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Grimmond, T. and Good, L. (2015) EXPO-S.T.O.P.-2012: Year Two of a national survey of sharps injuries and mucocutaneous blood exposures among healthcare workers in USA hospitals. Journal of the Association of Occupational Health Professionals in Healthcare. 35(2), p.52-57.


Purpose: Blood exposure (BE) among healthcare workers (HCW), either from percutaneous sharps injury (SI) or mucocutaneous (MC) exposure, is a serious occupational risk that healthcare facilities (HCF) strive to reduce. The Exposure Study of Occupational Practice (EXPO-S.T.O.P.) is used annually to ascertain BE incidence in the healthcare facilities of members of the Association of Occupational Health Professionals in Healthcare (AOHP). This BE incidence survey is for the 2012 calendar year.

Design: A fifteen -item electronic survey was developed and distributed to AOHP members to ascertain BE incidence and denominator data in their hospitals.

Methods: 2012 data was requested on: SI and MC incidence in all staff and in nurses; hospital bed size; location; teaching status; OSHA Form 300 inclusion items; and proportion of total SI occurring in surgical procedures. Several denominator metrics were also requested, including full time equivalent staff (FTE), Nurse FTE, average daily census (ADC) and adjusted patient days (APD). Incidence rates per 100 FTE, per 100 Nurse FTE, per 100 Occupied Beds (OB), and per 1000 APD were calculated and compared with relevant US databases, including the original EXPO-S.T.O.P.-2011 study. Best practices from the top 5 lowest-exposure teaching and top 5 non-teaching hospitals were also sought.

Findings: Responses from 157 hospitals in 32 states were received making the survey the largest in USA. Of the 9,494 BE reported, 73.9% were from SI and 26.1% from MC. Overall SI incidence rates were: 28.2 /100 OB (22.5 in non-teaching and 31.4 in teaching hospitals); 2.2 /100 FTE; 3.3 per 100 Nurse FTE; and 0.43 /1000 APD. Of the total SI, 43.9% occurred during surgical procedures. Overall MC incidence rates were: 10.1 /100 OB (9.8 in non-teaching and 10.5 in teaching hospitals); 0.8 /100 FTE; and 0.15 /1000 APD. Hospital size significantly impacted their incidence rates. The SI incidences in the top 5 teaching and non-teaching hospitals were more than 60% below their size-group average. Effective reduction strategies in these low-incidence, “sharps aware” hospitals included: prevention through education, data-driven communication, immediate root cause investigation of all exposures, adoption of safer safety engineered devices, engagement of staff on all levels and acceptance by staff that safety is their responsibility.

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