Date of Graduation


Document Type


Degree Type



College of Education and Human Services


Learning Sciences and Human Development

Committee Chair

Anne H. Nardi.


Standard precautions are mandated for the purpose of decreasing the risk of bloodborne pathogen transmission of diseases, namely human immunodeficiency virus (HIV) and hepatitis B infections. One of the stipulations of standard precautions is that used needles should not be recapped and should be disposed of in an appropriate sharps container. The rate of needle stick injuries among health care workers remains at a high level despite the 1992 passage of the Occupational Safety and Health Administration (OSHA) regulations regarding standard precautions. The role fear plays in decisions regarding individual health related behaviors such as intravenous drug use has been critically examined, but fear related to occupationally related behavior (e.g., needle re-capping and disposal by health care workers) has received little attention. With the severe threat of bloodborne diseases such as AIDS and Hepatitis B, it is important to determine what role fear plays in enhancing or deterring compliance with standard precautions (specifically, not recapping used needles). The purpose of this study was to determine the differences in fear, threat, efficacy, and safety climate perceptions across Prochaska's five stages of change (transtheoretical model) for health care workers who routinely handle needles and/or other sharps. The study used a self-administered mail questionnaire to assess health care worker perceptions. Results indicated that a clear risk of contracting HIV and Hepatitis B exists among health care workers in the sample. 72% of the sample had experienced a needle stick and 56% of those had been stuck more than one time. More alarming was the finding that 38% of the reported needle sticks involved blood contaminated needles. Surprisingly, neither fear nor threat levels differed across the stages of change. Efficacy levels were found to significantly increase across the stages as Prochaska and colleagues would predict. All four of the safety climate factors were found to significantly differ across the stages of change, indicating that the environmental context (occupational setting) is important in moving effectively through the behavior change process.