Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-28T00:50:16.216Z Has data issue: false hasContentIssue false
  • English
  • Français

Adverse Exposures and Universal Precautions Practices Among a Group of Highly Exposed Health Professionals

Published online by Cambridge University Press:  21 June 2016

Mary E. Willy ,
Gita L. Dhillon ,
Nancy L. Loewen ,
Robert A. Wesley  and
David K. Henderson
Mary E. Willy*
Affiliation:
The Hospital Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, Maryland
Gita L. Dhillon
Affiliation:
The Georgetown University School of Nursing, Washington, D.C.
Nancy L. Loewen
Affiliation:
The Georgetown University School of Nursing, Washington, D.C.
Robert A. Wesley
Affiliation:
The Information Systems Department, Clinical Center, National Institutes of Health, Bethesda, Maryland
David K. Henderson
Affiliation:
The Hospital Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, Maryland The Office of the Director, Clinical Center, National Institutes of Health, Bethesda, Maryland
*
Hospital Epidemiology Service, Building 10, Room 11N223, National Institutes of Health, Bethesda, MD 20892
Get access Rights & Permissions [Opens in a new window]

Abstract

An anonymous national survey of a representative population of healthcare workers who were thought likely to have frequent and intensive exposures to blood and other body fluids (certified nurse-midwives [CNMs]), was conducted to assess the type and frequency of self-reported occupational exposures to blood and body fluids experienced, the extent to which barrier precautions and other infection control measures were used, whether or not reported use of barriers was associated with a lower perceived rate of exposures and factors that influenced the use of infection control procedures.

Of those responding, 74% had soiled their hands with blood at least one time in the preceding six months, 51% had splashed blood or amniotic fluid in their faces and 24% reported one or more needlestick injuries during that same period. Our study also found evidence of an association between the practice of needle recapping and the occurrence of needlestick injury (p = .003). Despite a high level of training and knowledge, only 55% reported routinely practicing universal precautions (UPs).

Several factors that potentially influenced the use of UPS were studied, including healthcare worker perceptions of risk of occupational bloodborne infection, knowledge of routes of transmission of bloodborne pathogens and rationale for not using appropriate barriers. Our data suggest that occupational exposures occur frequently and that healthcare workers' (HCWs') perceptions of risk for occupational infection play an important role in influencing use of UPS. This study emphasizes the importance of developing new strategies for UP training.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 7 , July 1990 , pp. 351 - 356
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. West, DJ. Risk of hepatitis B infection among healthcare professionals in the United States: a review. Am J Med Sci. 1984;287:26–33.Google Scholar
2. CDC. Acquired Immune Deficiency Syndrome (AIDS): precautions for clinical and laboratory staffs. MMWR. 1982;31:577–580.Google Scholar
3. CDC. Recommendations for prevention of HIV transmission in health care settings. MMWR. 1987;36(Suppl 2S):1S–19S.Google Scholar
4. Department of Labor. Joint Advisory Notice: Department of Labor/Department of Health and Human Services. Federal Register. 1987;52:41818–41824.Google Scholar
5. Gardner, P, Cooper, B, Klimek, J. Are universal precautions universally necessary? Abstract 9006. Presented at the Fourth International Conference on AIDS. June 1988; Stockholm, Sweden.Google Scholar
6. Armitage, P. Statistical Methods in Medical Research. New York, NY: John Wiley & Sons; 1971.Google Scholar
7. Lehmann, E.. Nonparametrics. In: Statistical Methods Based on Ranks. San Francisco, Calif: Holden-Day; 1975:210.Google Scholar
8. Henderson, DK. HIV-1 in the health care setting. In: Mandeli, GL, Douglas, RG, Bennett, JE, eds. Principles and Practice of Infectious Diseases. 3rd ed. New York, NY: John Wiley & Sons, Inc.; 1990:2221–2236.Google Scholar
9. Grady, GF, Lee, VA, Prince, AM, et al. Hepatitis B immune globulin for accidental exposure among medical personnel: final report of a multicenter controlled trial. J Infect Dis. 1978;138:625–638.Google Scholar
10. Seefe, LB, Wright, EC, Zimmerman, HJ, et al. Type B hepatitis after needle-stick exposure: prevention with HBV immune globulin. Ann Intern Med. 1978;88:285–293.Google Scholar
11. Dienstag, JL, Ryan, DM. Occupational exposure to hepatitis B virus in hospital personnel: infection or immunization? Am J Epidemiol. 1982;115:26–39.Google Scholar
12. Henderson, DK, Fahey, BJ, Willy, ME. Frequency and intensity of cutaneous exposures to blood and body fluids among health care providers in a referral hospital. Abstract 9017. Presented at the Fourth International Conference on AIDS. June 1988; Stockholm, Sweden.Google Scholar
13. Gerberding, JL, Bryant-LeBlanc, CE, Nelson, K, et al. Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions. J Infect Dis. 1987;156:1–8.Google Scholar
14. McCray, E. Special report: occupational risk of the acquired immunodeficiency syndrome among health care workers. N Engl J Med. 1986;314:1127–1132.CrossRefGoogle Scholar
15. Jaeger, J. Hunt, EH. Brand-Elnaeear, J. Pearson, RD. Rates of needle-stick injury by various devices university hospital. TV Engl J Med. 1988;319:284–288.10.1056/NEJM198808043190506Google Scholar