Surgical nurses and compliance with personal protective equipment

The study objectives were to evaluate self-reported compliance with personal protective equipment (PPE) use among surgical nurses and factors associated with both compliance and non-compliance. A total of 601 surgical nurses, from 18 randomly selected hospitals (seven urban and 11 rural) in the Pomeranian region of Poland, were surveyed using a confidential questionnaire. The survey indicated that compliance with PPE varied considerably. Compliance was high for glove use (83%), but much lower for protective eyewear (9%). Only 5% of respondents routinely used gloves, masks, protective eyewear and gowns when in contact with potentially infective material. Adherence to PPE use was highest in the municipal hospitals and in the operating rooms. Nurses who had a high or moderate level of fear of acquiring human immunodeficiency virus (HIV) at work were more likely (P<0.005 and P<0.04, respectively) than staff with no fear to be compliant. Significantly higher compliance was found among nurses with previous training in infection control or experience of caring for an HIV patient; the combined effect of training and experience exceeded that for either alone. The most commonly stated reasons for non-compliance were non-availability of PPE (37%), the conviction that the source patient was not infected (33%) and staff concern that following locally recommended practices actually interfered with providing good patient care (32%). We recommend wider implementation, evaluation and improvement of training in infection control, preferably combined with practical experience with HIV patients and easier access and improved comfort of PPE.