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At least 1,009 records · Page 56Linked to original sources
PubMed1998

An assessment of cross-infection control procedures among English-speaking Caribbean general dental practitioners. A regional preliminary study.

A survey was undertaken to assess the level of compliance with recommended infection control procedures among English-speaking Caribbean general dental practitioners. A four page questionnaire was sent to all practitioners in 18 English-speaking Caribbean islands. A response rate of 32 per cent was obtained. A large proportion of dentists followed the recommended barrier techniques particularly the use of gloves and facemasks. The most commonly available methods of sterilisation were steam autoclaves (82 per cent) and cold solutions (94 per cent). Seventy four per cent of respondents had received hepatitis B vaccination. A high percentage of dentists showed willingness to treat HBV (95 per cent) and HIV (84 per cent) carriers and this level of willingness to treat infectious patients has rarely been reported previously. There is an urgent need for further improvements to avoid getting inoculation injuries and splatters in the face or eyes with body fluids. Disposal of sharps and collection of solid waste are to be upgraded. The Caribbean Atlantic Regional Dental Association is planning to carry out similar research before the end of the year 2000.

Cross Infection↗
PubMed1993

Needle-stick injuries and blood contacts during invasive radiologic procedures: frequency and risk factors.

OBJECTIVE: Possible nosocomial transmission of blood-borne pathogens is a serious concern for health care workers and patients alike. Needle-stick injuries and blood contacts pose a risk of pathogen transmission during procedures. We performed a study to determine the frequency of injuries and blood contacts during invasive radiologic procedures and to examine procedure-related factors that may increase risk of injury or exposure. SUBJECTS AND METHODS: A prospective study of needle-stick injuries and blood contacts during invasive radiologic procedures was performed. During a 10-week period, information about procedures was recorded by technologists or physicians, and needle-stick injuries and exposures to patients' blood and body fluids were noted. Data were analyzed with the SAS statistical package. RESULTS: Accidental exposure to patients' blood and body fluids occurred in 15 of 501 cases (3.0%; 95% confidence interval, 1.7-4.9%). Of 729 operators at risk, 15 were exposed (2.0%; 95% confidence interval 1.1-3.3%). Exposure was parenteral in one case and cutaneous in 14. Risk of exposure was correlated with procedure duration (p = .003), but not with emergency vs elective procedure status (p = .796), procedure type (p = .275), or operator experience level (p = .554). Three needle-stick injuries (0.6% of cases) occurred, all with sterile instruments; bleeding occurred in two cases. Risk of injury was correlated only with procedure type (p = .046). In no case was a patient exposed to a physician's blood. CONCLUSION: Whereas cutaneous exposure of physicians to patients' blood was not infrequent, parenteral exposure was rare in this series. Most of the exposures in this study could have been prevented by the use of protective equipment. Patients' contact with physicians' blood did not occur in this study.

Blood↗
PubMed1999

Practice behaviors of RNs related to hazardous risks within the clinical setting.

A practice behavior survey was distributed to 250 RNs in the Metropolitan Detroit area. Seventy percent of the RNs responded to questions focused on needle-stick and splash injuries, handwashing, gloving, and other available measures that prevent injuries and infection. Respondents reported a larger than expected number of sticks (34.5%) and splashes (40.8%), but most of these instances were handled to the nurses' satisfaction. The nurses reported that while occupationally acquired hepatitis B/C, along with AIDS, are serious concerns, a large majority (75%) had not heard of the Campaign For Health Care Safety. The results of this survey have implications for research, practice, management, and public policy. This exploratory pilot survey raises numerous professional issues.

Data Collection↗
PubMed2005

Safe injection practice among health care workers, Gharbiya, Egypt.

A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

Child↗
PubMed2000

Detection of surgical glove integrity.

Surgical glove integrity is essential for universal precautions; glove safety is verified by the water load test (WLT). Concerns regarding glove injury have prompted newer testing methodologies, including electrical conductance testing (ECT); however, the sensitivities of these tests are not known. We compared the sensitivity of WLT and ECT in detecting glove needle-stick injury in two commonly used brands of surgical gloves. Punctures were made with hollow-bore and solid surgical needles of various configurations. The WLT failed to detect glove holes from the smallest-caliber needles and only detected the injury in 60 per cent for the largest caliber. The ECT provided a graded index of glove injury in all holes made by both solid surgical needles and hollow-bore needles. The WLT is a poor test for clinical defects in latex surgical gloves; the ECT is significantly more sensitive and provides a gauge of the cross-sectional area of the defect. Interbrand differences in self-sealing properties of surgical gloves were evidenced and may be clinically relevant after glove perforation.

