Management of sharps injuries in the healthcare setting

Riddell, Anna; Kennedy, Ioana; Tong, C. Y. William

doi:10.1136/bmj.h3733

Cited by 30 publications

(26 citation statements)

References 19 publications

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“…This difference has been reported; however, percutaneous exposure to infected blood and other bodily fluids holds a higher risk for infection than mucocutaneous exposure. [17][18][19] The risk of infection from percutaneous exposure ranges from 1 in 3 for blood positive for hepatitis B e antigen, to 1 in 30 for blood positive for hepatitis C virus, to roughly 1 in 300 for HIV-positive blood. [17][18][19] The risk of infection from mucocutaneous exposure to infected blood and other bodily fluids is felt to be lower, less than 1 in 1000.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19] The risk of infection from percutaneous exposure ranges from 1 in 3 for blood positive for hepatitis B e antigen, to 1 in 30 for blood positive for hepatitis C virus, to roughly 1 in 300 for HIV-positive blood. [17][18][19] The risk of infection from mucocutaneous exposure to infected blood and other bodily fluids is felt to be lower, less than 1 in 1000. [17][18][19] Thus, it seems contrary that the use of eye protection is more common than double gloving when the higher-risk exposure events are more likely to occur involving a surgeon's hands.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19] The risk of infection from mucocutaneous exposure to infected blood and other bodily fluids is felt to be lower, less than 1 in 1000. [17][18][19] Thus, it seems contrary that the use of eye protection is more common than double gloving when the higher-risk exposure events are more likely to occur involving a surgeon's hands.…”

Section: Discussionmentioning

confidence: 99%

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Practice and attitudes regarding double gloving among staff surgeons and surgical trainees

Lipson¹,

Deardon²,

Switzer³

et al. 2018

cjs

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ReseaRch • RecheRchePractice and attitudes regarding double gloving among staff surgeons and surgical trainees Background: Despite supporting evidence, many staff surgeons and surgical trainees do not routinely double glove. We performed a study to assess rates of and attitudes toward double gloving and the use of eye protection in the operating room. Methods:We conducted an electronic survey among all staff surgeons and surgical trainees at 2 tertiary care centres in Alberta between September and November 2015. We analyzed the data using log-binomial regression for binary outcomes to account for multiple independent variables and interactions. For 2-group comparisons, we used a 2-group test of proportions. Results:The response rate was 34.3% (361/1051); 205/698 staff surgeons (29.4%) and 156/353 surgical trainees (44.2%) responded. Trainees were more likely than staff surgeons to ever double glove in the operating room (p = 0.01) and to do so routinely (p = 0.01). Staff surgeons were more likely than trainees to never double glove (p = 0.01). A total of 300/353 respondents (85.0%) reported using eye protection routinely in the operating room. Needle-stick injury was common (184 staff surgeons [92.5%], 115 trainees [74.7%]). Reduced tactile feedback, decreased manual dexterity and discomfort/poor fit were perceived barriers to double gloving.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Practice and attitudes regarding double gloving among staff surgeons and surgical trainees

Lipson¹,

Deardon²,

Switzer³

et al. 2018

cjs

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“…Care for HCP who have been exposed to blood or potentially contaminated fluids has been reviewed. 46,53,54,[58][59][60][61][62] Exposed HCP should immediately be provided with Health care personnel who have exudative lesions or weeping dermatitis on exposed body areas (hands/wrist and face/neck) must be excused from providing direct patient care or working patient equipment (OSHA regulation) Enhanced education on the proper use of safety engineered device first aid. Exposed mucous membranes should be flushed with water.…”

Section: Sharp Injuriesmentioning

confidence: 99%

Occupational Health Update

Weber

Rutala

2016

Infectious Disease Clinics of North America

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Health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, Clostridium difficile). An effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and isolation of potentially infectious patients, and hand hygiene; (2) assuring immunity to vaccine-preventable diseases; and, (3) immediate availability of a medical evaluation after a nonprotected exposure to an infectious disease.

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“…Furthermore, a single booster dose of HB vaccine 10 years after a primary course of vaccination is recommended for HCWs in Germany . Thus, the difference in the recommendation creates confusion for the management of HCWs . In contrast, there is no established HB vaccination policy for HCWs in Japan…”

Section: Introductionmentioning

confidence: 99%

Discordance of hepatitis B vaccination policies for healthcare workers between the USA, the UK, and Germany

Komatsu

Klenerman

Thimme

2020

Hepatology Research

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The hepatitis B (HB) vaccine is effective for the prevention of HB virus infection. It has been widely accepted that an anti‐HB surface antibody (HBs) level ≥10 mIU/mL is protective against HB virus infection. Although transient infection can occur in individuals who attain a peak level of anti‐HBs ≥10 mIU/mL after primary vaccination, long‐term follow‐up studies show that successful primary vaccination can prevent individuals from acute clinical hepatitis and chronic infection. Healthcare workers (HCWs) are at‐risk individuals. Based on the accumulated data, the USA considers an anti‐HBs level ≥10 mIU/mL to constitute successful vaccination for HCWs. In contrast, because some anti‐HBs assays cannot accurately measure in the low anti‐HBs range, including 10 mIU/mL, the UK and Germany consider an anti‐HBs level ≥100 mIU/mL to constitute successful vaccination for HCWs. In the USA and UK, a booster dose is unnecessary for HCWs after successful vaccination. In Germany, anti‐HBs testing is recommended for HCWs who are at particularly high individual exposure risk 10 years after successful primary immunization, and a booster dose is offered if the anti‐HBs level has declined to ˂100 mIU/mL. The differences in the goal of HB vaccination, reliability of anti‐HBs assays, and use of booster vaccination cause discordance in HB vaccination policies for HCWs.

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Management of sharps injuries in the healthcare setting

Cited by 30 publications

References 19 publications

Practice and attitudes regarding double gloving among staff surgeons and surgical trainees

Practice and attitudes regarding double gloving among staff surgeons and surgical trainees

Occupational Health Update

Discordance of hepatitis B vaccination policies for healthcare workers between the USA, the UK, and Germany

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