359 Guidelines designed to prevent health care workers (HCWs) from occupational exposure to bloodborne pathogens have been published by the Centers for Disease Control and Prevention. 1,2 Under Universal Precautions (UPs), HCWs should presume that each patient is infectious for diseases and therefore, they should adhere rigorously to infection control proce- dures. 3 Even though adoption of UPs (such as hand- washing, use of gloves, and proper handling and dis- posal of needles) has improved throughout the years, 4,5 several studies published in 1992 through 1994 report less than optimal UPs adherence rates. 6-9 According to Popejoy, 10 more than 20 different pathogens have been transmitted to HCWs after percu- taneous blood exposure incidents. 11 The average esti- mated risk for HIV infection for HCWs after a percuta- neous or mucous exposure has been reported to be approximately 0.4%. 11,12 However, in a recent interna- tional case-control study, it was suggested that this risk may be increased in cases involving higher risk percu- taneous exposure. 13 Gerberding 14 observed also that the postexposure incidence of hepatitis B virus was 55 times higher and that of hepatitis C virus was 1.5 times higher than that of HIV among HCWs. HCWs, especially nurses, 15 are generally exposed to bloodborne pathogens through percutaneous injuries. For instance, Henry and Campbell 16 surveyed US hospi- tals and found that about 252,000 sharp and needlestick injuries had occurred in 1990. According to the Centers for Disease Control and Prevention, 17 54 HCWs in the US had documented occupationally acquired HIV infection as of June 1998, and an additional 132 were considered probable cases. Among those with documented occupa- tionally acquired HIV infection, 22 (41%) were nurses and 46 (85%) had experienced percutaneous exposure incidents. Ippolito et al 18 reported that 49% of the total worldwide documented cases of occupationally acquired HIV infection occurred among nurses and that the majority of exposures were caused by hollow-bore nee- dles. Thus, despite intensive education and intervention programs, application of UPs remains inadequate. Larson and Kretzer 19 and Hanrahan and Reutter 15 have proposed that educational programs aimed at changing the behavior of HCWs should be theoretical- ly sound and multidimensional. To optimize the prob- ability of success of an educational intervention to modify behavior, it has been suggested that the devel- opment of the intervention be based on an understand- Determinants of nurses’ adherence to Universal Precautions for venipunctures Gaston Godin, PhD Herminé Naccache, MPH Sylvie Morel, MA Marie-France Ébacher, RN, MSc Ste-Foy, Quebec, Canada Objectives: The aim of this study was to predict and explain nurses’ adherence to Universal Precautions (UPs) when performing venipunctures. Methods: Data were gathered from 156 registered nurses working at a regional hospital. A self-administered questionnaire assessing the psychoso- cial variables (intention, attitude, subjective norm, perceived control, etc) was completed at baseline, and behavior was self-reported 3 months later. Results: The regression of intention on the variables yielded an adjusted R 2 of 0.68, with perceived barriers (β = .62, P < .001), social norm (β = .17, P < .01), and personal normative belief (β = .19, P < .01) being the significant variables. With respect to the 3-month follow-up, 28% of the variance associated with UPs adherence was explained by intention (β = .37, P < .001) and perceived behavioral control (β = .23, P < .05). Moreover, high (n = 116) and low intenders (n = 40) differed on several normative beliefs (P = .0003) and perceived barriers (P = .0001). Conclusions: It is suggested that perception of control, assessed either globally or by means of a belief-based measure, is a key factor in adherence. Specifically, the perceived difficulties associated with adherence to UPs appear to be related to a nurse’s training on UPs and to the existence of sub- optimal working conditions. (AJIC Am J Infect Control 2000;28:359-64) From the Laval University research group on behaviors in the field of health, Faculty of Nursing, Pavillon Comtois. Reprint requests: Gaston Godin, PhD, Pavilion Comtois, local 4108-A Laval University Ste-Foy, Quebec, Canada, G1K 7P4. Copyright © 2000 by the Association for Professionals in Infection Control and Epidemiology, Inc. 0196-6553/2000/$12.00 + 0 17/46/107594 doi:10.1067/mic.2000.107594