Measurement of nursing staff occupational exposures in the operating suite following introduction of a prevention programme

Abstract

This study measured the number and type of occupational exposures (OEs) reported by operating suite (OS) nurses after introducing a programme designed to reduce OEs among this group. OS included theatres (OT), day surgery units (DSUs) and anaesthetics & recovery (A&R). The researcher prospectively collected data relating to reported OEs in the OS from 1999-2001 in a 230 bed, not for profit, hospital in Sydney, Australia. An OE prevention programme commenced in 2000 and included health care worker (HCW) education, practice changes and implementation of sharps safety devices. OE rates among OT and DSU nurses decreased from 2.53 to 1.11 per 1000 surgical procedures and from 1.84 to 1.27 per 1000 surgical procedures respectively over the 2 year study. Half (50%) of the OT OEs were caused by solid bore (suture) needles and occurred most frequently during use (41%). In contrast, in DSUs (35%) and in A&R (67%), these OEs were due to mucocutaneous blood or body substance splashes to nurses not wearing protective eyewear. In DSUs, more than a quarter (26%) of the injuries occurred after use and before disposal. Nurses reported a reduced rate of OEs after the OE prevention programme was introduced. However, HCW attitudes to OE risk and prevention, particularly in regard to using personal protective equipment (PPE) and complying with standard precautions, must change before behaviour and practice can be altered. Prevention programmes incorporating ongoing surveillance and analysis of OEs, including consideration of risk among occupational groups, identification of implicated devices and practices, and HCW feedback, are critical to improve HCW safety programmes. Managerial and administrative support is crucial to drive prevention efforts and inculcate a culture of safety within the healthcare facility.