Blood/Body Fluids Exposure Module

Background

Transmission of bloodborne pathogens (e.g., hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV)) from patient to healthcare worker is an important occupational hazard faced by healthcare personnel (HCP). Risk factors for transmission of bloodborne pathogens after occupational exposure are likely related to the source patient (e.g., titer of virus in the source patient’s blood/body fluid), the type of injury, and quantity of blood/body fluid transferred to the HCW during the exposure, and the health status of the HCW himself or herself. The greatest risk of infection transmission is through percutaneous exposure to infected blood. Nevertheless, transmission of HBV, HCV, and HIV after mucous membrane or skin exposure to blood has also been reported and the risk of transmission of these pathogens through mucocutaneous exposure is considered lower than the risk associated with a percutaneous exposure.

An estimated 385,000 percutaneous injuries (i.e., needlesticks, cuts, punctures and other injuries with sharp objects) occur in U.S. hospitals each year. Prevention of occupational transmission of bloodborne pathogens requires a diversified approach to reduce blood contact and percutaneous injuries including the development of improved engineering controls (e.g., safer medical devices), work practices (e.g., technique changes to reduce handling of sharps), and the use of personal protective equipment (e.g., impervious materials for barrier precautions). Other strategies to prevent infection include hepatitis B immunization and postexposure prophylaxis for HIV and HBV. Strategies for prevention of percutaneous injuries are addressed in DHQP’s Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program.

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Module Overview

Occupational exposures to blood and body fluids in healthcare settings have the potential to transmit hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV). Use of the Blood and Body Fluid Exposure module permits a healthcare facility to record information about the exposure and its management. It can be used in any healthcare setting where there is potential for occupational exposure of healthcare personnel (HCP) to blood and body fluids. This module requires that data be provided to CDC when exposures occur, as indicated in the HPS Monthly Reporting Plan. In general, these data may be provided by the occupational health department in the facility or may be provided by the infection control/epidemiology department, as appropriate. Users should complete the NHSN forms to collect all required data, using the definitions of each data field.

Facilities are not required to collect data for exposures that involve intact skin or exposures to body fluids which do not carry a risk of transmission of infectious blood and body fluids (e.g., feces, nasal secretions, saliva, sputum, sweat, tears, urine and vomitus) unless they are visibly bloody. However, facilities that routinely collect data on such exposures may enter this information into the system.

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Facility-Level Options: Blood/Body Fluid Exposure with or without Exposure Management

A facility may choose to report exposure events alone or exposure events and subsequent management and follow-up of each event, including administration of postexposure prophylaxis to the HCW and any laboratory test results collected as part of exposure management.

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Corresponding Materials

Protocol and Instructions

• Healthcare Personnel Safety Component Protocol [PDF - 351 KB]
  Guidelines and procedures monitored in the Healthcare Personnel Safety Component includes instructions for completing data collection forms.
  August 2009.
• Importing Healthcare Worker Data [PDF - 102KB]
  August 2009.

Training

• Overview of Healthcare Personnel Safety Component [PDF - 716KB]
  September 2009.
• Setting up a Facility [PDF - 1.00MB]
  September 2009.
• Blood and Body Fluids Exposure Module [PDF - 1.12MB]
  September 2009.

Forms

• 57.205 Exposure to Blood / Body Fluids [PDF - 200 KB]
• 57.206 Healthcare Worker Prophylaxis/Treatment - BBF Postexposure Prophylaxis [PDF - 77 KB]
• 57.207 Follow-up Laboratory Testing [PDF - 73 KB]