Observed Use of Standard Precautions in Chilean Community Clinics

Abstract

Objective In Chile, little information about the use of standard precautions (SP) among health care workers (HCWs) exists. As part of a larger study to tailor and test an HIV prevention intervention for community HCWs, this study describes the observed frequency with which appropriate SP were used by HCWs in low-income community clinics of Santiago. Also, the availability of supplies is described. Sample A total of 52 structured observations with potential contamination with body fluids were done. Results HCWs used SP inconsistently, especially neglecting hand washing, surface cleaning, and cleaning of shared materials. Lack of materials contributed in some instances of failure to use SPs, especially wiping surfaces and safe disposal of sharp instruments, as shown by a positive correlation between use of SP and availability of materials. Essential materials were usually available. Although more education should relate to a better understanding of the importance of SP, no difference was found between professionals and paraprofessionals in the use of SP. Conclusions It is clear that the initial training, continuing education, and ongoing support for practicing SP are not adequate. Training should be offered to HCWs involved in caring for clients at community clinics to stop the spread of HIV or other infectious diseases in health care settings.

Stigma Related To HIV Among Community Health Workers In Chile

“…These findings are congruent with previous research documenting that stigmatization is an issue among health care workers (Cianelli, 2003; Talashek et al , 2007; Ferrer et al , 2009). Fear of contracting the disease and stereotypes related to HIV have been shown to be the primary causes of stigma towards people living with HIV.…”

“…Fear of contracting the disease and stereotypes related to HIV have been shown to be the primary causes of stigma towards people living with HIV. Chilean health workers fears about HIV also fostered their incorrect use of standard precautions, which is consistent with what was observed by Ferrer et al (2009) in these same Chilean community clinics. In this study, healthcare workers reported being afraid to tell their co-workers their personal serostatus due to fear of discrimination and isolation in their work place, a finding that is congruent with the study by Alvares and Ramos (2002).…”

“…Individual and social factors play a central role in the continuation, enactment, and experience of stigma and its effect on discrimination (Guajardo, 2000). This situation is worse in a community where health workers provide trusted sources of health information and yet are not appropriate role models for effective HIV prevention (Cianelli, 2003; Rahlenbeck, 2004; Ferrer et al , 2009). …”

The relationship between knowledge of HIV, self-perceived vulnerability and sexual risk behavior among community clinic workers in Chile

“…Items were added to incorporate new developments such as drug treatment for reducing mother-child transmission. The questionnaire was culturally adapted for Chile based on qualitative formative evaluation (25). A modified direct translation method was used for translating the questionnaire into Spanish (26), using a team of bilingual researchers.…”

Motivos e consequências da baixa adesão às precauções padrão pela equipe de enfermagem

“…Such recommendations should be adopted during care provided to any patient, regardless of their diagnosis (25) . Analysis of the reasons of low or non-adherence to SP shows that many of them are related to lack or insufficient investment on work conditions, which, in addition to exposing health professionals and patients to risks, generates an atmosphere of disharmony, dissatisfaction and lack of motivation in the workplace (26) . Therefore, we stress the importance of well-established standards and routines, with well-defined and disseminated flows, so that everyone has access to them and is aware of what Chart 1 -Characterization of the articles, results of adherence to standard precautions, reasons and consequences of low adherence and recommended interventions.…”