Adherence and Barriers to Standard Precautions among Nursing Professionals in Critical Care Settings: A Multicenter Analysis During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic has intensified the challenges of infection prevention in healthcare settings. Nursing professionals, particularly those working in critical care units, are at high risk of occupational exposure to biological hazards. Adherence to standard precautions (SP) is essential for infection control, yet compliance remains suboptimal. Methods: This descriptive, cross-sectional, multicenter study was conducted between September and October 2020 in two public hospitals in Brazil. Nursing professionals (n=384) working in critical care units participated. Data were collected using a structured questionnaire that assessed sociodemographic and professional characteristics and the Compliance with Standard Precautions Scale – Portuguese- Brazilian version (CSPS-PB). Bivariate analyses (Mann–Whitney U, Kruskal–Wallis, Chisquare tests) were performed, with a significance level of 5%. Results: The median SP adherence score was 15.2 (range: 15–20), reflecting a 65% compliance rate. Nursing technicians had the highest adherence (mean=15.44; SD=2.6), with older professionals also showing higher compliance (p<0.002). The most frequently reported barriers to adherence were procedural urgency (35.4%), general discomfort (34.9%), and discomfort with specific personal protective equipment (32.2%). Training on SP was significantly associated with higher compliance scores (p=0.05). Discussion: Despite ongoing training efforts, SP adherence among nursing professionals was below recommended levels, posing risks to both staff and patients. Factors such as professional category, age, and participation in SP training influenced adherence. Organizational and behavioral barriers were prominent, underscoring the need for multifaceted interventions. Conclusion: Nursing professionals exhibited low adherence to standard precautions during the COVID-19 pandemic. Targeted educational strategies, institutional support, and behavior-focused interventions are urgently needed to enhance compliance and reduce occupational risks.