Experiences of compliance with standard precautions during emergencies: A qualitative study of nurses working in intensive care units

Appl Nurs Res. 2019 Oct:49:35-40. doi: 10.1016/j.apnr.2019.07.007. Epub 2019 Jul 30.

Abstract

Aim To explore factors that influence intensive care nurses' experiences of being compliant with standard precautions (SP) during emergencies.

Background: Intensive care nurses can be exposed to a greater risk of biohazardous exposure during an emergency. The primary strategy to address the complex variety of biological hazards in clinical practice is represented by the implementation of SP guidelines. Previous research has indicated that nurses' compliance rates with SPs are suboptimal, but no study has focused on the factors influencing compliance during an emergency.

Design: A descriptive qualitative study was conducted in an Italian university hospital with 19 intensive care nurses who had at least two years of work experience in critical care. The nurses were interviewed in four focus groups and were asked about their experiences of being compliant with SPs during an emergency. Data were analyzed using conventional content analysis.

Results: Three themes emerged: conflict, competencies, and context. Conflict was reported regarding the need to save the patient and the need for self-protection through the use of SPs. In particular, nurses had to manage the pressure of limited time. Competencies were identified by nurses' knowledge, attitude, skills, training, and experience. Context was related to the work and organizational conditions during the emergency, including overcrowding.

Conclusion: To support intensive care nurses' compliance with SPs during emergencies, conflict, competencies, and context should be audited regularly in clinical practice. The findings of this study could inform infection control programs and training that targets intensive care nurses.

Keywords: Critical care nursing; Infection control; Occupational health; Standard precautions.

MeSH terms

  • Adult
  • Emergency Medical Services / standards*
  • Female
  • Guideline Adherence*
  • Humans
  • Infection Control / standards
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Nursing Staff, Hospital*
  • Occupational Health
  • Qualitative Research