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10 NURSES & PATIENT SAFETY Less Than 20% of Nurses Comply With Standard Precautions for Infection Prevention By Heather Punke J ust 17.4 percent of ambulatory care nurses reported that they comply with all nine standard precautions for infection prevention, according to a study published in January in the American Journal of Infection Control. Researchers from Northwell Health in Great Neck, N.Y., surveyed 116 registered nurses working in ambulato- ry care settings about their compliance with standard precautions, knowledge of hepatitis C virus and behavioral factors that influence compliance. e nine standard precautions are listed below. 1. Provide care considering all patients as potentially contagious 2. Wash hands aer removing gloves 3. Avoid placing foreign objects on my hands 4. Wear gloves when exposure of my hands to bodily fluids is anticipated 5. Avoid needle recapping 6. Avoid disassembling a used needle from a syringe 7. Use a face mask when anticipating exposure to air-transmitted pathogens 8. Wash hands aer providing care 9. Discard used sharp materials into sharp containers e standard precaution with the highest rate of compliance was wearing gloves (92 percent) and washing hands aer providing care (82 percent). Next was wearing a face mask (70 percent). "Self-reported data might be an over- estimate of actual compliance and that makes these results of particular concern for potential exposure to bloodborne diseases," according to the study authors. "Overall, the ambulatory care nurses chose to implement some behaviors and not others, and this behavior puts them at risk for acquiring a bloodborne infection." e authors also emphasize the importance of finding the reasons for noncompliance and how to encourage total compliance with all nine standard precautions. n Magnet-Recognized Hospitals Have Better Surgical Outcomes, Study Finds By Max Green P atients undergoing surgery at hospitals that are Magnet-recognized for nursing excellence are more likely to have better outcomes at lower costs, according to re- search from the Philadelphia-based University of Pennsylvania, published in JAMA Surgery. Researchers compared more than 25,000 matched pairs of Medicare patients who underwent the same surgeries in over 300 hospitals to determine the impact a Mag- net-recognition might have on outcomes. In addition to finding patients in Magnet-des- ignated hospitals had lower death rates after surgery, the authors reported better outcomes weren't significantly more expensive. "We found that Magnet hospitals achieved lower mortality at the same or lower costs by admitting 40 percent fewer patients to intensive care units and shortening length of hospital stay," Linda Aiken, PhD, RN, director of the Center for Health Outcomes and Policy Re- search at the University of Pennsylvania School of Nursing, said in a news release. n Evidence-Based Healthcare: Not a Top Priority for Hospitals, Survey of Nurses Finds By Brian Zimmerman U se of evidence-based practices remains low at several United States hospitals, even though use of such practices has been linked to higher care quality, better patient experiences and lower costs, according to a study in Worldviews on Evidence-Based Nursing. A team of researchers from Ohio State University in Columbus sur- veyed 276 chief nurse executives to gauge the prioritization of evi- dence-based practices at their institutions. More than half of survey participants asserted that evidence-based practice is implemented in their organization "not at all" or "somewhat." When asked to list their institute's top three priorities, they placed quality and safety in the one and two spots. Evidence-based practices ranked significantly lower. "When patients get evidence-based care, they have 28 percent better outcomes. That's a big deal," said study co-author Lynn Gallagher-Ford, PhD, RN. "The chief nurses we surveyed reported that they planned to focus on evidence-based practice as soon as they had a handle on quality and safety. That's the disconnect — leaders think it is a competing prior- ity when in reality, evidence-based practice is the exact mechanism that needs to be integrated in order to achieve and sustain safety." The researchers asserted that until hospital leadership aligns itself with investment in evidence-based practices, quality of care and patient safety will suffer. Bernadette Melnyk, PhD, RN, a study co-author, believes patients should seek practitioners who are willing to present the evidence behind the care. n