Electric Conductivity↗
PubMed1997

HCV activity in Calcutta--a serological study.

HCV infection, a global public health problem is quite prevalent in India. In the present study conducted during February-July 1996 a total of 153 samples of different age groups and of both sexes were tested by ELISA for detection of Anti-HCV antibody. Anti-HCV was found in 13% of multi-transfused cases and in 8.8% cases with multiple needle-stick injury. Maximum seropositivity (20%) could be observed amongst males between 31-40 yrs. age group. HCV activity was noted more in males (13%) than in females (8.2%) and more relatively in subjects without a history of jaundice (11.5%) than those having the features of jaundice (10.5%). An increasing trend has also been observed amongst the multi-transfused cases in Calcutta.

Adolescent↗
PubMed2001

[Nosocomial infection with hepatitis C virus(HCV)].

Nosocomial infection with HCV occurs in three ways. 1) Infection from medical personnel to patients is extremely rare, and only one report exists. Medical personnel should be aware of HCV infection status, but HCV-infected medical personnel need not be banned from medical activity. 2) The possibility of infection from patient to medical personnel is always present. The creation of a medical environment in which the possibility of injury from instruments contaminated by blood is eliminated is the most important measure. The probability of infection is estimated to be around 1%, and there are no methods of prevention. Interferon therapy is administered when acute hepatitis C infection develops. 3) Patient to patient infection is thought to have occurred frequently in the past as a result of re-use of syringes for intravenous injections. The most important measure against this occurrence is the strict disposal of disposable syringes.

Cross Infection↗
PubMedDate not supplied

Prevalence of safer needle devices and factors associated with their adoption: results of a national hospital survey.

OBJECTIVES: In this study, we collected and analyzed the first data available on the extent of the adoption of safer needle devices (engineered sharps injury protections [ESIPs]) by U.S. hospitals and on the degree to which selected factors influence the use of this technology. METHODS: We gathered data via a telephone survey of a random sample of 494 U.S. hospitals from November 1999 through February 2000. RESULTS: Although 83% of the sample reported some ESIP adoption, adoption was inconsistent across types of devices. All of the appropriate units in 52% of the facilities had adopted needleless intravenous delivery systems, but the hospitals used other types of ESIPs less often. A respondent's perception that the cost of ESIPs would not be a problem for the hospital was the best predictor of adoption of ESIPs in the facility, explaining 8% of the variance. Other predictors of adoption included the size of the hospital and the presence or absence of state legislative activity on the needlestick issue. CONCLUSIONS: Smaller hospitals may require special encouragement and assistance from outside sources to adopt expensive risk-reduction innovations such as ESIPs. Although use of ESIPs is the mandated and preferred way to protect workers from needlesticks, complete adoption of this technology will depend on the support of the social systems in which it is used and the people who use it.

Attitude of Health Personnel↗
PubMed1999

Accidental exposures to blood and other body fluids in a large academic medical center.

Healthcare workers' and students' exposures to blood-borne pathogens during a 1-year period (1997) at a large university academic medical center were analyzed. The university health manages the Blood-Borne Pathogen Post-Exposure Control Program at the university and treats all reported exposures of students, faculty, and staff. Comparative exposure rates for all categories of healthcare workers, the work site where injuries occurred, and the circumstances involved in 298 exposure incidents are outlined. A standardized postexposure prophylaxis protocol provides for definition of the health status of all known source patients and assessment of the potential need for treatment of the exposed clinician. Implications of the study for focusing on improvements in training healthcare workers in proper procedures and the use of personal protective equipment in dealing with blood-borne pathogens are discussed.

Blood-Borne Pathogens↗
PubMed2004

Surgeon, test (and heal) thyself: sharps injuries and hepatitis C risk.

