A review of the evidence for suboptimal compliance of healthcare practitioners to standard/universal infection control precautions

Abstract

Compliance to infection control precautions is internationally suboptimal. The evidence confirms that compliance to specific aspects of standard/UPs varies, and practitioners are selective in their application of recommended practice. Compliance does improve following a structured intervention; however, research fails to indicate for how long the intervention affects practitioner compliance, or whether compliance after a period of time returns to the norm. Several reasons for non-compliance are discussed, and recommendations for future research are suggested. Relevance to clinical practice. Suboptimal compliance has significant implications for staff safety, patient protection and the care environment. Infection control teams and researchers need to consider the reasons for non-compliance and provide a supportive environment that is conducive to the routine, long-term application of standard precautions.

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“…Studies typically did not clearly report the population characteristics of the two groups or control any potential differences, thus making comparisons difficult and potentially subject to bias. Few studies monitored compliance with infection control measures, which has been reported to frequently be suboptimal 71. High levels of compliance may be necessary for certain infection control measures to be effective.…”

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“…Additionally, Munoz-Price et al 45 noted that their experience suggested failure to comply with "isolation precautions" was common. An international review of the compliance of healthcare staff with infection control interventions found this to be sub-optimal but also highlighted that structured interventions can improve compliance 60 .…”

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“…[5][6][7] Compliance rates from as low as 30% for facemask use and 38% for use of eye protection have been reported. 8 Hand washing, the most basic of infection control measures, has been reported to be adhered to only approximately 40% of the time. 6 compliance; and 'not re-sheathing needles'-high favourable attitude (86%) but low compliance.…”