Healthcare Infection Prevention

Diverse settings, specific aims

A three-year observational and survey study on bloodborne pathogen exposures and risk factors in nonhospital-based health care workers will include the following settings and research aims:

Settings

The study is designed to address important knowledge gaps by collecting data from a wide variety of nonhospital settings, including: mental disabilities facilities, nursing homes, drug treatment facilities, AIDS clinics, emergency medical services, hemodialysis clinics, police departments, correctional facilities, home health care, and hospice facilities. The groups chosen for the study were selected either because of published reports that they may be at high risk (e.g., emergency medical services); or anecdotal reports of potential risk (e.g., correctional officers); because recent data suggest that they may be at risk (police officers); or simply because there is a lack of information on the population (hospice employees).

Aims

The research aims of the study include:

1. To estimate the occurrence (using a common denominator such as person days) of occupational blood/body fluid exposure incidents over the previous 123 months in a cross-section of health care workers employed in hospital settings

2. To identify the independent and joint effects of risk factors and barriers associated with exposure incidents, including:

A. worker-centered factors (demographics, psychosocial factors, perception, and knowledge of risk, etc.);

B. job/task, job/control variables (work flow, work pace, etc.);

C. organizational variables (availability and adequacy of resources, including the prevalence of safety devices and other controls.

3. To collect data from a sample of hospitals-based nurses working in similar jobs (with similar tasks) as a cohort of nonhospital nurses to compare risk between the two settings.

4. To construct a novel "risk grid," that can readily identify nonhospital workers at risk and can categorize that risk in order to simplify and stratify the adoption of risk control measures.

5. To identify risk reduction opportunities that will facilitate compliance with Occupational Safety and Health Administration-required and Centers for Disease Control and Prevention-recommended practices using innovative participatory action research (PAR) teams.