Determinants of blood and body fluid exposure in a large teaching hospital: hazards of the intermittent intravenous procedure.
Determinants of staff exposure to blood and body fluids in a 1100-bed hospital were examined over a 2-year period. Eighty-two percent of the 799 reported accidental exposures were needlestick injuries, and 18% were cutaneous or mucous membrane splashes. Nurses and nursing students incurred 78.8% of the exposures; respiratory technologists and laboratory personnel, 9.2%; medical personnel, 7.5%; and support staff, 4.2%. Rate of exposure per 100,000 hours worked showed nursing students to be at particularly high risk, highlighting the need for specific instruction. Analysis of events leading to needlestick-related exposures revealed that the heparin lock intermittent intravenous procedure was involved in 26%; recapping accounted for 17%; improper disposal, 15%; manipulating equipment, 14%; phlebotomy, 12%; and other needlestick events, 16%. Ocular splashes and spills onto nonintact skin each accounted for 50% of the total number of non-needlestick-related exposures. This study revealed the hazardous nature of the intermittent intravenous procedure, prompting specific revisions in this procedure as well as promoting point-of-use sharps disposal and other preventive measures.
Yassi
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Department of Community Health Sciences and Medicine, University of Manitoba, Winnipeg, Canada.
McGill
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D000056:Accident Prevention; D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D001769:Blood; D001826:Body Fluids; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching; D006801:Humans; D007275:Injections, Intravenous; D008350:Manitoba; D009339:Needles; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010564:Personnel, Hospital; D012308:Risk Management; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000209:etiology