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Use of Infection Control Guidelines by Workers in Healthcare Facilities to Prevent Occupational Transmission of HBV and HIV

Published online by Cambridge University Press:  02 January 2015

James C. Hersey  and
Linda S. Martin
James C. Hersey
Affiliation:
Centers for Public Health Research and Evaluation of Battelle Inc, Arlington, Virgina
Linda S. Martin*
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
*
NIOSH HIV Activity, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop F40, Atlanta, GA 30333
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Abstract

Objective:

Develop national estimates of compliance with infection control guidelines by workers in healthcare facilities to prevent occupational transmission of hepatitis B virus (HBV) and human immunodeficiency virus.

Design:

A national survey of 3,094 workers in hospitals.

Settings:

United States ambulatory care hospitals with emergency rooms.

Results:

While the sampled hospitals had policies that incorporated the Centers for Disease Control and Prevention's (CDC) infection control guidelines, only 55% of patient care staff, 56% of physicians, and 30% of housekeeping staffreported receiving at least one of the shots recommended in the HBV vaccination series. About one half of patient care staff reported that they recapped used needles at least sometimes after giving injections and after drawing blood. Only 43% of patient care staff “always” wore gloves to draw blood. While most patient care staff “always” changed gloves between patients, only 61% reported that they “always” washed their hands after taking off their gloves. One half of patient care staff reported a percutaneous exposure to a patient's blood, and one quarter reported a percutaneous exposure in the past year The most common cause of these exposures was recapping used needles.

Conclusions:

Efforts to reduce exposures to bloodborne pathogens will involve compliance with the Occupational Safety and Health Administration bloodborne pathogens standard and the CDC's infection control guidelines, continued education and training, and emphasis on engineering controls where applicable.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 4 , April 1994 , pp. 243 - 252
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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References

