Occupational Blood Exposure in Maharat Nakhon Ratchasima Hospital : Analysis of Trend After Implementating Safety Measures
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Abstract
Background: Health care workers (HCWs) are at risk of occupational exposures to bloodborne pathogens. The exposures can lead to serious or fatal infections with hepatitis B virus, hepatitis C virus, or human immuunodeficiency virus. According to the annual surveillance reports, the average incidence of such exposures in Maharat Nakhon Ratchasima hospital during 1993-1999 was 17.0/1,000 risk HCWs. Comparing with the prevalence rate (324.8/1,000 risk HCWs) obtained by cross-sectional survey in the year 2000, the figure is very low.
Objective. To study trend of occupational blood exposure in HCWs after implementing the preventive measures.
Methods: Prospective surveillance study was conducted and preventive efforts were implemented focusing on raising awareness, increasing exposure report, training HCWs, and providing protective devices and appropriate sharps disposal containers. In addition, timely HIV postexposure prophylaxis with follow-up testing and medical evaluation were also given.
Results: During the year 2000-2002, the reports of occupational blood exposure were significantly increased (31.9, 35.7, and 32.5/1,000 risk HCWs respectively) showing the trends toward exposures in medical staff and both medical and nursing students. Most of the events, among which needlestick injuries were the highest, occurred at hospital wards. HCWs were more knowledgeable regarding the risk of exposures and seeked medical advise despite the source persons were seronegative. Analysis of activities associated with needlestick injuries revealed obvious reduction in the ones occurring before disposal.
Conclusions: Implementation of prevention efforts can lcad to safety awareness, increasing occupational blood exposure report, and reducing pre-disposal needlestick injuries. Ready access to counseling and guidance is important for postexposure management.
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