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Health care workers’ experience with postexposure management of bloodborne pathogen exposures: A pilot study*,**

https://doi.org/10.1067/mic.2000.109907Get rights and content

Abstract

Purpose: This descriptive study of health care workers enrolled in a postexposure bloodborne pathogen management program had 3 goals: (1) to characterize their exposure incidents, (2) to assess health care workers’ experience with the program, and (3) to identify strategies to improve the management of exposure incidents. Methods: A confidential, self-administered, 5-page survey was mailed to 150 hospital employees who were recently evaluated in the employee health clinic for a blood/body fluid exposure. Results: Sixty-five usable surveys were returned to the study office, representing a 43% response rate. Although the majority of the employees enrolled in the postexposure management program were generally satisfied with the overall quality of care they received, many respondents perceived a lack of social support during the lengthy follow-up period. Long-term distress related to the exposure was not uncommon. The respondents’ suggestions for improvement focused on the need for department managers to become more personally involved when their staff members have an exposure incident. Conclusion: These qualitative data suggest that additional studies are needed to assess both the short-term and long-term impact of exposure incidents on the health and well being of affected health care workers. In addition, because of a paucity of information in this area, studies are needed to assess both the effectiveness of the United States Public Health Service recommendations for postexposure management and the degree to which they have been implemented by health care facilities. (AJIC Am J Infect Control 2000;28:421-8)

Section snippets

Methods

A confidential, self-administered, 5-page survey was developed to collect information from HCWs who had recently reported a blood/body fluid exposure incident to the hospital’s employee health department. The 115-item survey contained items on demographics (eg, sex, age, department, occupation, and length of tenure), the type and risk factors for exposure (eg, type of sharps device in use, type of personal protective equipment in use, and type of activity during the exposure incident), and

Demographic information

Most of the respondents were women (68%) and were nurses (29%) or house/medical staff members (39%). The mean age of the respondents was 35 years (range 23-65), and they had an average of 6 years of tenure at their present job. Six percent of the respondents were supervisors. Most of the respondents (97%) reported direct patient contact. The demographic profile of respondents is summarized in Table 1.

. Demographics of exposed HCWs (N = 65) responding to the survey

Variablen%
Sex
 Male2032
 Female4368
 

Discussion

Exposed HCWs want and deserve fast, compassionate, and knowledgeable postexposure care. It is important to recognize than an exposure incident may trigger an acute stress reaction in the exposed HCW. This type of reaction is typical after experiencing traumatic events, and it initially includes feelings of disbelief, fear, and anger followed by a combination of avoidance and reliving the experience.15 Eventually, for most persons, the event may then be resolved.16 For some persons, however,

Conclusion

Generally, persons conducting research in this particular area of occupational health and safety do not have the opportunity to talk with exposed HCWs because of the necessity to maintain patient confidentiality. However, qualitative input from exposed HCWs can be incredibly valuable in developing new risk-reduction strategies. Clearly, this type of information is important to any health facility’s risk management program. By using a confidential survey, both researchers and administrators can

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Funded by the Centers for Disease Control and Prevention/National Institute of Occupational Safety and Health, Cooperative Agreement # U60/CCU312197-03.

**

Reprint requests: Dr Robyn Gershon, The Joseph L. Mailman School of Public Health, Columbia University, 600 West 168th St, 5th floor, New York, NY 10032-3702.

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