Accidental Blood Exposure Research Articles

Attitudes and Practices of Senegalese Dentists towards Hepatitis B

Introduction: Hepatitis B is an infectious viral disease that causes inflammation of the liver. It is transmitted through body secretions and fluids, including genital secretions, saliva and blood. The objective of this study was to assess the attitudes and practices of dental surgeons in the face infection of Hepatitis B. Methods: This was a descriptive, cross-sectional a sample of 171 dental surgeons. Probabilistic multi-stage, stratified, and systematic sampling was used. Using a questionnaire, we gathered variables related to the attitudes and practices of dentists with respect to Hep B. Results: Nearly 22% of dentists were not vaccinated against hepatitis B virus; Compliance with the use of gloves, glasses, professional clothing, and hygiene in dental offices was not systematic. Blood exposure accidents (BEA) were common, with nearly 13% suffering from needle stick injuries, 10% from eye splashes and about 6% from sharp instruments. The majority of the actions to be taken in the event of (BEA) were disinfection in the event of sticks or injuries (52.1%) and rinsing in the event of eye splashes (66.7%). Conclusion: Dentists should be educated and informed about the need for vaccination and hygiene, sterilization, and good behaviour in case of exposure to blood.

Knowledge, Attitudes, and Practices of Health-Care Workers About Viral Hepatitis B and C in South Kivu.

Health-care workers (HCWs) are at risk of infections associated with accidental exposure to blood, including viral hepatitis B (HBV) and C (HCV). A survey using a questionnaire was conducted on 250 HCW in Bukavu, an eastern town of the Democratic Republic of Congo, to analyze their attitude and knowledge about these two viruses. A response rate of 86.8% (217/250) was obtained. The mean age of the respondents was 39.6 ± 9.8 years, in majority from paramedical staff (66.4%) and with more than 5 years of professional experience (60.8%). The mean proportion of adequate answers on HBV and HCV was 33.2% (±11%) and 30.6% (±7%), respectively. Ninety-three HCW (42.8%) reported recent experience of blood exposure accident, more frequently among the paramedical staff (50%) than physicians (28.8%; P = 0.002). This was mainly related to inadequate protection resources (76.9%). Among all participants, only 24.4% had a history of at least one injection of HBV vaccine; this was more frequently found among physicians than among paramedical staff (49.3% versus 11.8%; P < 0.001). Moreover, only 3.8% of vaccinated HCW received the complete vaccination schedule of three vaccine doses. The efficiency of this vaccine is not well recognized by HCW, and the majority of them seemed to be more worried about the risk of infection by human immunodeficiency virus than by viral hepatitis. Our study reveals that the level of knowledge about HBV and HCV is rather low among HCW in Bukavu.

Accidental blood exposures among emergency medicine residents and young physicians in France: a national survey.

The aim of the present study was to investigate the epidemiological characteristics of blood or fluid exposure (BFE) and occupational infection risk among emergency medicine (EM) residents and young physicians (<35years old) in France. We led a cross-sectional, anonymous, online survey. 1779 participants were contacted with a response rate of 36% (n=633). Among the respondents, 459 (72%) reported at least one BFE. Among participants with at least one BFE, 35% (n=163) never reported the exposure to the relevant medical authorities or support. Among participants who reported exposure, 63% (n=232) did it immediately. Among participants who never or not systematically reported their BFE, most of them (62%, n=181/289) did not do so because the procedure was too long, and 28% (n=82/289) estimated the risk as low even if only one-third (n=166/458) checked their HIV status even though the BFE was at a transmission risk. Circumstances in which the participants had the most BFE were: suturing 57% (n=262/457) and when making precipitated gestures 24% (n=111/457). The latest exposures were caused by a solid needle in 42% (n=191/455) or hollow-bore needle in 27% (n=123/455). Post-exposure reporting rates were low. Reporting procedure itself and self-management were the main reasons for BFE underreporting. Simplifying procedures might increase BFE reporting, and allow appropriate post-exposure counseling and/or prophylaxis.

