453 Emergency department (ED) personnel are at high risk for occupational exposures to bloodborne pathogens, especially in urban hospital settings. 1-4 Risk factors include the emergent nature of patient care, prolonged contact with patient’s blood, and high num- ber of trauma cases. Despite the emphasis on Universal Precautions training for all health care workers (HCWs), 5 the use of personal protective equipment (PPE) (eg gloves, fluid-resistant gowns, masks, and pro- tective eyewear) remains low. 6,7 In this study, ED per- Compliance with Universal Precautions among emergency department personnel: Implications for prevention programs Lynn E. Kim, MPH a Bradley A. Evanoff, MD, MPH b Rodney L. Parks, MA a Donna B. Jeffe, PhD c Sunita Mutha, MD b Carolyn Haase, MD d Victoria J. Fraser, MD a St Louis, Missouri Background: We developed a 50-item questionnaire to assess emergency department (ED) staff members’knowledge of bloodborne pathogen trans- mission, compliance with Universal Precautions, and the use of personal protective equipment. Method: A questionnaire was administered to 103 ED staff members including physicians, nurses, and technicians at Barnes-Jewish Hospital in St Louis, a Level-I trauma center. Results: ED personnel had inadequate knowledge of bloodborne pathogen infection risk, underreported exposures, and underused personal protection equipment during trauma cases. Conclusion: Further educational interventions for ED personnel are needed to increase their compliance with Universal Precautions. (AJIC Am J Infect Control 1999;27:453-5) From the Division of Infectious Diseases, a Division of General Medical Sciences, b Center for Health Behavior Research, c Division of Emergency Medicine, d Department of Medicine, Washington University School of Medicine. Supported by the Centers for Disease Control and Prevention/National Institute of Occupational Safety and Health Cooperative Agreement #U60CCU712176. Presented in part at the 25th Annual Meeting of the Association for Professionals in Infection Control and Epidemiology, Inc, May 11, 1998, San Diego, California. Reprint requests: Dr Victoria J. Fraser, Campus Box 8051, Division of Infectious Diseases, Washington University School of Medicine, 660 S Euclid, St Louis, MO 63110. Copyright © 1999 by the Association for Professionals in Infection Control and Epidemiology, Inc. 0196-6553/99/$8.00 + 0 17/49/95163 sonnel, who had all received the yearly 1-hour Occupational Safety and Health Administration train- ing, 8 completed a questionnaire to assess knowledge of bloodborne pathogen risks, attitudes toward current Occupational Safety and Health Administration stan- dards, and compliance with Universal Precautions. METHODS Baseline questionnaires were administered in November 1996 to all full-time (n = 75) and part-time (n = 87) ED personnel at monthly staff meetings and placed in staff mailboxes. Barnes-Jewish Hospital is a 1000-bed urban teaching hospital affiliated with Washington University School of Medicine in St Louis, Missouri. ED staff members provide care for approximately 1000 Level-I trauma cases per year in a 60,000 visit per year facility. The anonymous 50-item questionnaire was developed as part of a cooperative agreement with the Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health. We asked respondents to use a multiple choice format to identify the following: (1) knowledge of the epidemi- ology and transmission of bloodborne pathogens, (2) an unvaccinated HCW’s risk of infection after a needlestick injury from a source patient positive for HIV, hepatitis B virus (HBV), or hepatitis C virus (HCV), and (3) the effectiveness of postexposure prophylaxis for HIV.