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Prevention of occupational exposures to blood-borne pathogens among HCW in Brazil: Using surveillance data to guide the use of safety-engineered devices.
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Prevention of occupational exposures to blood-borne pathogens among HCW in Brazil: Using surveillance data to guide the use of safety-engineered devices C. Rapparini1, V. Saraceni1,2, G.C. Fernandes1,3, A.A. Machado1,4, PSBio Network - Surveillance System ofOccupationalExposurestoBlood-borne PathogensamongHCWs/Brazil 1 Projeto Riscobiologico.org / UFRJ, Rio de Janeiro, Brazil 2 SMSDC-RJ, Rio de Janeiro, Brazil 3 Santa Casa de Misericórdia, Juiz de Fora, Brazil 4 Faculdade de Medicina de Ribeirão Preto USP, Ribeirão Preto, Brazil
Riscobiologico.org Mailing list Website Surveillance System DISCLOSURE Unrestricted Educational Grants The Project has received Unrestricted Educational Grants from different companies over the last years, such as BD and BBraunas well as small funds to participated in different meetings and to present lectures in meetings organized by several different companies. The network of healthcare workers and facilities, founders and collaborators represents a voluntary network.
BACKGROUND - HCW frequently face the risk of occupational infection with blood-borne pathogens. • Most exposures among HCW are caused by percutaneous injuries with sharp objects contaminated with blood or body fluids. • - The Hierarchies of Control is a most critical underlying concept in preventing occupational injuries and ilnesses. - New regulatory policies in Brazil require that employers must promote sharps substitution for safety devices.
Safetydevices HINGED ARM / SNAP DOWN RETRACTING NEEDLE RETRACTING http://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html#bluntingneedles
METHODS - Projeto Riscobiologico.org is a non-profit university-based research group for the prevention of occupational infections among HCWs, founded in August of 2000 in Brazil. - Voluntary network with standardized methods for recording occupational exposures to blood-borne pathogens. - 22 collaborating centers in Brazil - 20 hospitals x 2 non-hospitals - 16 private x 6 public - 2 university x 20 non-university
RESULTS N=6,688 exposures to bloodorbloodyfluidsreported, N=5,487 Percutaneous injuries (82.0%) HCWcategories: -nurses/aides/students (52.6%) -physicians/residents/students (17.8%) -housekeepers (7.2%). Circumstances associated with percutaneous injuries: -finger/heelstick (13.4%) – (84.0% with hypodermic needles) -peripheral venous access/IV line (12.5%) -surgeries including suture (11.9%) -SQ/ID injections (9.0%) -phlebotomy (6.8%)
RESULTS - Percutaneous exposures occurred: • 18.1% needle/sharp in the trash, in linen, left on tray, on floor • 15.4% IV access • 14.4% disposal • 9.4% recapping needles • - Hollow-bore needles were responsible for 72.5% of all sharps injuries. • - Seven devices are responsible for nearly 80% of all injuries: • 52.0% hypodermic needles/disposable syringes • 17.6% IV devices - winged steel needles (5.8%),IV catheter stylets (5.4%), scalpe (4.8%), phlebotomy needles (1.6%). • 8.2% suture needles • 1.8% lancets
CONCLUSION Highnumberof cases associatedwitheasilypreventableexposures. Althoughsafetydevices are available/mandatory in Brazil, their use is still notwidespread. Besidestheneed for safetydevices to preventexposures more prone to cause blood-bornevirustransmission (e.g. IV devices) It seemsreasonable to include safetylancets for fingerstickbloodglucosemeasurements as a priorityconsidering its highfrequencyandnotnegligiblerisk.