Occupational exposure to blood and body fluids and use of human immunodeficiency virus post-exposure prophylaxis amongst nurses in a Gauteng province hospital

Prevalence and influence factors of occupational exposure to blood and body fluids in registered Chinese nurses: a national cross-sectional study

Background

Occupational exposure to blood and body fluids poses a threat to medical providers and to nurses especially. This harm is not only physical, but psychology as well and can ultimately impact patient safety. This study aims to understand the prevalence of occupational exposure to blood and body fluids among Chinese registered nurses and explores the factors that influence this exposure.

Methods

A cross-sectional online survey was conducted for 31 province-level divisions in China, using a self-created questionnaire entitled Status Survey on Occupational Exposure in Nurses. Descriptive statistics were used to describe both the demographic characteristics of the respondents and the characteristics of occupational exposure. Categorical variables were presented as frequencies and percentage, and the relationship between possible influential factors and the occurrence of occupational exposure was determined using binary logistic regression.

Results

Out of a total of 20,791 nurses analyzed, over half (52.1%) of them had experienced occupational exposure to blood or body fluids, but over 1/3 (34.6%) of them did not ever report their exposures to a supervisor/official. The top three causes of under-reporting were: the source patient failed to test positive for infectious pathogens (43.6%), perception of a burdensome reporting process (24.6%), and indifferent attitude towards being infected (16.9%). Nurses who worked over 8 hours per day had higher risks of exposure (OR 1.199, 95% CI 1.130 to 1.272, P < 0.001, respectively). The occupational exposure risk from providing 1–2 types of PPE is 1.947 times that of providing 9–10 types of PPE (OR 1.947, 95% CI 1.740 to 2.178, P < 0.001). Likewise, the occupational exposure risk of providing 1–2 types of safety-engineered injection devices is 1.275 times of that of providing 5–6 types (OR 1.275, 95% CI 1.179 to 1.379, P < 0.001).

Conclusions

Occupational exposure to blood and body fluids in registered nurses is common, but the rate of under-reporting such exposure is high. Implementing engineered “sharp” injury prevention devices, following exposure prevention procedures, giving sufficient education and training to healthcare personnel on exposure prevention and control, and developing exposure reporting policies are all steps that can both reduce exposure and increase its reporting.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01090-y.

Global Occupational Exposure to Blood and Body Fluids among Healthcare Workers: Systematic Review and Meta-Analysis

Background

Occupational exposure to blood and body fluids has become a serious public health problem for healthcare workers and is a major risk for the transmission of various infections such as human immune-deficiency virus, hepatitis B virus, and hepatitis C virus. This systematic review and meta-analysis aims to determine the career time and previous one-year global pooled prevalence of occupational exposure to blood and body fluids among healthcare workers.

Methods

For the review, the articles published in English were searched using the electronic databases (SCOPUS/Science Direct, PubMed, Web of Science, Google Scholar, CINAHL, MEDLINE, Cochrane Library, DOAJ, and MedNar) with a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords. A quality assessment was conducted to determine the relevance of the articles using JBI critical appraisal tools. Furthermore, several steps of assessment and evaluation were taken to select and analyze the relevant articles.

Results

Of the 3912 articles identified through the electronic database search, 33 that met the inclusion criteria were included in the final analysis. The current study found that the global pooled prevalence of blood and body fluids among healthcare workers during career time and in the previous one year accounted for 56.6% (95% CI: 47.3, 65.4) and 39.0% (95% CI: 32.7, 45.7), respectively. Based on subgroup analysis by publication year, survey year, and World Health Organization regions, the highest prevalence of blood and body fluid exposure in the last 12 months was observed among articles published between 2004 and 2008 (66.3%), conducted between 2003 and 2008 (66.6%), and conducted in the Southeast Asia Region (46.9%). The highest career time prevalence was 60.6%, 71.0%, and 68.4% for articles published between 2015 and 2020, conducted between 2015 and 2019, and reported in the African region, respectively.

Conclusion

The current study revealed a high prevalence of occupational exposure to blood and body fluids among healthcare workers and suggests the need to improve occupational health and safety services in healthcare systems globally.

Prevalence of Occupational Exposure to HIV and Factors Associated with Compliance with Post-Exposure Prophylaxis Among Health Workers of the Biyem-Assi, Buea, and Limbe Health Districts of Cameroon Maternal and Child Health and AIDS

BACKGROUND

Although a few studies have assessed occupational exposure and knowledge on post-exposure prophylaxis (PEP) for HIV among health care workers (HCWs), limited information is available on the factors that influence the use of HIV PEP among HCWs after occupational exposure in Cameroon. This study aimed to assess the prevalence and determinants of occupational exposure to HIV infection and identify factors (knowledge, attitudes, and practices) that influence compliance to the use of HIV PEP among HCWs in the Biyem-Assi, Buea, and Limbe health districts.

METHODS

A stratified cross-sectional study was carried out among health care workers from the Biyem-Assi, Buea, and Limbe health districts of Cameroon. A structured questionnaire adapted from previous studies was administered on the socio-demographic status, occupational exposure to biological agents as well as information on knowledge, awareness of PEP guidelines, attitude, and practice of the HCWs towards HIV PEP.

RESULTS

Of the 312 participants, 198 (63.5%) experienced an occupational injury, and 240 (76.9%) had a good attitude towards HIV PEP. Age, place of work, and inadequate knowledge were determinants of occupational exposure. Whereas, awareness of PEP guidelines and being a medical doctor influenced compliance with HIV PEP, with 158 (51.0%) having adequate knowledge of the guidelines. Out of the 198 who experienced occupational injury, 114 (57.6%) adopted the good practice and 60 (30.3%) made use of HIV PEP.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

Over half of health care workers had occupational exposure to HIV with poor utilization of post-exposure prophylaxis though they were aware and knowledgeable of PEP guidelines and exhibited good practice. Compliance with HIV PEP utilization was influenced by gender, awareness of PEP guidelines, and specialty of the health care worker.

The South African Nurse’s Knowledge of Occupational Human Immunodeficiency Virus Postexposure Prophylaxis in the Era of Controlled and Stable HIV Prevalence

Knowledge is a crucial aspect of nursing. Nurses, just like any other healthcare workers (HCWs), are empowered with the knowledge of Human Immunodeficiency Virus (HIV) Postexposure Prophylaxis (PEP) protocol to be followed, including post-exposure to blood and body fluids (BBFs). The utilization of HIV PEP demonstrated its capabilities to prevent HCWs from HIV infections. However, the practice in healthcare settings remains a challenge, as many HCWs do not adhere to the protocol. This study investigated how knowledgeable nurses are about HIV PEP in the era of controlled and stable HIV prevalence. Ninety-four nurses completed a self-administered questionnaire to provide information. A biostatistician assisted with data analysis, using Microsoft Excel converted to the STATA 13 format. Most (77.0%) were female with a mean age of 30 ± 9 years. The degree of knowledge was low, although the results showed that 90.43% of nurses had been informed about HIV PEP. Eighty (84%) did not know where to access HIV PEP, and (55.32%) were unaware of HIV PEP guidelines. A comparison between knowledge and work experience revealed that those with five years and less experience are less knowledgeable. There is a need to improve nurses’ knowledge of HIV PEP to reduce the risk of HIV acquisition from work-related activities.