1. Centers for Disease Control. Acquired immune deficiency syndrome (AIDS): Precautions for clinical and laboratory staffs. MMWR 1982;31:577–580.Google Scholar
2. Department of Labor and Department of Health and Human Services. Joint advisory notice: Protection against occupational exposure to hepatitis B virus and human immunodeficiency virus. Federal Register October 30, 1987;52(210):41818–41824.Google Scholar
3. Centers for Disease Control. Recommendations for prevention of HIV transmission in health care settines. MMWR 1987:32:2S.Google Scholar
4. Centers for Disease Control. Update: Universal precautions for prevention of transmission of HIV HBV, and other bloodborne pathogens in health care settings. MMWR 1988;37:377-382, 387–388.Google Scholar
5. Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens; final rule. Federal Register December 6, 1991;56:640004–640182.Google Scholar
6. Centers for Disease Control. Update: Human immunodeficiency virus infections in health care workers exposed to blood of infected uatients. MMWR 1987:36:285–289.Google Scholar
7. Marcus, R, the CDC Cooperative Needlestick Surveillance Group. Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. N Engl J Med 1988;319:1118–1123.Google Scholar
8. McCray, E, the Cooperative Needlestick Surveillance Group. Occupational risk of the acquired immunodeficiency syndrome among health care workers. N Engl J Med 1986;314:1127–1132.CrossRefGoogle ScholarPubMed
9. Tokars, J, Marcus, R, Culver, D, McKibben, R Bell, D, the Cooperative Needlestick Surveillance Group. Zidovudine (AZT) after occupational exposure to HIV-infected blood. Presented at the Sixth International Conference on AIDS; June 20-24, 1990; San Francisco, California.Google Scholar
10. Henderson, DK, Fahey, BJ, Willy, M, et al. Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures: a prospective evaluation. Ann Intern Med 1990;113:740–746.CrossRefGoogle ScholarPubMed
11. Gerberding, JL, Littell, C, Tarkington, A, Brown, A, Schecter, WI? Risk of exposure of surgical personnel to patients’ blood during surgery at San Francisco General Hospital. N Engl J Med 1990;322:1788–1793.Google Scholar
12. Elmslie, K, Mulligan, L, O'Shaughnessy, M. National surveillance programs: occupational exposure to human immunodeficiency virus (HIV-1) infection in Canada. Presented at the Fiih International Conference on AIDS; June 4-9, 11989; Montreal, Canada.Google Scholar
13. Haley, CE, Reff, VJ, Murphy, FK. Report of a possible laboratory acquired HIV infection. Presented at the Fifth International Conference on AIDS; June 4-9, 1989; Montreal, Canada.Google Scholar
14. Hadler, SC, Dotto, IL, Maynard, JE, et al. Occupational risk of hepatitis B infection in hospital workers. Infect Control 1985;6:24–31.Google Scholar
15. Baraff, IJ, Talan, DA Compliance with universal precautions in a university hospital emergency department. Ann Emerg Med 1989;18:654–667.Google Scholar
16. Edmond, M, Khakoo, R, McTaggart, B, Solomon, R Effects of bedside needle disposal units on needle recapping frequency and needlestick injury. Infect Control 1988;9:114–116.Google ScholarPubMed
17. Hamory, BH. Underreporting of needlestick injuries in a university hospital. Am /Infect Control 1983;11:174–177.CrossRefGoogle ScholarPubMed
18. Wong, ES, Stotka, JL, Chinchilli, VM, Williams, DS, Stuart, CG, Markowitz, SM. Are universal precautions effective in reducing the number of occupational exposures among health care workers? JAMA 1991;265:1123–1128.CrossRefGoogle ScholarPubMed
19. Fahey, BJ, Koziol, DE, Banks, SM, Henderson, DK. Frequency of nonparenteral occupational exposures to blood and body fluids before and after universal precautions training. Am J Med 1991;90:145–153.Google Scholar
20. Klein, RS. Universal precautions for preventing occupational exposures to human immunodeficiency virus type I. Am J Med 1991;90:141–144. Editorial.CrossRefGoogle Scholar
21. Hersey, JC, Mowery, P, Wheaton, K, Ward, J. Compliance with CDC Guidelines to Prevent Occupational Transmission of Human Immunodeficiency Virus and Hepatitis B Virus: Evaluation Findings from a National Survey of Health Care Workers. Final Report to the Centers for Disease Control (Contract No. 200880642). Arlington, VA: Battelle, 1992.Google Scholar
22. Moore, TF. Redesign of the National Health Interview Survey Statistical Methods Division Methodological Memorandum Series (report no. CB/SMD/MM/88/02). Washington, DC: U.S. Bureau of the Census; 1985.Google Scholar
23. Centers for Disease Control. HIV/AIDS Surveillance Report January 1991:1–22.Google Scholar
24. Hersey, JC, Boudreau, C, Ellis, B, Weinstein, S. Measuring Compliance with CDC Guidelines for Preventing Occupational Transmission of HN and HBV: Results of a Pilot Study. Report to CDC (Contract No. 200-880642). Arlington, VA Battelle and the University of Massachusetts Medical Center; 1991.Google Scholar
25. Campbell, S, Maki, M, Henry, K. Compliance with Universal Precautions among emergency department personnel. Presented at the Sixth International Conference on AIDS, June 24, 1990; San Francisco, California.Google Scholar
26. Henry, K, Campbell, S, Maki, M. A comparison of observed and self-reported compliance with universal precaution among emergency department personnel. Ann Emerg Med 1992; 21:940–946.Google Scholar
27. Henry, K, Collier, P, O'Boyle-Williams, C, Campbell, S. Observed and self-reported compliance with universal precautions among emergency department personnel at two suburban community hospitals. Presented at the Seventh International Conference on AIDS; June 1991; Florence, Italy. Abstract MD 58.Google Scholar
28. McCabe, K, Henry, K, Campbell, S, Rhame, E Differences in universal precautions policies at three Minnesota teaching hospitals. Presented at the Eighth International Conference on AIDS; July 1992; Stockholm, Sweden.Google Scholar