Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based health care providers still at risk?
To examine factors associated with blood exposure and percutaneous injury among health care workers, we assessed occupational risk factors, compliance with standard precautions, frequency of exposure, and reporting in a stratified random sample of 5123 physicians, nurses, and medical technologists working in Iowa community hospitals. Of these, 3223 (63%) participated. Mean rates of hand washing (32%-54%), avoiding needle recapping (29%-70%), and underreporting sharps injuries (22%-62%; overall, 32%) varied by occupation (P<.01). Logistic regression was used to estimate the adjusted odds of percutaneous injury (aOR(injury)), which increased 2%-3% for each sharp handled in a typical week. The overall aOR(injury) for never recapping needles was 0.74 (95% CI, 0.60-0.91). Any recent blood contact, a measure of consistent use of barrier precautions, had an overall aOR(injury) of 1.57 (95% CI, 1.32-1.86); among physicians, the aOR(injury) was 2.18 (95% CI, 1.34-3.54). Adherence to standard precautions was found to be suboptimal. Underreporting was found to be common. Percutaneous injury and mucocutaneous blood exposure are related to frequency of sharps handling and inversely related to routine standard-precaution compliance. New strategies for preventing exposures, training, and monitoring adherence are needed.
Doebbeling
Bradley N
BN
Program in Health Services Research, Veterans' Affairs Medical Center, Indianapolis, IN 46202, USA. bdoebbeling@hsrd.va.iupui.edu
Vaughn
Thomas E
TE
McCoy
Kimberly D
KD
Beekmann
Susan E
SE
Woolson
Robert F
RF
Ferguson
Kristi J
KJ
Torner
James C
JC
D017848:Blood-Borne Pathogens; D019983:Guideline Adherence; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D007484:Iowa; D016602:Needlestick Injuries / Q000453:epidemiology*; D010564:Personnel, Hospital; D012307:Risk Factors; D016635:Universal Precautions