Biomedical subjects

C Karkashian

Publications and source records attributed to C Karkashian.

5 recordsLinked to original sources

PubMed2001

Infection control practices among correctional healthcare workers: effect of management attitudes and availabiity of protective equipment and engineering controls.

OBJECTIVES: To determine the relation of the availability of personal protective equipment (PPE) and engineering controls to infection control (IC) practices in a prison healthcare setting, and to explore the effect on IC practices of a perceived organizational commitment to safety. DESIGN: Cross-sectional survey. SETTING: The study population was drawn from the 28 regional Correctional Health Care Workers Facilities in Maryland. PARTICIPANTS: All full-time Maryland correctional healthcare workers (HCWs) were surveyed, and 225 (64%) of the 350 responded. METHOD: A confidential, self-administered questionnaire was mailed to all correctional HCWs employed in the 28 Maryland Correctional Health Care Facilities. The questionnaire was analyzed psychometrically and validated through extensive pilot testing. It included items on three major constructs: IC practices, safety climate (defined as the perception of organizational commitment to safety), and availability of IC equipment and supplies. RESULTS: A strong correlation was found between the availability of PPE and IC practices. Similarly, a strong correlation was found between IC practices and the presence of engineering controls. In addition, an equally strong association was seen between the adoption of IC practices and employee perception of management commitment to safety. Those employees who perceived a high level of management support for safety were more than twice as likely to adhere to recommended IC practices. IC practices were significantly more likely to be followed if PPE was always readily available. Similarly, IC practices were more likely to be followed if engineering controls were provided. CONCLUSION: These findings suggest that ready availability of PPE and the presence of engineering controls are crucial to help ensure their use in this high-risk environment. This is especially important because correctional HCWs are potentially at risk of exposure to bloodborne pathogens such as human immunodeficiency virus and hepatitis B and C viruses. Commitment to safety was found to be highly associated with the adoption of safe work practices. There is an inherent conflict of "custody versus care" in this setting; hence, it is especially important that we understand and appreciate the relation between safety climate and IC practices. Interventions designed to improve safety climate, as well as availability of necessary IC supplies and equipment, will most likely prove effective in improving employee compliance with IC practices in this healthcare setting.

Adult↗

PubMed2000

Health care workers' experience with postexposure management of bloodborne pathogen exposures: a pilot study.

PURPOSE: This descriptive study of health care workers enrolled in a postexposure bloodborne pathogen management program had 3 goals: (1) to characterize their exposure incidents, (2) to assess health care workers' experience with the program, and (3) to identify strategies to improve the management of exposure incidents. METHODS: A confidential, self-administered, 5-page survey was mailed to 150 hospital employees who were recently evaluated in the employee health clinic for a blood/body fluid exposure. RESULTS: Sixty-five usable surveys were returned to the study office, representing a 43% response rate. Although the majority of the employees enrolled in the postexposure management program were generally satisfied with the overall quality of care they received, many respondents perceived a lack of social support during the lengthy follow-up period. Long-term distress related to the exposure was not uncommon. The respondents' suggestions for improvement focused on the need for department managers to become more personally involved when their staff members have an exposure incident. CONCLUSION: These qualitative data suggest that additional studies are needed to assess both the short-term and long-term impact of exposure incidents on the health and well being of affected health care workers. In addition, because of a paucity of information in this area, studies are needed to assess both the effectiveness of the United States Public Health Service recommendations for postexposure management and the degree to which they have been implemented by health care facilities.

Adult↗

PubMed1998

Correlates of infection control practices in dentistry.

BACKGROUND: Studies conducted in the first decade of the AIDS epidemic indicated that, in general, dentists had suboptimal levels of compliance with standard infection control practices, including work practices designed to reduce exposure to bloodborne pathogens. This study was designed to assess current rates of compliance with these practices in a population of Maryland dentists and to identify correlates of safe work practices. METHODS: We surveyed 648 Maryland dentists using a confidential, self-administered questionnaire. RESULTS: Three hundred and ninety-two questionnaires were returned (60% response rate). We found that infection control practices were variable as reported by responding dentists. In addition, several potentially modifiable factors were found to be significantly correlated with these practices, including (1) attitudes toward patients infected with HIV and (2) safety program management within the practice. CONCLUSION: These data are encouraging in that recommended infection control practices are being adopted, at least among a sample of Maryland dentists. Strategies for further improvement are identified.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Tuberculosis risk in funeral home employees.

In order to estimate the risk of tuberculosis infection among employees in the funeral service industry, we conducted a risk-assessment study of a convenience sample of funeral home employees. Study participants completed a risk-assessment questionnaire and underwent tuberculin skin testing. Of 864 employees tested, 101 (11.7%) had a reactive tuberculin skin test. Reactivity to the tuberculin skin test was significantly associated with job category; funeral home employees with a present or past history of embalming deceased-human remains were twice as likely to be reactive as were non-embalming personnel (14.9% versus 7.2%, P < 0.01). Reactivity was also associated with age, gender, race, past history of close contact with a person diagnosed with tuberculosis, and work history. After controlling for age and other factors, tuberculin reactivity was found to be associated in embalming personnel with the number of years spent performing embalmings (> or = 20), and, in non-embalming personnel, with a history of close contact with infected individuals. Based on these results, it is recommended that funeral home employees who routinely embalm cadavers undergo annual tuberculin skin testing, receive initial training on tuberculosis prevention, and wear respiratory protection when preparing known tuberculosis cases.

Adult↗

PubMedDate not supplied

Universal precautions: an update.

Universal precautions, the set of work practice recommendations designed to help minimize occupational exposure to bloodborne pathogens, have been shown to be effective. However, lack of compliance with these recommendations has been well documented, both before and after the enactment of the OSHA Bloodborne Pathogens Standard. Current issues, including occupationally acquired human immunodeficiency virus, percutaneous exposures and lack of compliance are discussed in this article.

Blood-Borne Pathogens↗