In response to a request from hospital administration, an investigation was made of the effectiveness of procedures and personnel protective equipment used to minimize exposures to bloodborne disease among employees in a small hospital serving a local rural population. The written policy instructions at the hospital were consistent with Centers for Disease Control recommendations and the OSHA bloodborne pathogen standard. Several procedures appeared to present numerous occasions for injuries from sharp instruments which may be contaminated with body fluids. The location of sharps disposal containers presented a risk of injuries from sharps. Results of a questionnaire indicated that 90 employees experienced 170 exposures during 1990 through November 23 of 1991. The system in place at the hospital for monitoring percutaneous exposures probably underestimated the true incidence of such exposures. The most frequent exposure occurred during administration of a parenteral medication to a patient or while inserting an intravenous catheter in the patient. The second most commonly reported exposure scenario occurred during administration of medications by intravenous piggyback (IVPB) or during disposal of the IVPB sets. Several instances were noted of noncompliance with universal precautions.
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