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Adoption of Guidelines for Universal Precautions and Body Substance Isolation in Canadian Acute-Care Hospitals

Published online by Cambridge University Press:  21 June 2016

David Birnbaum ,
Michael Schulzer ,
Richard G. Mathias ,
Michael Kelly  and
Anthony W. Chow
David Birnbaum*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Michael Schulzer
Affiliation:
Departments of Statistics and Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Richard G. Mathias
Affiliation:
Department of Healthcare and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada
Michael Kelly
Affiliation:
Division of Medical Microbiology, Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
Anthony W. Chow
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
*
Division of Infectious Diseases, G.F. Strong Research Laboratory, Vancouver General Hospital, 2733 Heather Street, Vancouver, British Columbia V5Z 1M9, Canada
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Abstract

The impact of recently recommended hospital infection control guidelines on Canadian acute-care hospitals is unknown. A confidential cross-sectional mailed survey of all acute-care Canadian hospitals was conducted to determine rates of receipt and adoption of published guidelines for Universal Precautions (UP) or Body Substance Isolation (BSI), rationale for adoption and knowledge of costs and benefits. Five hundred and seventy-nine of 943 sites (61%) responded (exceeding 80% in urban centers); 94% among hospitals with at least 300 beds and 57% among those under 300 beds. Seventy-four percent of responders claimed adoption of UP (65%) or BSI (9%), staff protection being their primary motivation. Adoption of either UP or BSI was associated with size (p<.001), increasing progressively from 45% in the smallest group (~25 beds) to 64% in the largest (2500 beds). Many hospitals introduced modifications and some substituted names other than UP or BSI in adopting a new strategy. In practice, UP and BSI now mean different things in different hospitals, and the distinction between them has become blurred. Furthermore, only 5% claiming adoption of a new strategy adopted all of the fundamental policies expected under UP or BSI. Receipt of guidelines was also correlated with size: one-third of hospitals under 200 beds had not received key publications defining UP and BSI. Only 19% claiming adoption of a new strategy indicated knowledge of cost implications. These results suggest a need for closer collaboration among hospitals and government agencies in developing uniform infection control policies, and for systematic evaluation of the cost and effectiveness of new strategies. (Infect Control Hosp Epidemiol. 1990;11:465-472.)

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 9 , September 1990 , pp. 465 - 472
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

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