The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector

Robyn Gershon, Julie M. Pearson, Martin F. Sherman, Stephanie M. Samar, Allison N. Canton, Patricia W. Stone

Research output: Contribution to journalArticle

Abstract

Background: Patients continue to enter home health care (HHC) "sicker and quicker," often with complex health problems that require extensive intervention. This higher level of acuity may increase the risk of percutaneous injury (PI), yet information on the risk and risk factors for PI and other types of exposures in this setting is exceptionally sparse. To address this gap, a large cross-sectional study of self-reported exposures in HHC registered nurses (RNs) was conducted. Methods: A convenience sample of HHC RNs (N = 738) completed a survey addressing 5 major constructs: (1) worker-centered characteristics, (2) patient-related characteristics, (3) household characteristics, (4) organizational factors, and (5) prevalence of PIs and other blood and body fluid exposures. Analyses were directed at determining significant risk factors for exposure. Results: Fourteen percent of RNs reported one or more PIs in the past 3 years (7.6 per 100 person-years). Nearly half (45.8%) of all PIs were not formally reported. PIs were significantly correlated with a number of factors, including lack of compliance with Standard Precautions (odds ratio [OR], 1.72; P = .019; 95% confidence interval [CI]: 1.09-2.71); recapping of needles (OR, 1.78; P = .016; 95% CI: 1.11-2.86); exposure to household stressors (OR, 1.99; P = .005; 95% CI: 1.22-3.25); exposure to violence (OR, 3.47; P = .001; 95% CI: 1.67-7.20); mandatory overtime (OR, 2.44; P = .006; 95% CI: 1.27-4.67); and safety climate (OR, 1.88; P = .004; 95% CI: 1.21-2.91) among others. Conclusion: The prevalence of PI was substantial. Underreporting rates and risk factors for exposure were similar to those identified in other RN work populations, although factors uniquely associated with home care were also identified. Risk mitigation strategies tailored to home care are needed to reduce risk of exposure in this setting.

Original languageEnglish (US)
Pages (from-to)525-533
Number of pages9
JournalAmerican Journal of Infection Control
Volume37
Issue number7
DOIs
StatePublished - Sep 1 2009

Fingerprint

Health Care Sector
Home Care Services
Odds Ratio
Nurses
Confidence Intervals
Wounds and Injuries
Delivery of Health Care
Body Fluids
Climate
Needles
Cross-Sectional Studies
Safety
Health
Population

Keywords

  • Home health care
  • percutaneous injuries
  • registered nurses

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector. / Gershon, Robyn; Pearson, Julie M.; Sherman, Martin F.; Samar, Stephanie M.; Canton, Allison N.; Stone, Patricia W.

In: American Journal of Infection Control, Vol. 37, No. 7, 01.09.2009, p. 525-533.

Research output: Contribution to journalArticle

Gershon, Robyn ; Pearson, Julie M. ; Sherman, Martin F. ; Samar, Stephanie M. ; Canton, Allison N. ; Stone, Patricia W. / The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector. In: American Journal of Infection Control. 2009 ; Vol. 37, No. 7. pp. 525-533.
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T1 - The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector

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AU - Pearson, Julie M.

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AU - Samar, Stephanie M.

AU - Canton, Allison N.

AU - Stone, Patricia W.

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N2 - Background: Patients continue to enter home health care (HHC) "sicker and quicker," often with complex health problems that require extensive intervention. This higher level of acuity may increase the risk of percutaneous injury (PI), yet information on the risk and risk factors for PI and other types of exposures in this setting is exceptionally sparse. To address this gap, a large cross-sectional study of self-reported exposures in HHC registered nurses (RNs) was conducted. Methods: A convenience sample of HHC RNs (N = 738) completed a survey addressing 5 major constructs: (1) worker-centered characteristics, (2) patient-related characteristics, (3) household characteristics, (4) organizational factors, and (5) prevalence of PIs and other blood and body fluid exposures. Analyses were directed at determining significant risk factors for exposure. Results: Fourteen percent of RNs reported one or more PIs in the past 3 years (7.6 per 100 person-years). Nearly half (45.8%) of all PIs were not formally reported. PIs were significantly correlated with a number of factors, including lack of compliance with Standard Precautions (odds ratio [OR], 1.72; P = .019; 95% confidence interval [CI]: 1.09-2.71); recapping of needles (OR, 1.78; P = .016; 95% CI: 1.11-2.86); exposure to household stressors (OR, 1.99; P = .005; 95% CI: 1.22-3.25); exposure to violence (OR, 3.47; P = .001; 95% CI: 1.67-7.20); mandatory overtime (OR, 2.44; P = .006; 95% CI: 1.27-4.67); and safety climate (OR, 1.88; P = .004; 95% CI: 1.21-2.91) among others. Conclusion: The prevalence of PI was substantial. Underreporting rates and risk factors for exposure were similar to those identified in other RN work populations, although factors uniquely associated with home care were also identified. Risk mitigation strategies tailored to home care are needed to reduce risk of exposure in this setting.

AB - Background: Patients continue to enter home health care (HHC) "sicker and quicker," often with complex health problems that require extensive intervention. This higher level of acuity may increase the risk of percutaneous injury (PI), yet information on the risk and risk factors for PI and other types of exposures in this setting is exceptionally sparse. To address this gap, a large cross-sectional study of self-reported exposures in HHC registered nurses (RNs) was conducted. Methods: A convenience sample of HHC RNs (N = 738) completed a survey addressing 5 major constructs: (1) worker-centered characteristics, (2) patient-related characteristics, (3) household characteristics, (4) organizational factors, and (5) prevalence of PIs and other blood and body fluid exposures. Analyses were directed at determining significant risk factors for exposure. Results: Fourteen percent of RNs reported one or more PIs in the past 3 years (7.6 per 100 person-years). Nearly half (45.8%) of all PIs were not formally reported. PIs were significantly correlated with a number of factors, including lack of compliance with Standard Precautions (odds ratio [OR], 1.72; P = .019; 95% confidence interval [CI]: 1.09-2.71); recapping of needles (OR, 1.78; P = .016; 95% CI: 1.11-2.86); exposure to household stressors (OR, 1.99; P = .005; 95% CI: 1.22-3.25); exposure to violence (OR, 3.47; P = .001; 95% CI: 1.67-7.20); mandatory overtime (OR, 2.44; P = .006; 95% CI: 1.27-4.67); and safety climate (OR, 1.88; P = .004; 95% CI: 1.21-2.91) among others. Conclusion: The prevalence of PI was substantial. Underreporting rates and risk factors for exposure were similar to those identified in other RN work populations, although factors uniquely associated with home care were also identified. Risk mitigation strategies tailored to home care are needed to reduce risk of exposure in this setting.

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