Sharps injuries experienced by surgeons are common, but are under-recognised and under-reported. The overall risks of transmission of blood-borne viruses to surgeons are low, with hepatitis C posing the greatest transmission risk. Recent trials show that early treatment of acute hepatitis C results in a cure rate approaching 100%. Surgeons and theatre staff should be encouraged to report and follow up sharps injuries to allow early detection and treatment. Additionally, because exposures to blood-borne viruses may be unrecognised, surgeons should have regular tests for blood-borne viruses. There should be no restriction of practice in the "window period" between potential exposure and obtaining results of testing, because of the overall low risk of transmission.

Accidents, Occupational↗
PubMed1996

[The risk of needle-stick-injuries during abdominal closure].

A randomized study is being presented, which compares closure of laparotomy with 2 different needles (sharp: HR48, blunt: HR48PP = protect point). Handling and glove perforation rate is to be compared. 400 gloves in 100 laparotomies have been tested. Slightly more effort was reported from the surgeon to perforate the fascia with the blunt needle, but there was also a significantly lower perforation rate in the glove of his non-dominant hand. To avoid a contamination during operation the use of blunt needles has to be recommended.

Abdomen↗
PubMed1995

Direct needle insufflation for pneumoretroperitoneum: anatomic confirmation and clinical experience.

OBJECTIVES: The feasibility and safety of direct needle insufflation to create pneumoretroperitoneum was assessed by an imaging study and clinical experience. METHODS: A total of 10 patients without previous retroperitoneal surgery or diseases received computed tomography scans of the retroperitoneum 2 cm above the iliac crest. Distances between quadratus lumborum and colon (Q-C distance) were measured in the supine and lateral positions. Changes of Q-C distance were calculated when the patient was changed from the supine to the lateral position. Operative charts on 38 retroperitoneoscopic procedures were collected prospectively to assess complications related to direct needle insufflation, which was performed by inserting a 14 G Veress needle blindly along the posterior axillary line 2 cm above the iliac crest. RESULTS: Q-C distance increased from 8.7 to 27.3 mm (left side) and 4.6 to 18.1 mm (right side) when the patient was changed from the supine to the lateral position, both P values < 0.05. An average distance of 23 mm between colon and quadratus lumborum was found when patients were lying laterally. The misplacement of a Veress needle was encountered in 1 patient, in which a prefascia insufflation resulted in conversion of the endoscopic procedure. Needle puncture caused no visceral or great vessel injury. CONCLUSIONS: Significant anterior movement of the colon was found when patients were changed from the supine to the lateral position. It provided a window for inserting the Veress needle blindly into the retroperitoneum. The high success rate (97%) and low complication rate of direct needle insufflation were found in actual clinical applications. We considered needle insufflation a safe and effective method of establishing a pneumoretroperitoneum for any retroperitoneoscopic procedure.

Adult↗
PubMed1999

Double gloving and a glove perforation indication system during the dental treatment of HIV-positive patients: are they necessary?

AIM: The aim of this study was to compare the incidence of glove perforation when double gloved or single gloved during the routine treatment of HIV-positive patients. In addition, a glove perforation indication system based on a double gloving technique was assessed. DESIGN: Prospective, randomised and open study of glove perforation. METHODS: 138 consecutive HIV-positive patients underwent routine dental treatment by senior dental staff and dental hygienists in a teaching hospital. Staff wore either single gloves (Regent Biogel D or standard surgical gloves) or double gloves (Regent 'Reveal' perforation indication system or standard surgical gloves). A subjective assessment of glove comfort, sensitivity and ease of donning was made using a visual analogue scale. RESULTS: The incidence of glove perforation/procedure was low, 2.9%. There were no skin penetrating injuries, visible exposure to body fluids or unnoticed perforations. Double gloving was subjectively less comfortable and sensitive than single gloving (P < 0.0001). The glove perforation indication system did not increase the detection of intra-operative perforations. CONCLUSIONS: There is unlikely to be any significant benefit from the use of a double gloving technique or perforation indication system during the routine dental treatment of HIV-positive patients.

Dental Care for Chronically Ill↗
PubMed2006

Multiple needle-stick injuries with risk of human immunodeficiency virus exposure in a primary school.

Twenty children received needle-stick injuries with a risk of exposure to human immunodeficiency virus type 1 during an incident in a primary school playground. All were counseled and offered human immunodeficiency virus postexposure prophylaxis. All 20 children started postexposure prophylaxis, and 19 attended for follow-up testing 3 months later. More than one-half of the children completed the full 4-week course of treatment. None of the 19 children tested seroconverted after the incident.

