Hospital nurses' occupational exposure to blood: Prospective, retrospective, and institutional reports

Objectives. This study examined nurses' risk of exposure to blood resulting from injuries with needles and sharps, the methods of estimating those risks, and the factors affecting risks. Methods. Nurses on 40 medical units in 20 hospitals in cities with a high incidence of AIDS were studied. Percutaneous injuries were documented for every shift during a 30-day period. These prospective reports were compared with retrospective and institutional reports. Factors affecting the likelihood of injuries were also explored. Results Based on the prospective reports, the rate of injuries to staff nurses was 0.8 per nurse-year. Prospective 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, taking precautions to avoid blood contact were associated with fewer injuries. Conclusions. Injuries from needlesticks are more common than institutional reports suggest and do not occur at random. Diminishing the frequency with which nurses recap needles, increasing precautions they take, reducing use of temporary nursing personnel, and implementing organizational changes may lower the odds of nurses being injured.