title: Assessment of management policies and practices for occupational exposure to bloodborne pathogens in dialysis facilities.
abstract: BACKGROUND
  Occupational exposure management is an important element in preventing the transmission of bloodborne pathogens in health care settings. In 2008, the US Centers for Disease Control and Prevention conducted a survey to assess procedures for managing occupational bloodborne pathogen exposures in outpatient dialysis facilities in the United States.
  
  
  METHODS
  A cross-sectional survey of randomly selected outpatient dialysis facilities.
  
  
  METHODS
  339 outpatient dialysis facilities drawn from the 2006 US end-stage renal disease database.
  
  
  METHODS
  Hospital affiliation (free-standing vs hospital-based facilities), profit status (for-profit vs not-for-profit facilities), and number of health care personnel (≥100 vs <100 health care personnel).
  
  
  RESULTS
  Exposures to hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV); provision of HBV and HIV postexposure prophylaxis.
  
  
  METHODS
  We calculated the proportion of facilities reporting occupational bloodborne pathogen exposures and offering occupational exposure management services. We analyzed bloodborne pathogen exposures and provision of postexposure prophylaxis by facility type.
  
  
  RESULTS
  Nearly all respondents (99.7%) had written policies and 95% provided occupational exposure management services to health care personnel during the daytime on weekdays, but services were provided infrequently during other periods of the week. Approximately 10%-15% of facilities reported having HIV, HBV, or HCV exposures in health care personnel in the 12 months prior to the survey, but inconsistencies were noted in procedures for managing such exposures. Despite 86% of facilities providing HIV prophylaxis for exposed health care personnel, only 37% designated a primary HIV postexposure prophylaxis regimen. For-profit and free-standing facilities reported fewer exposures, but did not as reliably offer HBV prophylaxis or have a primary HIV postexposure prophylaxis regimen relative to not-for-profit and hospital-based facilities.
  
  
  CONCLUSIONS
  The survey response rate was low (37%) and familiarity of individuals completing the survey with facility policies or national guidelines could not be ascertained.
  
  
  CONCLUSIONS
  Significant improvements are required in the implementation of guidelines for managing occupational exposures to bloodborne pathogens in outpatient dialysis facilities.
authors: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. cmbaeyi@cdc.gov
authors: Chukwuma
authors: C
authors: Mbaeyi
authors: Adelisa L
authors: AL
authors: Panlilio
authors: Cynthia
authors: C
authors: Hobbs
authors: Priti R
authors: PR
authors: Patel
authors: David T
authors: DT
authors: Kuhar
mesh_terms: D000488:Allied Health Personnel; D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000592:standards; D017848:Blood-Borne Pathogens; D019538:Health Care Surveys; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control* / Q000592:standards; D006435:Renal Dialysis