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Occupational blood exposure among unlicensed home care workers and home care registered nurses: are they protected?

Authors
Lipscomb-J; Sokas-R; McPhaul-K; Scharf-B; Barker-P; Trinkoff-A; Storr-C
Source
Am J Ind Med 2009 Jul; 52(7):563-570
NIOSHTIC No.
20035992
Abstract
BACKGROUND: Little is known about the risk of blood exposure among personnel providing care to individual patients residing at home. The objective of this study was to document and compare blood exposure risks among unlicensed home care personal care assistants (PCAs) and home care registered nurses (RNs). METHODS: PCAs self-completed surveys regarding blood and body fluid (BBF) contact in group settings (n = 980), while RNs completed mailed surveys (n = 794). RESULTS: PCAs experience BBF contact in the course of providing care for home-based clients at a rate approximately 1/3 the rate experienced by RNs providing home care (8.1 and 26.7 per 100 full time equivalent (FTE), respectively), and the majority of PCA contact episodes did not involve direct sharps handling. However, for PCAs who performed work activities such as handling sharps and changing wound dressings, activities much more frequently performed by RNs, PCAs were at increased risk of injury when compared with RNs (OR = 7.4 vs. 1.4) and (OR = 6.3 vs. 2.5), respectively. CONCLUSION: Both PCAs and RNs reported exposures to sharps, blood, and body fluids in the home setting at rates that warrant additional training, prevention, and protection. PCAs appear to be at increased risk of injury when performing nursing-related activities for which they are inexperienced and/or lack training. Further efforts are needed to protect home care workers from blood exposure, namely by assuring coverage and enforcement of the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard [Occupational Safety and Health Administration. 1993. Frequently Asked Questions Concerning the Bloodborne Pathogens Standard.
Keywords
Bloodborne-pathogens; Health-care-facilities; Health-care-personnel; Health-hazards; Injuries; Injury-prevention; Medical-care; Medical-personnel; Medical-services; Needlestick-injuries; Nurses; Occupational-diseases; Occupational-exposure; Occupational-hazards; Occupational-health; Pathogenesis; Pathogenicity; Pathogens; Risk-analysis; Safety-education; Safety-measures; Safety-practices; Safety-research; Work-environment; Worker-health; Work-performance; Workplace-monitoring; Workplace-studies; Work-practices; Author Keywords: home care; blood and body fluid contact; needlesticks; occupational health and safety; prevention
Contact
J. Lipscomb, Work and Health Research Center, School of Nursing, University of Maryland, 655 West Lombard Street, Room 655c, Baltimore, MD 21210
CODEN
AJIMD8
Publication Date
20090701
Document Type
Journal Article
Email Address
lipscomb@son.umaryland.edu
Funding Type
Grant
Fiscal Year
2009
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008237
Issue of Publication
7
ISSN
0271-3586
Source Name
American Journal of Industrial Medicine
State
MD
Performing Organization
University of Maryland, Baltimore
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