Universal precautions in the family physician's office

The risk of occupational exposure to the human immunodeficiency virus (HIV) may be one of the important issues facing family physicians in the 1990s. The use of universal precautions has been shown to reduce the incidence of exposures to bloodborne pathogens. Studies indicate, however, that these guidelines are not being followed consistently by physicians or their staffs.

A survey of 3568 randomly sampled members of the American Academy of Family Physicians was performed using a questionnaire that was designed by the authors. Three mailings were conducted.

The total response rate was 39%. Approximately 80% of the respondents reported that they used gloves appropriately and disposed of sharp instruments in a puncture-resistant container. Only 39% "always" or "almost always" used eye protection when indicated, and only 35% "almost never" or "never" recapped used needles. There was a significant number of physicians who reported that they or their office staff had had an occupational exposure to bloodborne pathogens within the last year.

Family physicians and their staffs do not uniformly follow universal precaution guidelines and, as a result, many have been exposed to blood products. If the physician or the office staff would not recap used needles and would place used sharp instruments in a puncture-resistant container, the greatest risks of occupational exposure would be reduced.