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577 Incidence of occupation exposure of health care workers in a resource limited setting

Saturday, March 20, 2010
Grand Hall (Hyatt Regency Atlanta)
Sanjeev Singh, MBBS, DCH, MPhi , Amrita Institute of Medical Sciences, Kochi, India
S Fini , Amrita Institute of Medical Sciences, Kochi, India
R Aneena , Amrita Institute of Medical Sciences, Kochi, India
K Anita , Amrita Institute of Medical Sciences, Kochi, India
Background:

The incidence of sharp injury (SI) from India is limited. Health care worker safety is of paramount importance.

Objective: To describe the incidence of needle stick injury (NSI) & blood and body fluid exposure (BBE) in a resource limited setting.

Methods:

Epinet software to analyze the data from Jan 2006 to Dec 2008 (from University of Virginia).   The statistical analysis was carried out using SPSS software.

 

Results:

A total of 268 NSI and 18 blood and BBEs were reported during the study period.

Majority of SI occurred to nursing (n= 183, 68%), technicians & students (n=36; 13%), housekeeping (n=30, 11 %), doctors (n=12; 5%) and others (n=7, 3%). These injuries most commonly in in-patient room (n=112, 42%), ICUs (n=54, 20%), Operative Room (n=47,18%), out-patient (n=21, 8%), ER (n=11, 4%) and others (n=21, 8%). Majority of SI occurred during the IV insertion (n=96, 35%), recapping (n=41, 15%) during disposal after use (n=25, 9%), during surgery (n=17, 6%), waste collection (n=17, 6%) and others (n=59, 22%). In (n=200, 74%) of the events the source was identifiable, of which HBV (n=41, 15%), HCV (n=21, 8%), HIV (n=5, 2%) and in 35% cases, source was unidentifiable. Immunization for hepatitis B among HCW was 80%. One HCW had acquired HCV and was successfully treated with Interferon and ribovarin. Needles on disposable syringes were the commonest device causing injury followed by IV catheter stylet (9.05%) and suture needle (5.76%). 62% of the total SI were contaminated and 11% were uncontaminated. The presence of safety design was  analyzed and 77% of the injuries occurred due to unprotected instruments.

The other locations where HCWs commonly got exposed to BBF were operating room or recovery room (15.23%), outside patient room (10.3%) and intensive care units (10.3%).

Conclusions:

Intervention to reduce the SI among HCW is being planned viz. puncture proof containers at the bed side, use of safety devices during IV insertion and phlebotomy. Training for proper waste segregation, collection and disposal among all HCW is also essential.