RESUMEN
OBJECTIVES: The study assessed compliance among health workers in the Emergency Room at the University Hospital of the West Indies with universal precautions. This was done by determining the knowledge, practices and perceptions of staff of universal precautions and by assessing compliance. Reported adherence with universal precautions was compared with observed practice. METHODS: This was a cross-sectional study conducted over a one-year period. It was approved by the University Hospital of the West Indies/University of the West Indies/Faculty of Medical Sciences Ethics Committee. Data were analysed using Stata version 11.1. RESULTS: During the study period, 67 persons gave consent for the study, data were obtained for 62 of these participants and 52 of the respondents were observed. All of the participants were aware that universal precautions related to blood. Eighty-six per cent erroneously thought that universal precautions apply to urine. Seventy-nine per cent of the participants reported always washing their hands after performing a procedure and 43.5% reported always washing their hands before a procedure. Just over half of the participants reported always wearing gloves while doing procedures (56.5%). Only 9% reported always using a gown with a trauma patient. However, 31% and 43.3% reported wearing a gown when placing a chest tube and when anticipating splashes, respectively. Of those participants who reported washing their hands often after a procedure, over 30% did not perform hand-washing when observed. Fifty per cent of persons that reported never recapping needles were observed to recap needles by hand. CONCLUSION: The study revealed that compliance among staff in the Emergency Room with universal precautions was unsatisfactory. The need for education in this area was recognized.
RESUMEN
On screening fecal organisms for hydroxysteroid dehydrogenase activities applicable to bile acid metabolism studies, we have isolated a gram negative "Bacteroides-like" anaerobe which yields both 12alpha- and 7alpha-hydroxysteroid dehydrogenase (HSDH) activities in cell-free preparation. At the optimal harvest time of 36 hours, approximately 4500 units 12alpha-HSDH and 360 units 7alpha-HSDH were produced per 10(10) viable cells. The two enzymes appear to be separate entities in the basis of their stabilities on freezing, and prolonged storage at room temperature and elution volumes on Sephadex G 200. Thin layer chromatography studies on oxidation products confirmed the respective sites of oxidation to be the 12alpha-OH and 7alpha-OH position. No 3alpha-OH oriented activity was measurable. Preliminary kinetic studies of the 12alpha-HSDH revealed a broad pH curve with optimal activity at pH 9.5. Michaelis constants for glycodeoxycholate and NADP were estimated at 1.5 x 10(-4)M and 3.3 x 10(-5)M respectively.