Universal Precautions (UPs), procedures to reduce the likelihood of accidental exposure to blood-borne pathogens, were observed among seven Certified Nurse Anesthetists and one anesthesia technician during intravenous line procedures. After six weeks of base-line measures, nurses participated in training, goal setting, and feedback targeting hand sanitizing practices. Three weeks later immediate needle disposal was targeted. Hand sanitizing behaviors increased from a group baseline percentage of 24% to 65% during the intervention, and 52% during withdrawal. No significant increases in immediate needle disposal were found. Participants disposed of needles immediately 53% of the time during baseline, 58% during the intervention phase, and 45% during withdrawal. Non-targeted UP behaviors also increased as a result of the intervention: Recapping needles with on-hand increased from 45% during baseline to 61% during the intervention phases; removing gloves from inside out increased from 61% to 93%; and wearing gloves when discarding waste increased from 31% to 52%. Auxiliary behaviors such as nurse and patient interactions remained consistently high throughout the study.
ARTICLEHealth care workers, including physicians, nurses, emergency medical personnel, operating room personnel, laundry workers, and lab technicians, are routinely at risk for exposure to blood-borne pathogens (BBPs). BBPs are infectious microorganisms present in human blood that can be fatal to infected persons (Occupational Safety and Health Administration, 1999). BBPs include Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV). There is an estimated 0.3% risk of infection with HIV after percutaneous exposure (often through accidental needle stabs through the skin) to HIV-contaminated blood (Gershon, Vlahov, Felknor, Vesley, Johnson, Delclos, & Murphy, 1995) although this risk has been estimated as high as .5% (Linn, Kahn,&Leake, 1990).The risk of contracting Hepatitis B after exposure is 30% and Hepatitis C (HCV) is 6 to 10% (Gershon et al., 1995). In addition to HIV, HBV and HCV, 20 other pathogens may be transmitted through exposure to blood-borne pathogens (Gershon, Karkashian, & Felknor, 1994).As of 1998, the Centers for Disease Control (n.d.) documented a total of 54 cases of health care employees in the United States who had acquired HIV infection at work. As many as 134 additional cases may have occurred but could not be directly linked to an occupational exposure incident.The Exposure Prevention Information Network (EPINet; reported 590,164 annual percutaneous injuries for health care workers in hospital and non-hospital settings (Perry, 2000). Additionally, Hersey and Martin (1994) reported data on percutaneous injuries among health care workers in 1991. Seven percent of exposures occurred when needles had been set down while completing a procedure and 6% occurred while inserting an intravenous or peripheral line. Nurses are an especially at-risk group. In one year in the United States, there were 13 documented occ...