Patient-days: a better measure of incidence of occupational bloodborne exposures.
BACKGROUND
There is currently no accepted standard denominator to calculate and to report the incidence of occupational exposures to bloodborne pathogens (OEBBPs) in health care.


METHODS
We performed a multicenter study of OEBBP injuries reported from 31 community hospitals in the southeastern United States from January 2003 to December 2006. A qualitative design was used to assess 4 commonly used denominators to calculate the incidence of OEBBP: patient-days; staffed beds; occupied beds and full-time employee equivalents (FTEs). Six criteria were used to assess the quality and suitability of each denominator as a standard method to calculate incidence of OEBBP. We also analyzed the correlation of hospital rankings produced by these 4 denominators.


RESULTS
During 4 years of study, a total of 3375 occupational exposures were reported. Patient-days outperformed others as a denominator to calculate rates of OEBBP when judged by 6 predefined criteria. Data for staffed beds, occupied beds, and FTE were manually collected, infrequently reported, and often subject to missing data. Furthermore, FTE and staffed beds data also captured unoccupied beds and non-clinical employee data that were not associated with risk of OEBBP.


CONCLUSIONS
Patient-days may be the most suitable and readily available denominator for standard reporting and benchmarking of incidence of OEBBP. Patient-days may be used as a standard method for comparing rates of OEBBP.
Chen
Luke F
LF
Division of Infectious Diseases, Duke Infection Control Outreach Network, Duke University Medical Center, Durham, NC 27710, USA. Luke.Chen@duke.edu
Sexton
Daniel J
DJ
Kaye
Keith S
KS
Anderson
Deverick J
DJ
D019985:Benchmarking; D017848:Blood-Borne Pathogens; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission; D006760:Hospitalization / Q000706:statistics & numerical data*; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D016602:Needlestick Injuries / Q000150:complications / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D015144:Southeastern United States; D016526:Workload