BACKGROUND: Universal precautions for all healthcare workers have been recommended by the Centers for Disease Control and were mandated by the Occupational Safety and Health Administration in 1991. OBJECTIVES: The purpose of this study was to examine compliance with universal precautions by direct observation and by self-reporting questionnaire in a random sample of critical care nurses, a group with a high daily index of exposure to blood and body fluids. Additionally, knowledge, attitudes, and supply and equipment variables that might affect the rate of compliance were examined. METHODS: Data were collected on a random sample of 25 nurses in two critical care units in a military medical center. The same sample of nurses was then asked to complete an 85-item questionnaire that produced a score for knowledge of universal precautions, attitudes toward universal precautions, and the nurses' opinions of the supplies and equipment. RESULTS: The overall observed compliance score for all nurses was 67%, with a range of 25% to 100%. The observed compliance rates showed no statistically significant correlations with knowledge of universal precautions, attitudes toward universal precautions, or the quality, fit, availability, or accessibility of supplies and equipment. Power analyses showed that the sample size was too small to reveal significant findings. CONCLUSIONS: A larger sample size might show that these factors are indeed associated with use of universal precautions.