Effect of educational program on compliance with glove use in a pediatric emergency department
L. R. Friedland, M. Joffe, J. F. Wiley 2nd, A. Schapire and D. F. Moore
Division of Emergency Medicine, St. Christopher's Hospital for Children, Philadelphia, Pa.
OBJECTIVE--To investigate the effect of an educational program on
compliance with glove use in a pediatric emergency department.
DESIGN--Without their knowledge, participants were observed for routine use
of gloves during vascular access procedures before and after an educational
program. Participants with up to 3 years' vascular access experience were
defined as less experienced and those with 4 or more years' experience were
defined as more experienced. Their success rates performing vascular access
procedures with and without wearing gloves were also monitored.
SETTING--Inner-city pediatric hospital emergency department.
PARTICIPANTS--Twenty-three emergency department registered nurses.
INTERVENTIONS--A 30-minute lecture with slides, written materials, and
posters addressing the reasons and need for universal precautions, and
recommended methods of barrier precautions to prevent skin and mucous
membrane exposure when handling sharp instruments. MEASUREMENTS/MAIN
RESULTS--For the less experienced registered nurses, the compliance rate
before the educational program was 70% and remained at about 93% afterward.
For the more experienced registered nurses, the compliance rate before the
program was only 15%. After the program, this compliance rate rose to 93%,
but declined to only 50% by the fifth month. The registered nurses' success
rate on the first attempt at vascular access while wearing gloves was 75%
compared with 70% without gloves. CONCLUSION--Educational programs can
result in a clinically significant increase in glove use by pediatric
emergency department registered nurses. Long-term improvement was less
pronounced for the group of more experienced registered nurses. We also
observed that glove use does not appear to interfere with the proficient
performance of vascular access procedures.