Prevalence of Hepatitis B and C Virus in Health Care Personnel in Ibn Sina Hospital, Rabat, Morocco

Risk of infection by hepatitis B (HBV) and C (HCV) viruses remains a permanent problem, not only for health care workers but also for patients. It is often a major public health concern in low incomes countries. The aims of this study were to determine seroprevalence of viral hepatitis B (HBV) and C (HCV), frequency occurrence of blood exposure accidents (BEA) and identify key risk factors for infection among 601 health care workers of Ibn Sina Hospital in Rabat. In this study nineteen health personnel (3.16%) were HBsAg positive and fifteen (2.50%) were anti-HCV antibodies positive. The seropositivity to hepatitis B and C in the surgical department respectively was 4.22% and 3.45%. Nurses were the most affected by hepatitis virus infections. We noticed that HCV came first with a prevalence of 4.44%. The seropositivity reached its acme within the health staff having practiced for more than 20 years, hepatitis C coming first with a prevalence of 4.27%. Globally, 34 health care personnel are positive for HBV or HCV, 32 among them were victims at least once of blood exposure accident (BEA) while practicing. The needlestick represented 81.25% of the BEA type. Prevalence of hepatitis B and C serologic markers in health care workers in our Hospital outnumbered that of the general population. Nurses, surgery department personnel and the professional having worked for a long time were the main factors behind the high risks of infections.

Attitudes and practices of nursing students confronted with blood exposure accidents in Abidjan

Background: Blood Exposure Accidents (BEAs) are frequent in healthcare settings and may cause such severe consequences as HIV and Hepatitis B and C infections. The objective of the study was to determine the attitudes and practices of nursing students facing BEAs.Materials and Methods: This was a cross-sectional prospective study conducted from August 16 to 23, 2011 at the “Institut National de Formation des Agents de la Santé d’Abidjan” (the National Institute in charge of training Health Workers). Data were collected by means of self-administered questionnaires.Results: Out of 266 student nurses included in the study, 73.3% were females while 26.7% were males. Their mean age was 29 years [20 years - 37 years]. A previous training was conducted on BEAs for 67.3% of nursing students. Those students who were immunized against hepatitis B were 75.2%. Needle recapping was practiced by 43.6% of nursing students. Unclean needles were eliminated in containers by 96.2% of the students and waste containers were within close reach of only 65.4%. Glove wearing was systematic in 77.1% of the students. Before the survey 38% of nursing students had been victim of BEAs at least once. Those BEAs were not reported in 68.3% of the victims.Conclusion: The attitudes and practices of nursing students are inadequate with regards to BEAs. A module on Hospital Hygiene is necessary in view of improving the training of nursing students.Key words: Attitudes - BEAs - Knowledge - Nursing students - Practices

Blood exposure accidents: knowledge and practices of hospital health workers in Mali

This is a prospective study conducted in December 2012 among 128 at the Nianankoro Fomba Hospital in Segou in order to assess their knowledge and practices on Blood Exposure Accidents (BEA). The average age of caregivers was 35.4 ± 9 years (range: 22-59 years). The nurses were predominant with 37.5%. The definition of BEA was mastered by 43.8%. The main transmissible infectious agents (HIV, HBV and HCV) were ignored by 76.6%. Questioning revealed that during the treatment, 78.9% wore gloves and 36.0% recapped needles after use. The concept of washing and disinfection after BEA was known by 68.8%. The disinfectant applied was correct for 21.9% of the cases, the time of application for 69.5%. Consulting a referring physician after BEA was mandatory for 32% of them. The time limit of 48 hours delay for the declaration of BEA was experienced by 51.3%. Among staff interviewed 82 caregivers (64.1%) experienced at least one BEA. Students and nursing students were most at risk. Needle pricks were the most frequent (73.2%). BEA is a major problem in the Segou Nianankoro Fomba Hospital. Compliance with standard precautions is not of common practice. Post-exposure care is not widely known. The experienced cases show poor management of BEA in the structure.

