Beltrami E M, McArthur M A, McGeer A, Armstrong-Evans M, Lyons D, Chamberland M E, Cardo D M
HIV Infections Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Infect Control Hosp Epidemiol. 2000 Dec;21(12):765-70. doi: 10.1086/501730.
To estimate the frequency of, and assess risk factors for, percutaneous, mucous membrane, and cutaneous blood contacts sustained by healthcare workers (HCWs) during the delivery of infusion therapy and the performance of procedures involving sharp instruments in the home setting.
Prospective surveillance of percutaneous, mucous membrane, and cutaneous blood contacts.
Eleven home healthcare agencies in the United States and Canada from August 1996 through June 1997.
HCWs who provided home infusion therapy or performed procedures using hollow-bore needles and other sharp instruments in the home setting.
Each participating worker recorded information about the procedures performed and blood contacts experienced during each of his or her home visits for a 2- to 4-week period using standard questionnaires. HCWs also completed questionnaires regarding job duties, reporting of previous occupational blood contacts, and their use of protective barriers in the home setting.
Participating HCWs provided information about 33,606 home visits. A total of 19,164 procedures were performed during 14,744 procedure visits. Fifty-three blood contacts occurred during these visits, for a blood-contact rate of 2.8 blood contacts per 1,000 procedures and 0.6 percutaneous injuries per 1,000 procedures with needles or lancets. Gloves were worn for 52%, masks for 5%, gowns for 3%, and protective glasses or goggles for 2% of all procedure visits. HCWs used barriers for 53% of visits during which at least 1 procedure was performed and for 27% of other visits.
HCWs involved in home health care are at risk for blood contact. Infection control barrier use was low in our study. The majority of skin contacts could have been prevented by glove use.
评估医护人员（HCWs）在家庭环境中进行输液治疗及实施涉及锐器的操作过程中，经皮、黏膜和皮肤血液接触的发生率，并评估相关危险因素。
对经皮、黏膜和皮肤血液接触进行前瞻性监测。
1996年8月至1997年6月期间，美国和加拿大的11家家庭保健机构。
在家庭环境中提供家庭输液治疗或使用空心针及其他锐器进行操作的医护人员。
每位参与的工作人员使用标准问卷记录其在2至4周的家庭访视期间每次访视所进行的操作及经历的血液接触情况。医护人员还填写了关于工作职责、既往职业血液接触报告以及在家庭环境中使用防护屏障的问卷。
参与的医护人员提供了33606次家庭访视的信息。在14744次操作访视中共进行了19164项操作。这些访视期间发生了53次血液接触，血液接触率为每1000项操作2.8次血液接触，每1000次使用针头或采血针的操作中有0.6次经皮损伤。在所有操作访视中，52%的访视戴了手套，5%戴了口罩，3%穿了隔离衣，2%戴了防护眼镜或护目镜。在至少进行了1项操作的访视中，医护人员有53%使用了屏障，在其他访视中有27%使用了屏障。
参与家庭保健的医护人员有血液接触的风险。在我们的研究中，感染控制屏障的使用率较低。大多数皮肤接触本可通过戴手套预防。
