Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-25T02:52:51.727Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of Safety-Engineered Devices on the Incidence of Occupational Blood and Body Fluid Exposures Among Healthcare Personnel in an Academic Facility, 2000–2014

Published online by Cambridge University Press:  09 February 2016

Hajime Kanamori ,
David J. Weber ,
Lauren M. DiBiase ,
Karen L. Pitman ,
Stephanie A. Consoli ,
James Hill ,
Emily E. Sickbert-Bennett  and
William A. Rutala
Hajime Kanamori*
Affiliation:
Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina
David J. Weber
Affiliation:
Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina Occupational Health Service, University of North Carolina Health Care, Chapel Hill, North Carolina
Lauren M. DiBiase
Affiliation:
Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina
Karen L. Pitman
Affiliation:
Occupational Health Service, University of North Carolina Health Care, Chapel Hill, North Carolina
Stephanie A. Consoli
Affiliation:
Occupational Health Service, University of North Carolina Health Care, Chapel Hill, North Carolina
James Hill
Affiliation:
Occupational Health Service, University of North Carolina Health Care, Chapel Hill, North Carolina Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Emily E. Sickbert-Bennett
Affiliation:
Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina
William A. Rutala
Affiliation:
Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina Occupational Health Service, University of North Carolina Health Care, Chapel Hill, North Carolina
*
Address correspondence to Hajime Kanamori, MD, PhD, MPH, Hospital Epidemiology, UNC Health Care, 1001 West Wing CB #7600, 101 Manning Dr, Chapel Hill, NC 27514 (kanamori@med.unc.edu).
Get access Rights & Permissions [Opens in a new window]

Abstract

BACKGROUND

Legislative actions and advanced technologies, particularly dissemination of safety-engineered devices, have aided in protecting healthcare personnel from occupational blood and body fluid exposures (BBFE).

OBJECTIVE

To investigate the trends in BBFE among healthcare personnel over 15 years and the impact of safety-engineered devices on the incidence of percutaneous injuries as well as features of injuries associated with these devices.

METHODS

Retrospective cohort study at University of North Carolina Hospitals, a tertiary care academic facility. Data on BBFE in healthcare personnel were extracted from Occupational Health Service records (2000–2014). Exposures associated with safety-engineered and conventional devices were compared. Generalized linear models were applied to measure the annual incidence rate difference by exposure type over time.

RESULTS

A total of 4,300 BBFE, including 3,318 percutaneous injuries (77%), were reported. The incidence rate for overall BBFE was significantly reduced during 2000–2014 (incidence rate difference, 1.72; P=.0003). The incidence rate for percutaneous injuries was also dramatically reduced during 2001–2006 (incidence rate difference, 1.37; P=.0079) but was less changed during 2006–2014. Percutaneous injuries associated with safety-engineered devices accounted for 27% of all BBFE. BBFE was most commonly due to injecting through skin, placing intravenous catheters, and blood drawing.

CONCLUSIONS

Our study revealed significant overall reduction in BBFE and percutaneous injuries likely due in part to the impact of safety-engineered devices but also identified that a considerable proportion of percutaneous injuries is now associated with these devices. Additional prevention strategies are needed to further reduce percutaneous injuries and improve design of safety-engineered devices.

