       Document 0148
 DOCN  M9620148
 TI    Are universal precautions realistic?
 DT    9602
 AU    Gerberding JL; Lewis FR Jr; Schecter WP; University of California, San
       Francisco, School of Medicine, USA.
 SO    Surg Clin North Am. 1995 Dec;75(6):1091-104. Unique Identifier :
       AIDSLINE MED/96071858
 AB    In concluding whether universal precautions are necessary, it certainly
       appears that we need something to reduce the significant problem of HIV
       transmission to health-care providers. As occupational risk goes, it
       exceeds the occupational risk of a number of other high-risk
       professions. Unfortunately, we do not know if universal precautions are
       effective. We also do not know the true compliance rate in use of
       universal precautions, nor whether they have an impact on transmission
       even if effectively used. What are the alternatives? They are not great,
       but some have not been adequately explored or implemented.
       Re-engineering around needle use in the hospital is clearly the most
       likely area to produce concrete results, because needlesticks are
       overwhelmingly the greatest source of infection, but this has not been
       encouraged to the degree it could be, even with systems already
       developed. Universal testing does not appear to be a viable alternative,
       for numerous reasons already discussed. Finally, are universal
       precautions more important for other pathogens than HIV? I would say
       yes. Hepatitis B, hepatitis C, and nosocomial infections are more
       important both as public health issues and as health-care provider
       prevention issues. If universal precautions are effective in reducing
       any of these, they are worthwhile.
 DE    Disease Transmission, Patient-to-Professional/PREVENTION &  CONTROL
       Health Personnel  Human  HIV Infections/*PREVENTION & CONTROL  HIV-1
       Infection Control  *Operating Rooms  *Universal Precautions  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

