Journal Article

Percutaneous Injury, Blood Exposure, and Adherence to Standard Precautions: Are Hospital-Based Health Care Providers Still at Risk?

Bradley N. Doebbeling, Thomas E. Vaughn, Kimberly D. McCoy, Susan E. Beekmann, Robert F. Woolson, Kristi J. Ferguson and James C. Torner

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 8, pages 1006-1013
Published in print October 2003 | ISSN: 1058-4838
Published online October 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/377535
Percutaneous Injury, Blood Exposure, and Adherence to Standard Precautions: Are Hospital-Based Health Care Providers Still at Risk?

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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.

Journal Article.  4733 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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