Standard Precautions in the Pediatric Emergency Department

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Abstract
To determine if pediatric residents (PRs) and emergency medicine residents (EMRs) differ in their knowledge, attitudes, and behaviors about standard precautions (SPs) in the pediatric emergency department and to identify any differences in perceived obstacles to adherence to SPs. A cross-sectional survey of PRs and EMRs from 1 program was conducted. The survey addressed 4 domains: knowledge, attitudes, behaviors, and obstacles to adherence to SPs. Seventy-five percent of PRs (80/106) and 80% of EMRs (28/35) responded to the survey. There were no significant differences identified in knowledge or attitudes about SPs. A significantly lower proportion of PRs reported compliance with using face masks (28% vs 56%, P = 0.01) and eye shields (34% vs 56%, P = 0.05) during at least 95% of all irrigations and using face masks (30% vs 66%, P = 0.001) and eye shields (31% vs 60%, P = 0.01) for at least 95% of all incision and drainage procedures. A significantly higher proportion of EMRs reported using gloves at least 95% of the time for venipuncture and intravenous catheter placement (84% vs 58%, P = 0.04). The following were identified as more likely to be an obstacle for PRs: interference of blood-drawing device with technical skill (74% vs 50%, P = 0.03), unsure which protective barrier to use (59% vs 32%, P = 0.01), and lack of familiarity with newer devices (75% vs 50%, P = 0.01). The PRs report more unsafe practices than EMRs. Many of the obstacles noted by all residents are easily remedied.