Infect Control Hosp Epidemiol 2016;37:497–504

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 5 , May 2016 , pp. 497 - 504
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Centers for Disease Control and Prevention (CDC). Workbook for designing, implementing and evaluating a sharps injury prevention program. CDC website. http://www.cdc.gov/sharpssafety/pdf/sharpsworkbook_2008.pdf. Accessed July 19, 2015.Google Scholar
2. Tarantola, A, Abiteboul, D, Rachline, A. Infection risks following accidental exposure to blood or body fluids in health care workers: a review of pathogens transmitted in published cases. Am J Infect Control 2006;34:367–375.Google Scholar
3. Deuffic-Burban, S, Delarocque-Astagneau, E, Abiteboul, D, Bouvet, E, Yazdanpanah, Y. Blood-borne viruses in health care workers: prevention and management. J Clin Virol 2011;52:4–10.CrossRefGoogle ScholarPubMed
4. Panlilio, AL, Orelien, JG, Srivastava, PU, et al; NaSH Surveillance Group; EPINet Data Sharing Network. Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997-1998. Infect Control Hosp Epidemiol 2004;25:556–562.Google Scholar
5. US General Accounting Office (GAO). Occupational safety: selected cost and benefit implications of needlestick prevention devices for hospitals, GAO-01-60R. GAO website. http://www.gao.gov/new.items/d0160r.pdf. Published November 17, 2000.Google Scholar
6. Phillips, EK, Conaway, M, Parker, G, Perry, J, Jagger, J. Issues in understanding the impact of the Needlestick Safety and Prevention Act on hospital sharps injuries. Infect Control Hosp Epidemiol 2013;34:935–939.CrossRefGoogle ScholarPubMed
7. Needlestick Safety and Prevention Act of 2000, Pub L No. 106-430, 114 Stat 190. National Institutes of Health website. https://history.nih.gov/research/downloads/PL106-430.pdf. Published November 6, 2000.Google Scholar
8. Jagger, J, Perry, J, Gomaa, A, Phillips, EK. The impact of US policies to protect healthcare workers from bloodborne pathogens: the critical role of safety-engineered devices. J Infect Public Health 2008;1:62–71.Google Scholar
9. Jagger, J, Perry, J. Safety-engineered devices in 2012: the critical role of healthcare workers in device selection. Infect Control Hosp Epidemiol 2013;34:615–618.CrossRefGoogle ScholarPubMed
10. Phillips, EK, Conaway, MR, Jagger, JC. Percutaneous injuries before and after the Needlestick Safety and Prevention Act. N Engl J Med 2012;366:670–671.CrossRefGoogle ScholarPubMed
11. Tosini, W, Ciotti, C, Goyer, F, et al. Needlestick injury rates according to different types of safety-engineered devices: results of a French multicenter study. Infect Control Hosp Epidemiol 2010;31:402–407.Google Scholar
12. Black, L. Chinks in the armor: percutaneous injuries from hollow bore safety-engineered sharps devices. Am J Infect Control 2013;41:427–432.Google Scholar
13. The National Institute for Occupational Safety and Health (NIOSH). Stop Sticks Campaign. NIOSH website. http://www.cdc.gov/niosh/stopsticks/sharpsinjuries.html. Accessed December 4, 2015.Google Scholar
14. Tuma, S, Sepkowitz, KA. Efficacy of safety-engineered device implementation in the prevention of percutaneous injuries: a review of published studies. Clin Infect Dis 2006;42:1159–1170.CrossRefGoogle ScholarPubMed
15. Tarigan, LH, Cifuentes, M, Quinn, M, Kriebel, D. Prevention of needle-stick injuries in healthcare facilities: a meta-analysis. Infect Control Hosp Epidemiol 2015;36:823–829.CrossRefGoogle ScholarPubMed
16. Floret, N, Ali-Brandmeyer, O, L’Hériteau, F, et al; Working Group AES-RAISIN. Sharp decrease of reported occupational blood and body fluid exposures in French hospitals, 2003-2012: results of the French National Network Survey, AES-RAISIN. Infect Control Hosp Epidemiol 2015;36:963–968.Google Scholar
17. Haiduven, D, Applegarth, S, Shroff, M. An experimental method for detecting blood splatter from retractable phlebotomy and intravascular devices. Am J Infect Control 2009;37:127–130.Google Scholar
18. Ansari, A, Ramaiah, P, Collazo, L, Salihu, HM, Haiduven, D. Comparison of visual versus microscopic methods to detect blood splatter from an intravascular catheter with engineered sharps injury protection. Infect Control Hosp Epidemiol 2013;34:1174–1180.Google Scholar
19. Roff, M, Basu, S, Adisesh, A. Do active safety-needle devices cause spatter contamination? J Hosp Infect 2014;86:221–223.CrossRefGoogle ScholarPubMed
20. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L, Healthcare Infection Control Practices Advisory Committee (HICPAC). 2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. HICPAC website. http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf. Accessed July 19, 2015.Google Scholar