ATTITUDES AND PRACTICES OF NURSING STUDENTS CONFRONTED WITH BLOOD EXPOSURE ACCIDENTS IN ABIDJAN

Background: Blood Exposure Accidents (BEAs) are frequent in healthcare settings and may cause such severe consequences as HIV and Hepatitis B and C infections. Objective: to determine the attitudes and practices of nursing students facing BEAs. Materials and Methods: this was a cross-sectional prospective study conducted from August 16 to 23, 2011 at the “Institut National de Formation des Agents de la Sante d’Abidjan” (the National Institute in charge of training Health Workers). Data were collected by means of self-administered questionnaires. Results: out of 266 student nurses included in the study, 73.3% were females while 26.7% were males. Their mean age was 29 years [20 years - 37 years]. A previous training was conducted on BEAs for 67.3% of nursing students. Those students who were immunized against hepatitis B were 75.2%. Needle recapping was practiced by 43.6% of nursing students. Unclean needles were eliminated in containers by 96.2% of the students and waste containers were within close reach of only 65.4%. Glove wearing was systematic in 77.1% of the students. Before the survey 38% of nursing students had been victim of BEAs at least once. Those BEAs were not reported in 68.3% of the victims. Conclusion: the attitudes and practices of nursing students are inadequate with regards to BEAs. A module on Hospital Hygiene is necessary in view of improving the training of nursing students.

Blood exposure accidents: Knowledge, attitudes and practices of nursing and midwifery students at the Bobo-Dioulasso teaching hospital (Burkina Faso)

Blood exposure accidents are the source of major risks of contamination of healthcare personnel. The objective of this study was to describe the knowledge of standard precautions, and the attitudes and practices of nursing and midwifery students in relation to this accidental exposure. This cross-sectional survey, conducted in November 2011, was based on voluntary anonymous questionnaires completed by students working in the medical ward of the Bobo-Dioulasso teaching hospital. Of the 275 students asked to participate, 219 (92.8%) completed the questionnaire: 138 (63,0%) were student nurses and 81 (37.0%) student midwives. Their mean age was 27.9±5 years. Among them, 64 (29.1%) acknowledged accidental exposure to blood during treatment performed as part of their hospital work. Only 30 of these 64 cases were reported at the time. The standard precautions for the prevention of these accidents were known to 131 students (59.8%); 58.4% always wore gloves for invasive procedures; 74.9% reported that the syringe container was "always" or "often" used. The needles used were "always" or "often" recapped before disposal in only 39.1% of cases. Only 11.0% were fully vaccinated against hepatitis B. Blood exposure accidents were not uncommon among these students and their knowledge of the standard precautions and actions to take in case of an accident is insufficient. These data show the need for further training and awareness campaigns to improve these hospital practices.

The importance of implementing safe sharps practices in the laboratory setting in Europe

Healthcare workers are at risk of sharps injuries and subsequent infection from more than 40 bloodborne pathogens or species. Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) together account for the vast majority of cases. The Directive 2010/32/EU “Prevention from sharp injuries in the hospital and healthcare sector”, issued to protect workers from these risks, requires an integrated approach to prevention including awareness-raising, education, training, elimination of unnecessary needles, safe procedures for sharps use and disposal, banning of recapping, vaccination, use of personal protective equipment, provision of safety-engineered devices, and appropriate surveillance, monitoring, response and follow-up.As laboratories represent a high-risk setting both in the preanalytical and analytical phase, we reviewed accidents and prevention in this setting in the light of the new legislation.Phlebotomy is the procedure carrying the highest risk of exposure and infection, involved in 30–50% of HIV and HCV cases detected in nationwide systems following accidental blood exposures implemented since the 1990s in Italy and France. In laboratories, problems in the management of sharps containers, recapping, needle disassembly by hand and blood transfer from syringes into tubes were observed and accounted for two-thirds of injuries. These accidents could be reduced through education and monitoring of behaviours, and introduction of medical devices incorporating safety-engineered protection mechanisms with appropriate training. Laboratory staff should be immunized against HBV, and know policies and procedures for the post-exposure management and prophylaxis. The management commitment to safety is crucial to ensure the necessary support to these changes.

Évaluation des pratiques des médecins libéraux sur la gestion des risques professionnels liés à l’exposition aux liquides biologiques

