Occupational Blood Exposure of Nursing Staff During Dialysis Connection and Disconnection Procedures: A Quantitative Assessment

Abstract

Background: Hemodialysis patients are at high risk for developing healthcare-associated infections and acquiring multidrug-resistant microorganisms. The importance of hand hygiene in the prevention of healthcare-associated infections is well known. To date, no quantitative study has been undertaken to verify hand hygiene and nosocomial infection management prevention and control. Methods: This quantitative, exploratory, descriptive, observational study used the pyramidon semi-quantitative examination method to detect hemoglobin on the fingers of enrolled nursing staff. We sampled all the fingers of participants who had just finished operating vascular access routes during randomly selected 15-min detection periods that covered all steps of a hemodialysis session (connection and disconnection). Findings: In all the periods that were investigated, numerous residual blood-exposure positive results were found on the fingers of the nurses. Among a total of 454 samples, 273 were found to be residual blood positive and 181 were negative on semi-quantitative examination. The processes where significant differences were found included connection and disconnection of the vascular access routes to the hemodialysis machine (p<0.001). Interpretation: The novel detection method provides direct evidence for hand-based exposure to blood by hemodialysis nurses during the operation of the patient’s vascular access route for hemodialysis. Pyramidon semi-quantitative examination is an excellent method for the evaluation of blood exposure in a hemodialysis unit. Enhanced hand hygiene can be achieved through immediate and intuitive feedback. Clinical Trial Registration Details: This study has been registered with the China Clinical Trial Center, and the number is: ChiCTR2100051448. Funding Information: This study did not receive any funding or financial support. Declaration of Interests: All other authors do not declare any conflict of interest related to the results of this study. Ethics Approval Statement: This research project was approved by the ethical review board of the Affiliated Hospital of Inner Mongolia Medical University (No. KY2020027).