HOSPITAL NURSES OCCUPATIONAL EXPOSURE TO BLOOD - PROSPECTIVE, RETROSPECTIVE, AND INSTITUTIONAL REPORTS

Objectives. This study examined nurses' risk of exposure to blood resu lting from injuries with needles and sharps, the methods of estimating those risks, and the factors affecting risks. Methods. Nurses on 40 m edical units in 20 hospitals in cities with a high incidence of AIDS w ere studied. Percutaneous injuries were documented for every shift dur ing a 30-day period. These prospective reports were compared with retr ospective and institutional reports. Factors affecting the likelihood of injuries were also explored. Results Based on the prospective repor ts, the rate of injuries to staff nurses was 0.8 per nurse-year. Prosp ective and retrospective rates were similar, while institutional rates were significantly lower. Factors associated with increased injuries included recapping needles and temporary work assignments. Working in hospitals characterized by professional nurse practice models and, tak ing precautions to avoid blood contact were associated with fewer inju ries. Conclusions. Injuries from needlesticks are more common than ins titutional reports suggest and do not occur at random. Diminishing the frequency with which nurses recap needles, increasing precautions the y take, reducing use of temporary nursing personnel, and implementing organizational changes may lower the odds of nurses being injured.