs. The views of individual employees were subsequently studied via a questionnaire and results from this survey showed there was preference for isolating HIV-positive patients and identifying them with a sign.