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Author Credentials

Natavoot Nick Chongswatdi MD Associate Professor Medical Director Occupational Health and Wellness Division Dept. of Family and Community Health Joan C. Edwards School of Medicine Marshall University Callie Seaman MD Resident, Family Medicine Walter Reed National Medical Center Fort Belvoir VA William Rollyson MD Resident Dept. of Family and Community Health Joan C. Edwards School of Medicine Marshall University Diane Harmon Nursing Informaticist Information Services Marshall Health Adam M. Franks, MD (ORCID #: 0000-0002-3710-6138) Professor & Vice Chair Dept. of Family and Community Health Joan C. Edwards School of Medicine Marshall University

Author ORCID Identifier

Adam M. Franks, MD (ORCID #: 0000-0002-3710-6138)

Keywords

Blood Borne Pathogens, Post exposrue adherance, Occuptional medicine, Needle stick, Academic Medical center

Disciplines

Family Medicine | Health and Medical Administration | Infectious Disease | Medicine and Health Sciences | Virus Diseases

Grant Award Number

None

Abstract

Introduction

Health care workers (HCW) are at risk for occupational blood borne pathogen exposures (BBPE). Effective prevention and management of BBPEs relies upon reporting and post-exposure follow-up protocol adherence. As post-exposure monitoring completion is largely unexplored, seven years of a university healthcare system’s BBPE exposure data was explored and compared to documented rates.

Methods

The Marshall Health Occupational Health and Wellness division collected seven years (2012-2018) of BBPE follow-up monitoring adherence rates and demographic data. Data for HCW occupation, exposure incident, and source patient disease status were evaluated. Differences were analyzed with Chi square, Fischer Exact and logistic regression tests.

Results

Of the HCWs (n =293), 31.7% completed follow-up monitoring. Completion rates of physicians and their learners (29.8%) trended lower than non-physician HCWs (43.9%; p < 0.071). Similar completion rates were seen for all types of exposures (p = 0.470). Reported incidents had higher completion rates than unreported incidents (P = 0.001). Reported incidents (OR 6.906; 95% CI 1.936-24.637) and source patient status independently predicted completion, regardless of type of infection. Seropositive source patient status (67.2%) was associated with the highest HCW adherence rate (OR 4.747; 2.359-9.552), while unknown source patient status (17.1%) was the lowest (OR 0.423; 0.208-0.859).

Conclusion

Current literature is limited regarding adherence rates to post-exposure monitoring protocols, favoring reporting rate analysis. Above results differ from some published reports potentially identifying unique demographic patterns in medical centers of differing size and governance. Understanding demographics associated with BBPEs may provide insight to institutional post-exposure monitoring adherence rates.

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