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The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector.

Authors
Gershon-RR; Pearson-JM; Sherman-MF; Samar-SM; Canton-AN; Stone-PW
Source
Am J Infect Control 2009 Sep; 37(7):525-533
NIOSHTIC No.
20036045
Abstract
Background: Patients continue to enter home health care (HHC) ''sicker and quicker,'' often with complex health problems that require extensive intervention. This higher level of acuity may increase the risk of percutaneous injury (PI), yet information on the risk and risk factors for PI and other types of exposures in this setting is exceptionally sparse. To address this gap, a large cross-sectional study of self-reported exposures in HHC registered nurses (RNs) was conducted. Methods: A convenience sample of HHC RNs (N5738) completed a survey addressing 5 major constructs: (1) worker-centered characteristics, (2) patient-related characteristics, (3) household characteristics, (4) organizational factors, and (5) prevalence of PIs and other blood and body fluid exposures. Analyses were directed at determining significant risk factors for exposure. Results: Fourteen percent of RNs reported one or more PIs in the past 3 years (7.6 per 100 person-years). Nearly half (45.8%) of all PIs were not formally reported. PIs were significantly correlated with a number of factors, including lack of compliance with Standard Precautions (odds ratio [OR], 1.72; P5.019; 95% confidence interval [CI]: 1.09-2.71); recapping of needles (OR, 1.78; P5.016; 95% CI: 1.11-2.86); exposure to household stressors (OR, 1.99; P5.005; 95% CI: 1.22-3.25); exposure to violence (OR, 3.47; P5.001; 95% CI: 1.67-7.20); mandatory overtime (OR, 2.44; P5.006; 95% CI: 1.27-4.67); and safety climate (OR, 1.88; P5.004; 95% CI: 1.21-2.91) among others. Conclusion: The prevalence of PI was substantial. Underreporting rates and risk factors for exposure were similar to those identified in other RN work populations, although factors uniquely associated with home care were also identified. Risk mitigation strategies tailored to home care are needed to reduce risk of exposure in this setting.
Keywords
Exposure-methods; Health-care-personnel; Health-hazards; Health-services; Health-surveys; Injury-prevention; Medical-care; Medical-personnel; Medical-services; Nurses; Nursing; Occupational-exposure; Occupational-hazards; Occupational-health Occupational-health-nursing; Occupational-health-services; Physical-reactions; Physical-stress; Risk-analysis; Risk-factors; Statistical-analysis; Work-environment; Worker-health; Work-performance; Author Keywords: Home health care; percutaneous injuries; registered nurses
Contact
Robyn R. M. Gershon, MT, MHS, DrPH, Mailman School of Public Health, Columbia University, 722 West 168th Street, Suite 1003, New York, NY 10032
CODEN
AJICDC
Publication Date
20090901
Document Type
Journal Article
Email Address
rg405@columbia.edu
Funding Type
Grant
Fiscal Year
2009
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008215
Issue of Publication
7
ISSN
0196-6553
Source Name
American Journal of Infection Control
State
NY
Performing Organization
Columbia University, Health Sciences
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