TY - JOUR
T1 - Percutaneous Injury, Blood Exposure, and Adherence to Standard Precautions
T2 - Are Hospital-Based Health Care Providers Still at Risk?
AU - Doebbeling, Bradley N.
AU - Vaughn, Thomas E.
AU - McCoy, Kimberly D.
AU - Beekmann, Susan E.
AU - Woolson, Robert F.
AU - Ferguson, Kristi J.
AU - Torner, James C.
N1 - Funding Information:
Survey methods. A modified Dillman method was used for mailings, with various strategies to maximize response rates [26–31]. A cover letter, information summary, survey, and self-addressed, stamped envelope were mailed in January 1997. The cover letter acknowledged collaboration and funding by the CDC and the National Institute for Occupational Safety and Health. A support letter from state public health authorities was included. A postcard reminder and a “collect call” telephone number for questions or a new survey were mailed several weeks later. The entire packet was then remailed to nonresponders at 4-and 6-week intervals.
PY - 2003/10/15
Y1 - 2003/10/15
N2 - 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 (aORinjury), which increased 2%-3% for each sharp handled in a typical week. The overall aORinjury 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 aORinjury of 1.57 (95% CI, 1.32-1.86); among physicians, the aORinjury 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.
AB - 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 (aORinjury), which increased 2%-3% for each sharp handled in a typical week. The overall aORinjury 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 aORinjury of 1.57 (95% CI, 1.32-1.86); among physicians, the aORinjury 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.
UR - http://www.scopus.com/inward/record.url?scp=0142249434&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0142249434&partnerID=8YFLogxK
U2 - 10.1086/377535
DO - 10.1086/377535
M3 - Article
C2 - 14523763
AN - SCOPUS:0142249434
SN - 1058-4838
VL - 37
SP - 1006
EP - 1013
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 8
ER -