Adult↗
PubMed1991

Infection control in dentistry.

The risk of transmission of infection within the dental workplace is low, but recent data have indicated that human immunodeficiency virus transmission between dentist and patient can occur, and that while nosocomial transmission of hepatitis B virus is now less likely, a small but significant number of staff may be at risk of hepatitis C virus and varicella zoster virus infection during dental treatment. Despite these continued risks, shortcomings remain in cross-infection control in the dental workplace. Dental clinicians still fail to take adequate steps to minimize nosocomial infection, inconsistently using appropriate methods of sterilization and not providing ancillary staff with suitable protective clothing. Similarly, although vaccinated against hepatitis B virus, a substantial number of clinicians are reluctant to treat hepatitis B virus- or human immunodeficiency virus-infected patients. Cross-infection control procedures continue to be modified. Of importance, it has been confirmed that protective rubber gloves cannot be reused, as micropunctures develop during rewashing. Sharps injuries are common in dental practice, but there are still no effective measures to prevent postinjury human immunodeficiency virus or hepatitis C virus infection. Instrument sterilization is generally safe and effective, but the contamination of dental unit water supplies remains to be overcome, and while impressions can be placed in disinfectants for up to 1 hour without significant dimensional change, it is not known if infectious agents within the impression material are inactivated by this procedure.

Attitude of Health Personnel↗
PubMed2003

Occupational exposures occurring among dental assistants in a UK dental school.

PURPOSE: The cross-infection risks for dentists have been well recognised, and much has been published regarding the incidence of occupational exposures to patient body fluids. Less has been reported regarding the risks to dental assistants. The purpose of this study was to evaluate the incidence of occupational exposures to patient body fluids among dental assistants, to assess the rate of reporting of such incidents, and to evaluate the association of various factors with these exposures. METHOD: All 84 dental assistants working at Birmingham Dental Hospital were asked to complete a confidential questionnaire to provide retrospective information regarding the nature and incidence of any occupational exposures they had experienced. RESULTS: An overall response rate of 94% was achieved. Dental nurses experienced fewer occupational exposures than dental students at the same institution, and reported incidents more frequently. More injuries occurred after the treatment session. Handling local anaesthetic syringes was associated with more injuries, and percutaneous injuries predominated. Trainee nurses had experienced more occupational injuries in the preceding six months than their qualified colleagues. There was no significant association with any of the other factors evaluated. CONCLUSIONS: The general incidence of occupational exposures among the dental assistants in this survey was low in comparison to dental students at the same institution. A further reduction may be possible by increasing the training of unqualified nurses with particular regard to post-treatment handling of sharp dental instruments and equipment.

Accidents, Occupational↗
PubMed2002

[Needle stick injuries in health care - frequency, causes und preventive strategies].

Healthcare workers (HCW) are at risk for infections with blood-borne pathogens - especially hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) - resulting from occupational blood-exposure trough injuries with sharp instruments and needle sticks. Results of a study on the epidemiology of needle stick injuries (NSI) among HCW in two German hospitals indicate that 500,000 NSI occur annually in Germany. Most of these injuries occur during disposal of used syringes and "recapping". Administration of the post-exposure prophylaxis is recommended for HCW who are occupationally exposed to HBV (vaccine/immunoglobulin) and HIV (antiretroviral drugs) i.e. the immediately reporting of blood exposure is very important. Comprehensive programmes to prevent NSI - e.g. avoiding of recapping, use of disposal containers, surgical gloves and in particular safety devices - minimize a high cost of NSI due to the administration of PEP, developing of chronic hepatitis, cirrhosis and liver cancer.

Blood-Borne Pathogens↗
PubMed1996

Laboratory animal allergy: anaphylaxis from a needle injury.

A 32 year old male research physician accidentally received a minor wound from a needle which had been previously used on rabbit tissue. Within 15 minutes serious anaphylactic reactions started and he was taken to hospital where his condition stabilised within five hours. Serum immunoglobulin E antibodies to rabbit epithelium were high (16.2 U/ml), although other antibody titres were low. Allergy tests were not carried out before employment, so this alarming scenario could not have been predicted. People with confirmed laboratory animal allergy should be warned of the dangers of continued unprotected exposure and avoidance of the allergen should be encouraged by good laboratory practice and respiratory protective equipment.

Adult↗