Occupational exposure to HIV: a conflict situation for health workers

Abstract

KUMAKECH E., ACHORA S., BERGGREN V. & BAJUNIRWE F. (2011) Occupational exposure to HIV: a conflict situation for health workers. International Nursing Review58, 454–462 Aim: To determine the frequency of occupational exposure to human immunodeficiency virus (HIV), the circumstances and predisposing factors, the high‐risk groups, the extent to which exposures are reported and the post‐exposure prophylaxis (PEP) utilized by health‐care workers (HCWs) and students in a Ugandan hospital. Background: Occupational exposure to HIV is a low but potential risk of HIV infection to health workers. Method: Self‐administered questionnaire was given to 224 participants (including 98 HCWs and 126 students) in Mbarara Hospital, Uganda. Data were analysed with descriptive statistics using the Statistical Package for the Social Sciences version 15.0 (SPSS Inc, Chicago, IL, USA). Findings: Of the 224 participants surveyed, 19.2% reported having sustained injection needle stick injuries in the previous year, of which 4.46% occurred with HIV‐infected blood. Other reported injuries were cannula needle stick injury (0.89%), suture needle stick injuries (3.13%), scalpel cut injuries (0.45%) and muco‐cutaneous contamination (10.27%). The most affected groups were nurses–midwives for scalpel injuries and students for stick injuries. The predisposing factors reported included lack of protective devices and recapping of needles. Exposures were under‐reported. Uptake of PEP was also low. Conclusion: Occupational exposure to HIV presents a conflict situation for HCWs. It remains a frequent occurrence particularly among student nurses–midwives, despite being avoidable. Its prophylactic treatment is hampered by poor reporting and investigation of exposures, and poor access to PEP. Strict adherence to universal precaution and proper handling of occupational exposure to HIV should be encouraged.

Knowledge, Attitudes and Practices related to standard precautions among nurses: A comparative study

“…The poorer practices of Ethiopian nurses when exposed to a potential infection risk may be attributable to lack of adequate risk perception and/or selective application of SPs. Several studies have documented selective application of SPs by healthcare providers (Gammon, Morgan‐Samuel, & Gould, ; Kumakech, Achora, Berggren, & Bajunirwe, ).…”

Reporting and case management of occupational exposures to blood-borne pathogens among healthcare workers in three healthcare facilities in Tanzania

“…The lack of training of HCW on prevention and management of occupational exposures and PEP among HCW has been described in resource-limited settings (Gupta et al, 2008;Kumakech et al, 2011). Lack of awareness could be addressed with appropriate and routine trainings on standard precautions, reporting and post-exposure care.…”

The Experience of Ugandan Nurses in the Practice of Universal Precautions

“…Despite this recommendation, HCWs, and particularly nurses (Kumakech, Achora, Berggren, & Bajunirwe, 2011), often find it difficult to translate the principles of universal precautions into practice and may be noncompliant in their use (Aultman & Borges, 2011;Cutter & Jordan, 2004;Reda, Vandeweerd, Syre, & Egata, 2009). Several authors (Gammon et al, 2008;Kumakech et al, 2011) reported that practitioners were selective in the application of universal precautions and that compliance with infection control precautions was suboptimal. Studies have shown that nurse compliance with universal precautions is affected by the availability of protective equipment, the perceived commitment of management to safety, and perceptions that universal precautions interfere with job performance (Lee, 2009).…”

“…Therefore, universal precautions have been recommended when caring for all patients, regardless of diagnosis (CDC, 1987). Despite this recommendation, HCWs, and particularly nurses (Kumakech, Achora, Berggren, & Bajunirwe, 2011), often find it difficult to translate the principles of universal precautions into practice and may be noncompliant in their use (Aultman & Borges, 2011;Cutter & Jordan, 2004;Reda, Vandeweerd, Syre, & Egata, 2009). Several authors (Gammon et al, 2008;Kumakech et al, 2011) reported that practitioners were selective in the application of universal precautions and that compliance with infection control precautions was suboptimal.…”