ATTITUDES, PRACTICES, AND INFECTION RISKS OF HEMOPHILIA TREATMENT CENTER NURSES WHO TEACH INFECTION-CONTROL FOR THE HOME

OBJECTIVE: To examine the practices toward infection control training and to assess the attitudes about, and risks for, exposures to blood a mong hemophilia treatment center (HTC) nurses who teach home infusion therapy (HIT). DESIGN AND POPULATION: Written and telephone interview surveys of the 153 nurses who teach HIT at federally funded HTCs. MAIN OUTCOME MEASURES: Hemophilia treatment center nurses' teaching practi ces and infection control messages taught, and frequency of exposures to blood. RESULTS: The response rate to the written nurses survey was 60% and to the telephone interview 88%. Nurses taught patients a media n of three HIT sessions totaling 4 hours of instruction. Reevaluation of patients' HIT practices took place every 6 months by 22% and every 12 months by 59% of nurses. Nurses frequently reported teaching proper use of a sharps disposal container (99%) and gloves (93%), but less o ften reported teaching patients to wash hands after infusions (26%) an d to report needlestick injuries to HTCs (11%). me respondents identif ied several barriers to effective infection control as it is practiced in the home by patients. Although at least 30% of HTC nurses recalled having had percutaneous exposure to blood, they considered their risk for hepatitis B infection low but greater than for infection with the human immunodeficiency virus (HIV). CONCLUSIONS: While some important infection control messages are stressed during HIT teaching, others m ay be underemphasized. Failure to instruct patients about all infectio n control precautions may be related to nurse educators' perception of low to moderate personal risk for hepatitis B and HIV infection. Pati ents receiving HIT, and those who assist them, need to be fully aware of, and to have reinforced periodically, universal infection control s trategies in the home.