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Audit on the degree of application of universal precautions in a haemodialysis unit.

BACKGROUND
The purpose of the study was to investigate the degree of compliance with standard precautions (hand washing and wearing of gloves) by health workers in one haemodialysis unit.


METHODS
During 4 months, two observers monitored the activities of the health care staff in the dialysis unit. Thirty five randomly distributed observation periods of 60 min duration covered one haemodialysis session. The observers evaluated (i) the total number of potential opportunities to implement standard precautions and (ii) the number of occasions when these were actually put into practice.


RESULTS
A total of 364 opportunities to wear gloves and to wash hands thereafter and 273 opportunities to wash hands before a patient-oriented activity were observed. The proportion of occasions when gloves were actually used was 18.7%. Hand washing after a patient-oriented activity was performed only on 32.4% of occasions. Finally, only on 3% of such occasions was hand washing before the activity.


CONCLUSIONS
The degree of compliance with standard precautions by health care personnel is unsatisfactory and this favours nosocomial transmission in haemodialysis units.