During their practice, liberal physicians might have a risk of viral exposure to biological fluids. That risk is well-known in hospitals. The purpose of this study was to measure those occupational risks into their own private practice. This observational descriptive transversal multicentral, epidemiological study is based on the information collected from 400 physicians (general practitioners, ENT specialists, dermatologists, pediatricians, rheumatologists and gynecologists), working in own private practice in Lorraine. They received by post a confidential survey consisting of multiple-choice and open questions, asking for their activity, their risks of being exposed to biological fluids, their vaccine coverage and their potentially infectious medical waste (PIMW) management. Among 175 physicians who replied to the survey, 153 did invasive procedures and 58 encountered an accidental blood exposure (ABE). The execution of invasive procedures was the main factor in having an ABE (P=0.0023). Around 89.5 % of the complications were due to percutaneous injuries. Still 30.9 % of the physicians always recapped needles and 40 % hadn't a complementary health cover. More than 82 % were up-to-date on mandatory vaccinations (hepatitis B and diphtheria-tetanus-poliomyelitis). In private practice, 97.6 % of physicians sort out blunt objects (prickly or sharp), which is quite satisfactory in comparison with only 60.5 % of them who sort out soft wastes and 44.6 % of blunt objects at patient's home. Even if physician's blunt objects disposal in private practice and their mandatory vaccination are satisfactory, "standard" precautions, safety equipment use and soft wastes disposal can be improved.

P2.141 Knowledge, Attitudes and Practices of Healthcare Workers from University Hospital of Ouagadougou (Burkina Faso) Face to Accidental Blood Exposure (ABE) and Biological Fluids in Caregiving Facilities

ObjectiveAccidental blood exposure (ABE) is defined as “any accidental exposure to blood or to a biological fluid contaminated by blood, including a cutaneous injury during an incision or injection, or...

P296: Epidemiological profile and management of accidental blood exposure, Bamako

Results We collected 40 AES with a male predominance (sexratio = 2). The median age was 32 years [19-54 years]. Our study population was composed of students (42.5%), physicians (22.5%), nurses (15%) and surface technicians (sanitizers) (7.5%). The AES had occurred mainly in hospitals (57.5%) and 20% in home care. The surgery department was more concerned (45%). The main circumstances of occurrence were the needle stick (42.5%); puncture by scalpel (22.5%); recapping (10%) and the projection on the mucosa (10%). The majority had done the washing with water / soap (92.5%) of which 25% immediately. Eight people were reported after 48 hours. HIV status of the source patient was known in 47.5% of which 25% were positive. A lady had a positive HIV serology after accidental blood exposure (seroconversion) At the time of AES, serology for hepatitis B and C were not known in the majority of patients and victims sources. Thirty have benefited from ARV prophylaxis. Conclusion Difficulties encountered in the declaration and management of AES require training of health personnel of University Hospital Teaching of Point G.

Hygiene and security management in medical biology laboratory

Risk management in Medical Biology Laboratory (MBL) which includes hygiene and waste management, is an integrated process to the whole MBL organisation. It is composed of three stages: risks factors identification, grading and prioritization, and their evaluation in the system. From the legislation and NF EN ISO 15189 standard's requirements viewpoint, prevention and protection actions to implement are described, at premises level, but also at work station environment's one (human resources and equipments) towards biological, chemical, linked to gas, to ionizing or non ionizing radiations and fire riks, in order not to compromise patients safety, employees safety, and quality results. Then, although NF EN 15189 standard only enacts requirements in terms of prevention, curative actions after established blood or chemical exposure accident are defined.

P310: The blood accidents exposure (aes) in principal hospital dakar (hpd): about 152 cases collected in 12 years

Blood exposure accidents (BEA) are a risk to all personnel of the health services. Today, support for BEA is well codified. In Senegal, a strategy implemented by ISAARV provides rapid and optimized response to these accidents, in order to reduce the risk of HIV seroconversion.

P302: Securing the venous sampling: a priority for the safety and caregivers of patients in the ped

Objectives The provision of antiretroviral treatment in developing countries led to the medical care of an increasing number of patients infected with HIV and other viruses and to an increase in invasive procedures practiced by healthcare personnel. Healthcare workers are particularly exposed to the risk of transmission of pathogens during a blood exposure accident (AES). In 2012, the problem of infectious risks related to venepuncture remains a concern for health care in Africa: lack of awareness and lack of resources, inadequate equipment and high prevalence of infection in the population, increase in invasive procedures performed related to extension the management of these diseases and access to health care for the population.

P301: The blood exposure accidents to hospital regional of Tenkodogo

Accidental blood exposure (AES), whether occurring during professional activities or not, is defined by contact with blood or blood-containing liquid at a prick with a needle, a cut with a sharp objects or by contact with blood or contaminated liquid from a wound, non-intact skin or mucous membranes. To date, very few studies have been conducted in the field of AES in Burkina Faso.

