TEMPLATE DESIGN © PRACTICE OF UNIVERSAL PRECAUTIONS AND OCCUPATIONAL EXPOSURES AMONG HEALTH CARE WORKERS Tuteja A, Chintamani, Tuteja G, Department of Surgery,VMMC & SJH, New Delhi. INTRODUCTION RESULTS AND OBSERVATIONS LIMITATIONS WHO estimates 2.5%of HIV,40% of Hep B and Hep C among HCWs –result of occupational exposures. UP-reduce risk of transmission of blood borne pathogens Level of knowledge and awareness of universal precautions –differs from one type of HCW to another. Medical and nursing students –inadequate knowledge of appropriate protective equipment –involved in clinical procedures Compliance of staff to universal precautions is generally deficient. Suboptimal reporting of occupational exposure. To study the knowledge and attitude of HCWs about universal precautions. To estimate the level of adherence of universal precautions among HCWs. To study the frequency and type of occupational accidents suffered by medical personnel. Study Design Cross sectional Time Period July 2011 Study Location VMMC and SJH hospital ParticipantsN = 500, randomly selected HCW (medical doctors, nurses, porters, medical and nursing students). METHODOLOGY A 25 Item self administered, structured questionnaire was devised de novo and tested. Written and informed consent was taken. Demographic information, knowledge, awareness and compliance of UP, incidence of needle stick injuries,steps to follow on occupational exposure was collected. Analysis-SPSS version 16 PARTICIPANT DEMOGRAPHICS GENDERNo. of Percentages Subject (n = 414) Female % Male % AGE (in yrs) 26 (17-59) EDUCATIONAL STATUS Medical students % M B B S % M S / M D % Nursing Students % GNM + Class 12th % BSc (nursing ) % Class 8th % FACTORS AFFECTING UNIVERSAL PRECAUTIONS Higher education level correlates positively with correct awareness and adherence of UPs. (P=0.000) More than 5 yrs of practice is associated with greater knowledge and compliance of UP (P<0.05) Self rated knowledge and confidence are not correlated with awareness and adherence of UP (P > 0.05). Source of awareness helps to determine the level of knowledge, and although 77.8 % have received it through books, yet they did not have correct knowledge. Most HCW on grading themselves felt their knowledge of UPs was sufficient, even though 55 % did not have correct information regarding recapping. Occupational training is a comprehensive and reliable medium to receive ground knowledge, but only 24.9 % have received it. Practice of UP has an attitudinal influence related to education and work experience. General positive attitude to care for infected persons is seen. Although not optimal –the level of awareness of PEP was 62.6 %. Sampled population is small – difficult to generalize the findings. Few respondents are students with limited clinical experience Despite efforts to ensure privacy during interviews & no penalty for any response-under reporting of discriminatory behaviour and over reporting of correct practice and attitudes. Obligatory training programs of universal precautions for all tiers of health staff. Sufficient personal protective equipment to be provided. Posters to be put up in all the wards promoting the use of UP s and establishing post exposure reporting systems. Routine immunization of HCW s against Hep B. Adherence and practice of UP are a concern and internationally suboptimal among many professionals (Askarian et al 2005). Corroboration exists amongst the researchers as to the reasons for noncompliance such as lack of time, lack of means,precautions not warranted,interfere with patient care (Madan et al 2002). Level of awareness of UP increased with longer years of service in health care sector and educational status (Vaz K, 2010). Research confirms that compliance improves following structured intervention, such as educational training programme (Pruss-Ustua A. et al. 2005). RESULTS AND OBSERVATIONS PROFESSIONNo. of Percentages Subject (n = 414) Medical Students10425 Nursing Students Doctors Nurses Porters WORK EXPERIENCE < 5 YRS >5 YRS HBV VACCINATION YES NO RESPONDENTS UNDERSTANDING OF AIMS OF AIMS OF UP No. of Subjects (%) Protect HCWs 220 (53.1) Protect patients getting 112 (27.1) infected from HCWs Prevent mutual transfer of infection 252 (60.9) Protect HCWs -infectious waste 171 (41.3) Protect HCWs - sharp waste 194 (46.9) Identifying all correct aims 109 (26.2) SHOULD RECAPPING BE DONE ? Content goes here… OPTIONAL LOGO HERE OBJECTIVE MATERIALS AND METHOD RESULTS AND OBSERVATIONS SOURCE OF KNOWLEDGE OF RESPONDENTS ABOUT UP OCCUPATIONAL EXPOSURES 24.9% have received training of universal precautions 11.1% subjects have had occupational exposures from blood and body fluid pathogens 62.6 % -aware of steps of post exposure prophylaxis DISCUSSION TAKE HOME MESSAGE REVIEW OF LITERATURE