Percutaneous Exposure Incidents of the Health Care Personnel in a Newly Founded Tertiary Hospital: A Prospective Study

Abstract

BackgroundPercutaneous exposure incidents (PEIs) and blood splashes on the skin of health care workers are a major concern, since they expose susceptible employees to the risk of infectious diseases. We undertook this study in order to estimate the overall incidence of such injuries in a newly founded tertiary hospital, and to evaluate possible changes in their incidence over time.Methodology/Principal FindingsWe prospectively studied the PEIs and blood splashes on the skin of employees in a newly founded (October 2000) tertiary hospital in Athens, Greece, while a vaccination program against hepatitis B virus, as well as educational activities for avoidance of injuries, were taking place. The study period ranged from October 1, 2002 to February 28, 2005. Serologic studies for hepatitis B (HBV) and C virus (HCV) as well as human immunodeficiency virus (HIV) were performed in all injured employees and the source patients, when known. High-titer immunoglobulin (250 IU anti-HBs intramuscularly) and HBV vaccination were given to non-vaccinated or previously vaccinated but serologically non-responders after exposure. Statistical analysis of the data was performed using Mc Nemar's and Fisher's tests. 60 needlestick, 11 sharp injuries, and two splashes leading to exposure of the skin or mucosa to blood were reported during the study period in 71 nurses and two members of the cleaning staff. The overall incidence (percutaneous injuries and splashes) per 100 full-time employment-years (100 FTEYs) for high-risk personnel (nursing, medical, and cleaning staff) was 3.48, whereas the incidence of percutaneous injuries (needlestick and sharp injuries) alone per 100 FTEYs was 3.38. A higher incidence of injuries was noted during the first than in the second half of the study period (4.67 versus 2.29 per 100 FTEYs, p = 0.005). No source patient was found positive for HCV or HIV. The use of high-titer immunoglobulin after adjustment for the incidence of injuries was higher in the first than in the second half of the study period, although the difference was not statistically significant [9/49 (18.37%) vs 1/24 (4.17%), p = 0.15].Conclusions/SignificanceOur data show that nurses are the healthcare worker group that reports most of PEIs. Doctors did not report such injuries during the study period in our setting. However, the possibility of even relatively frequent PEIs in doctors cannot be excluded. This is due to underreporting of such events that has been previously described for physicians and surgeons. A decrease of the incidence of PEIs occurred during the operation of this newly founded hospital.

Risk of occupational exposure to the HBV infection in non-clinical healthcare personnel

“…Similarly to the observations by other researchers, both Polish and foreign [12][13][14][15], in our study nursing staff were the largest group after the exposure. This may be attributed to the fact that nurses are the largest occupational group among the HCWs [16].…”

Prevalence and Post-exposure Prophylaxis use for Needlestick Injuries among Health Care Providers in a Tertiary Care Hospital in Kochi, India

“…In the present study, majority of NSIs were reported by staff nurses, (42.9%), which is a similar result compared with previous studies (4,6,(13)(14)(15)(16). This incidence rate is high though compared with a study done by Jayanth et al (17), where 28% of nurses had experienced NSIs.…”

Accidents By Sharp Instruments Of Nursing Professionals In A Hospital Unit

“…Studies [18,19,20,21,22] conducted in health professionals in Brazil and other countries highlighted the nursing staff as the most injured during professional practice, with the greatest risk factor contact with sharps and potentially contaminated biological materials. Among the reasons given for greater vulnerability of nursing staff are the characteristics of the profession, as being the largest individual group of health professionals responsible for uninterrupted 24 hours a day service and perform a higher volume of direct patient care.…”