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Hospital Bloodborne Pathogens Programs: Program Characteristics and Blood and Body Fluid Exposure Rates

Published online by Cambridge University Press:  02 January 2015

Susan E. Beekmann
Affiliation:
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa
Thomas E. Vaughn
Affiliation:
Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa
Kimberly D. McCoy
Affiliation:
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa
Kristi J. Ferguson
Affiliation:
Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa
James C. Torner
Affiliation:
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
Robert F. Woolson
Affiliation:
Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa
Bradley N. Doebbeling*
Affiliation:
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
*
Department of Internal Medicine, SE 625 GH, 200 Hawkins Dr, Iowa City, IA 52242

Abstract

Objective:

To describe hospital practices and policies relating to bloodborne pathogens and current rates of occupational exposure among healthcare workers.

Participants and Methods:

Hospitals in Iowa and Virginia were surveyed in 1996 and 1997 about Standard Precautions training programs and compliance. The primary outcome measures were rates of percutaneous injuries and mucocutaneous exposures.

Results:

153 (64%) of 240 hospitals responded. New employee training was offered no more than twice per year by nearly one third. Most (79%-80%) facilities monitored compliance of nurses, housekeepers, and laboratory technicians; physicians rarely were trained or monitored. Implementation of needlestick prevention devices was the most common action taken to decrease sharps injuries. Over one half of hospitals used needleless intravenous systems; larger hospitals used these significantly more often. Protected devices for phlebotomy or intravenous placement were purchased by only one third. Most (89% of large and 80% of small) hospitals met the recommended infection control personnel-to-bed ratio of 1:250. Eleven percent did not have access to postexposure care during all working hours. Percutaneous injury surveillance relied on incident reports (99% of facilities) and employee health records (61%). The annual reported percutaneous injury incidence rate from 106 hospitals was 5.3 injuries per 100 personnel. Compared to single tertiary-referral institution rates determined more than 5 years previously, current injury rates remain elevated in community hospitals.

Conclusions:

Healthcare institutions need to commit sufficient resources to Standard Precautions training and monitoring and to infection control programs to meet the needs of all workers, including physicians. Healthcare workers clearly remain at risk for injury. Further effective interventions are needed for employee training, improving adherence, and providing needlestick prevention devices.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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