Management of accidental exposure to HCV, HBV and HIV in healthcare workers in Romania

Accidental blood exposure in healthcare workers is an important issue worldwide. We present a study which analyzed the route of exposure, the source of infection and the post-exposure prophylaxis treatment administered. We performed retrospective study of occupational exposure to HBV, HCV and HIV and the subsequent post-exposure prophylaxis among healthcare workers at the National Institute of Infectious Diseases "Prof.Dr. Matei Balş", Bucharest, Romania, from December 2002 to December 2011. Sixty healthcare workers with a mean age of 36 reported an occupational exposure during a period of 9 years, 54 (90%) were females and 6 (10%) were males. 48 (80%) exposed healthcare workers were nurses, 7 (11.6%) were doctors and 5 (8.3%) were medical assisting staff. In 49 (81.6%) cases the exposure was percutaneous and in 11 (18.3%) cases the exposure was mucosal/corneal. Ten (16.6%) exposed healthcare workers had insufficient levels of antibody (HBsAb) response, (below 10 mIU/mL), 6 (10%) had titers between 11 and 500 mIU/mL, 31 (51.6%) between 501-1000 mIU/mL, and 13 (21.6%) above 1000 mIU/mL). The exposure events analysis in this study yielded similar results compared to other previous parallel studies. Minimizing risks to HCWs for acquisition of blood-borne pathogens and correct and rapid post-exposure prophylaxis treatment in case of exposure should be an integral part of the infection control and occupational health programs in all healthcare facilities.

Les accidents d’exposition au sang en réanimation : épidémiologie, prévention et prise en charge

Accidental exposures to blood are common in healthcare settings. Intensive care units have a higher frequency of nurse and medical acts and thus of accidental exposures to blood with increased risk of blood-borne agents transmission. Prevention relies mainly on a decrease in the frequency of accidental blood exposures, and in some cases, in the use of post-exposure prophylaxis.

Registration of Blood Exposure Accidents in the Netherlands by a Nationally Operating Call Center

Healthcare providers and other employees, especially those who do not work in a hospital, may not easily find help after the occurrence of a blood exposure accident. In 2006, a national call center was established in The Netherlands to fill this gap. All occupational blood exposure accidents reported to the 24-hours-per-day, 7-days-per-week call center from 2007, 2008, and 2009 were analyzed retrospectively for incidence rates, risk assessment, handling, and preventive measures taken. A total of 2,927 accidents were reported. The highest incidence rates were reported for private clinics and hospitals (68.5 and 54.3 accidents per 1,000 person-years, respectively). Dental practices started reporting incidents frequently after the arrangement of a collective financial agreement with the call center. Employees of ambulance services, midwife practices, and private clinics reported mostly high-risk accidents, whereas penitentiaries frequently reported low-risk accidents. Employees in mental healthcare facilities, private clinics, and midwife practices reported accidents relatively late. The extent of hepatitis B vaccination in mental healthcare facilities, penitentiaries, occupational health services, and cleaning services was low (<70%). The national call center successfully organized the national registration and handling of blood exposure accidents. The risk of blood exposure accidents could be estimated on the basis of this information for several occupational branches. Targeted preventive measures for healthcare providers and other employees at risk can next be developed.

Protecting patients from harm: Design and implementation of an institutional bloodborne pathogen protocol

Patients are sometimes exposed to the blood of health care workers (HCWs) while receiving medical care. No national guidelines exist that authoritatively articulate the responsibility of HCWs infected with a potentially transmissible bloodborne pathogen (BBP). Geisinger Health System crafted and implemented a policy delineating the responsibilities of an HCW in the event of accidental blood exposure of a patient, specifically addressing HCWs known to be infected with a BBP. In 2008, a multidisciplinary group convened to review available published resources from the American Medical Association, specialty society positions, state and national guidelines, Centers for Disease Control and Prevention, and Society for Healthcare Epidemiology, as well as selected commentaries. A policy was crafted and enacted within a large integrated heath care system that provided clear guidelines and responsibilities for HCWs who are either infected with a BBP or expose patients to blood in the course of providing medical care. This policy balances the rights of both patients and providers. The resources to devise policies regarding BBP exposure to patients are available but require distillation of complex scientific data and social and/or legal opinion or precedent. We offer Geisinger Health System's policy as a workable and readily accessible model that defines the obligations of providers to protect patients in the event of a BBP exposure.