About 1 in 2 nurses experience blood exposure, other than from a needlestick, on their skin or in their eyes, nose or mouth at least once a month when inserting a peripheral intravenous (IV) catheter, according to a new study by the International Healthcare Worker Safety Center at the University of Virginia. Exposure to blood carries the risk of infection from pathogens such as human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV) and MRSA.
Healthcare workers place more than 300 million short peripheral intravenous catheters (SPIVCs) every year in the United States alone. The study shows nurses are at risk of exposure to blood pathogens in 128 of 100,000 IV catheter insertions. The more commonly recognized risk of exposure to bloodborne pathogens from a needlestick injury with non-safety catheters is 6.6 per 100,000 devices. The Centers for Disease Control and Prevention (CDC) define at-risk blood exposure as "contact of mucous membrane (MME) or exposed skin (chapped, abraded, or afflicted with dermatitis) with blood, tissue, or other body fluids that are potentially infectious."
Yet, the majority of such exposures go unreported. Of the total mucous membrane exposures (MMEs) sustained by respondents in this study, 69% were not reported. In comparison, the CDC's underreporting rate for sharps injuries is 57 percent.
Almost 9 in 10 of those nurses who did not report the incident said they did not think the exposure was significant enough to report; more than one third said they were too busy, and 9 percent said they were concerned about others' perceptions.
"The use of safety IV catheters has helped reduce needlestick exposures. This study demonstrates the need to consider technology and precautions to reduce the risk of all sources of blood exposure," says Janine Jagger, PhD, MPH, lead author of the study and director of International Healthcare Workers Safety Center at the University of Virginia. The study looked at the practices of 379 nurses nationwide who place IV catheters. It was published in the December issue of Nursing 2011.
Study respondents also report a monthly average of 10 incidents of blood contact to gloves during IV insertions and say they unexpectedly come into contact with blood in a patient's room (on bed rails, bedside trays, or pump touchpads) an average of 3.55 times per month, or almost once a week. Pathogens in blood residue on these surfaces can be transferred to healthcare workers, housekeeping staff and visitors who might come in contact with these surfaces.
BD has recently launched its latest innovation in safety peripheral IV catheter technology designed to keep healthcare workers safe from needlestick injuries and blood exposure. In addition to proven needlestick protection, BD Insyte Autoguard BC with Blood Control Technology has also been proven to reduce the risk of blood exposure by 95 percent, compared to a non-blood control IV catheter, according to a recently published study. This latest technology joins the BD Nexiva Closed IV Catheter System and broadens the choice clinicians have in selecting a safety IV catheter that offers protection from sharps and non-sharps blood exposure.
BD Medical, a segment of BD (Becton, Dickinson and Company) and the world's leading provider of IV catheters, sponsored this research through an unrestricted educational grant to the authors. For additional information on healthcare worker safety or "Making Safety Safer," visit www.bd.com/IAGBC and www.bd.com/bloodcontrol.
1. Jagger J, Perry J, Parker G, Komblatt Phillips E. Blood exposure risk during peripheral IV catheter insertion and removal. Nursing 2011. 2011;41(12):45-49.
2. Onia R, Eshun-Wilson I, Arce C, et al. Evaluation of a new safety peripheral IV catheter designed to reduce mucocutaneous blood exposure. Curr Med Res Opin. 2011;27(7):1339-1346.