A survey of doctors' and nurses' knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals

J Hosp Infect. 2003 May;54(1):68-73. doi: 10.1016/s0195-6701(03)00074-4.


This study investigated knowledge about infection control amongst doctors and nurses through a cross-sectional survey conducted between March and May 2001 in three Birmingham, UK teaching hospitals. Seventy-five doctors and 143 nurses, representing 7% and 4%, respectively, of potential respondents, participated in the study measuring knowledge of, attitudes towards, and compliance with universal precautions. Overall knowledge of risks of blood-borne virus (BBV) transmission from an infected patient after needlestick injury was low [44.0% for hepatitis B virus (HBV), 38.1% for hepatitis C virus (HCV), 54.6% for human immunodeficiency virus (HIV)]. There were significant differences between doctors and nurses concerning the estimations of HBV (e-antigen +) (P=0.006) and HIV (P<0.001) transmission risks. Eighty-six percent of nurses stated that they treat each patient as if they are carrying a BBV compared with 41% of doctors. Doctors and nurses differed significantly in their attitudes about and reported compliance with washing hands before and after patient contact and with wearing gloves when taking blood (P<0.001 for all). Doctors consistently de-emphasized the importance of, and reported poor compliance with, these procedures. Doctors were also more likely to state that they re-sheath used needles manually than were nurses (P<0.001). Thirty-seven percent of respondents reported that they had suffered a needlestick injury with a used needle, with doctors more likely to be injured than nurses (P=0.005). Twenty-eight percent of these doctors and 2% of the nurses did not report their needlestick injuries (P=0.004). Education, monitoring, improved availability of resources, and disciplinary measures for poor compliance are necessary to improve infection control in hospitals, especially amongst doctors.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Clinical Competence
  • Cross-Sectional Studies
  • England / epidemiology
  • Female
  • Guideline Adherence
  • HIV Infections / prevention & control
  • Hepatitis B / prevention & control
  • Hepatitis C / prevention & control
  • Hospitals, Teaching
  • Humans
  • Infection Control / methods
  • Infection Control / standards
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Male
  • Middle Aged
  • Nurses*
  • Occupational Exposure / statistics & numerical data*
  • Physicians*
  • Surveys and Questionnaires
  • Universal Precautions