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Results for “Needlestick Injuries”

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PubMed1997

Early therapy with interferon for acute hepatitis C acquired through a needlestick.

Because there is no effective neutralizing antibody or vaccine for preventing hepatitis C virus (HCV) transmission, HCV can be transmitted to health care workers through accidental needlesticks. Recently, two of our health care workers acquired HCV infection through needlestick accidents and developed acute hepatitis C. The route of transmission was confirmed by molecular evolutionary analysis with use of the E2 region of the HCV genome. After the clinical onset of acute hepatitis, the health care workers were treated with interferon (IFN) (total dose, approximately 300 megaunits). Neither individual developed chronic hepatitis. This finding raises the possibility that treatment with low-dose IFN following an accidental needlestick may be beneficial, even when it is started after the clinical onset of hepatitis.

Acute Disease↗
PubMed1994

Conflicts over post-exposure testing for human immunodeficiency virus: can negotiated settlements help?

Health care workers with needlestick exposures to patients' blood often request a test of the patient for evidence of infection with human immunodeficiency virus. If the patient refuses the test, a conflict develops between the interests of the health care worker and those of the patient. Traditional approaches to this dilemma attempt to balance the rights or utilities of abstract patients and health care workers. While these approaches have the advantage of offering clear guidelines in advance of conflict, the interests of the actual participants may differ from those used to create the guidelines. In nonmedical settings, conflicts are often resolved efficiently through negotiation and monetary exchanges. Although negotiated monetary settlements between health care workers and patients may be an impractical way to resolve medical conflicts, models developed from these perspectives provide insights into the individual interests of physicians and patients. Changing existing rules about medical record documentation, or increasing the penalties for the misuse of medical information, may satisfy the interests on both sides of the conflict and so represent integrative bargaining solutions. Even so, as the relationship between health care workers and their patients evolves, more explicit strategies for negotiation may become a reasonable solution to the problem of conflict.

AIDS Serodiagnosis↗
PubMed1997

HIV infection, risk taking, and the duty to treat.

The paper advances a consequence-based argument in support of the American Medical Association's policy that a physician may not ethically refuse to treat a person with HIV solely because the patient is seropositive. A limited number of alternative arguments, both in support of and in opposition to this policy are also considered, but are found wanting. The paper then concludes with a discussion of some of the other obstacles to quality health care that persons with HIV must often confront.

Blood-Borne Pathogens↗
PubMed1996

New York City police officers incidence of transcutaneous exposures.

Urban based police officers may be at high risk for the transmission of infectious disease. This study was undertaken to assess the incidence of needlestick and human bites to police officers based in an urban environment. A retrospective analysis of self-reported transcutaneous exposures and demographic information of police officers in the New York City Police Department (NYCPD) for 1992-93 was performed. Urine toxicology results of arrested individuals for 1990-91 was also analyzed. The transcutaneous exposure rate of NYCPD was 38.7 per 10,000. No differences occurred between males and females although officers between 20-29 years old had the highest incidence. The highest exposure rate occurred between 4-10 years of service. Greater than 60% of arrested individuals tested positive for potentially injectable drugs. Urban based police officers continue to have transcutaneous exposure incidents during their career. Widespread vaccination and continued education on universal precautions should be considered for all officers.

Adult↗
PubMed2006

The impact of educational interventions on primary health care workers' knowledge of occupational exposure to blood or body fluids.

AIM: To assess the impact of educational interventions on primary health care workers' knowledge of management of occupational exposure to blood or body fluids. METHODS: Cluster-randomized trial of educational interventions in two National Health Service board areas in Scotland. Medical and dental practices were randomized to four groups; Group A, a control group of practices where staff received no intervention, Group B practices where staff received a flow chart regarding the management of blood and body fluid exposures, Group C received an e-mail alert containing the flow chart and Group D practices received an oral presentation of information in the flow chart. Staff knowledge was assessed on one occasion, following the educational intervention, using an anonymous postal questionnaire. RESULTS: Two hundred and fifteen medical and dental practices were approached and 114 practices participated (response rate 53%). A total of 1120 individual questionnaires were returned. Face to face training was the most effective intervention with four of five outcome measures showing better than expected knowledge. Seventy-seven percent of staff identified themselves as at risk of exposure to blood and body fluids. Twenty-one percent of staff believed they were not at risk of exposure to blood-borne viruses although potentially exposed and 16% of exposed staff had not been immunized against hepatitis B. Of the 856 'at risk' staff, 48% had not received training regarding blood-borne viruses. CONCLUSIONS: We found greater knowledge regarding management of exposures to blood and body fluids following face to face training than other educational interventions. There is a need for education of at risk primary health care workers.

Allied Health Personnel↗
PubMed1995

Infection control in general practice: results of a questionnaire survey.

BACKGROUND: Infection control is an important aspect of quality of care. General practitioners (GPs) have a high throughput of patients, some attending because of a communicable disease, others for investigations or minor operations. This situation provides an opportunity for the spread of infections. This study looked at the development of practice policies on infection control and the need for further information and guidelines. METHODS: A postal questionnaire was sent to 117 practices in a single Family Health Services Authority. The questionnaire contained sections to be completed by a GP and a practice nurse in each surgery. RESULTS: A response rate of 74.5 per cent was obtained. Of the practices replying, 85 per cent did not have a written infection control policy. Sterilization of instruments was carried out in over 90 per cent of surgeries. Autoclaves were used in almost four-fifths of these practices; most did not have any written procedures covering their use. Few practices provided information on procedures for infected patients or staff. A third of practices did not have a needlestick policy, and sharps incidents were not recorded in 42 per cent of surgeries. Three-quarters of practices said that they would welcome guidelines on infection control. Half of the practice nurses thought that more training on infection control was required. CONCLUSIONS: The need for more training and the implications of the information from the study on the development and implementation of guidelines are discussed. Recommendations are made which aim to increase the awareness of this issue by means of guidelines and training focused on practice nurses.

Disinfection↗
PubMedDate not supplied

Regulation of tattooing in Minneapolis and St. Paul, Minnesota: tattooists' attitudes and relationship between regulation and practice.

OBJECTIVE: This study investigated tattooists' attitudes regarding government regulation and the relationship between existing tattooing regulation and tattooists' knowledge and practice of infection control. METHODS: Self-reported and observational data were collected in a cross-sectional study of professional tattooists. A written survey was used to investigate knowledge and practice of infection control and attitudes toward government regulation. Infection control practice was also examined through direct observation of tattooing. Rating scales were used to compare tattoo artists subject to local tattooing ordinances with those in areas without ordinances. RESULTS: Sixty-one tattooists (45 regulated, 16 unregulated) completed surveys and 25 (17 regulated, 8 unregulated) were observed. Attitudes toward regulation were generally positive. Most participants supported health department inspections and training requirements. The presence of local tattooing ordinances was not associated with tattooists' knowledge (p=0.53), but was associated with self-reported practices (p=0.05). A more positive attitude toward regulation was associated with the use of more self-reported infection control procedures (p<0.01). CONCLUSION: Tattoo artists in areas with local tattooing ordinances may implement more bloodborne pathogen precautions than those in areas without ordinances, despite working from a similar knowledge base. Tattooists most in need of improvement may be difficult to reach due to opposition to government intrusion. Federal guidelines, clarification of OSHA rules applying to tattooists, and statewide regulation are needed. Tattooists should be involved in the development of regulations.

Attitude to Health↗
PubMed1992

The needlestick.

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Acquired Immunodeficiency Syndrome↗