Nongyao Kasatpibal1, JoAnne D Whitney2, Sadubporn Katechanok3, Sukanya Ngamsakulrat3, Benjawan Malairungsakul3, Pinyo Sirikulsathean4, Chutatip Nuntawinit5, Thanisara Muangnart6. 1. Division of Nursing Science, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand. Electronic address: nongyaok2003@gmail.com. 2. Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA, USA. 3. Operating Room and Recovery Room Service, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand. 4. Operating Room, Rajavithi Hospital, Bangkok, Thailand. 5. Operating Room, Siriraj Hospital, Mahidol University, Bangkok, Thailand. 6. Operating Room, Police General Hospital, Bangkok, Thailand.
Abstract
BACKGROUND: Improper or inadequate actions taken after blood and body fluid exposures place individuals at risk for infection with bloodborne pathogens. This has potential, significant impact for health and well-being. OBJECTIVES: To evaluate the practices and the personal impact experienced following blood and body fluid exposures among operating room nurses. DESIGN: A cross-sectional, multi-center study. SETTINGS: Government and private hospitals from all parts of Thailand. PARTICIPANTS: Operating room nurses from 247 hospitals. METHODS: A questionnaire eliciting responses on characteristics, post-exposure practices, and impacts was sent to 2500 operating room nurses. RESULTS: Usable questionnaires were returned by 2031 operating room nurses (81.2%). Of these 1270 had experience with blood and body fluid exposures (62.5%). Most operating room nurses did not report blood and body fluid exposures (60.9%). The major reasons of underreporting were low risk source (40.2%) and belief that they were not important to report (16.3%). Improper post-exposure practices were identified, 9.8% did not clean exposure area immediately, 18.0% squeezed out the wound, and 71.1% used antiseptic solution for cleansing a puncture wound. Post-exposure, 58.5% of them sought counseling, 16.3% took antiretroviral prophylaxis, 23.8% had serologic testing for hepatitis B and 43.1% for hepatitis C. The main personal impacts were anxiety (57.7%), stress (24.2%), and insomnia (10.2%). CONCLUSIONS: High underreporting, inappropriate post-exposure practices and impacts of exposure were identified from this study. Comprehensive education and effective training of post-exposure management may be keys to resolving these important problems.
BACKGROUND: Improper or inadequate actions taken after blood and body fluid exposures place individuals at risk for infection with bloodborne pathogens. This has potential, significant impact for health and well-being. OBJECTIVES: To evaluate the practices and the personal impact experienced following blood and body fluid exposures among operating room nurses. DESIGN: A cross-sectional, multi-center study. SETTINGS: Government and private hospitals from all parts of Thailand. PARTICIPANTS: Operating room nurses from 247 hospitals. METHODS: A questionnaire eliciting responses on characteristics, post-exposure practices, and impacts was sent to 2500 operating room nurses. RESULTS: Usable questionnaires were returned by 2031 operating room nurses (81.2%). Of these 1270 had experience with blood and body fluid exposures (62.5%). Most operating room nurses did not report blood and body fluid exposures (60.9%). The major reasons of underreporting were low risk source (40.2%) and belief that they were not important to report (16.3%). Improper post-exposure practices were identified, 9.8% did not clean exposure area immediately, 18.0% squeezed out the wound, and 71.1% used antiseptic solution for cleansing a puncture wound. Post-exposure, 58.5% of them sought counseling, 16.3% took antiretroviral prophylaxis, 23.8% had serologic testing for hepatitis B and 43.1% for hepatitis C. The main personal impacts were anxiety (57.7%), stress (24.2%), and insomnia (10.2%). CONCLUSIONS: High underreporting, inappropriate post-exposure practices and impacts of exposure were identified from this study. Comprehensive education and effective training of post-exposure management may be keys to resolving these important problems.