Research Article

Occupational blood exposure among unlicensed home care workers and home care registered nurses: Are they protected?

  1. J. Lipscomb PhD, RN, FAAN1,†,*,
  2. R. Sokas MD2,
  3. K. McPhaul PhD, RN1,
  4. B. Scharf MSN, RN1,
  5. P. Barker BS, RN1,
  6. A. Trinkoff PhD, RN, FAAN1,
  7. C. Storr PhD1

Article first published online: 28 MAY 2009

DOI: 10.1002/ajim.20701

Issue

American Journal of Industrial Medicine

American Journal of Industrial Medicine

Volume 52, Issue 7, pages 563–570, July 2009

Additional Information

How to Cite

Lipscomb, J., Sokas, R., McPhaul, K., Scharf, B., Barker, P., Trinkoff, A. and Storr, C. (2009), Occupational blood exposure among unlicensed home care workers and home care registered nurses: Are they protected?. Am. J. Ind. Med., 52: 563–570. doi: 10.1002/ajim.20701

Author Information

  1. 1

    School of Nursing, University of Maryland, Maryland

  2. 2

    Chicago School of Public Health, University of Illinois, Illinois

  1. †

    Director.

*Work and Health Research Center, School of Nursing, University of Maryland, 655 West Lombard Street, Room 655c, Baltimore, MD 21210, USA.

Publication History

  1. Issue published online: 10 JUN 2009
  2. Article first published online: 28 MAY 2009
  3. Manuscript Accepted: 5 APR 2009

Funded by

  • The National Institute for Occupational Safety and Health (NIOSH). Grant Number: R01 OH008237-01

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Keywords:

  • home care;
  • blood and body fluid contact;
  • needlesticks;
  • occupational health and safety;
  • prevention

Abstract

Background

Little is known about the risk of blood exposure among personnel providing care to individual patients residing at home. The objective of this study was to document and compare blood exposure risks among unlicensed home care personal care assistants (PCAs) and home care registered nurses (RNs).

Methods

PCAs self-completed surveys regarding blood and body fluid (BBF) contact in group settings (n = 980), while RNs completed mailed surveys (n = 794).

Results

PCAs experience BBF contact in the course of providing care for home-based clients at a rate approximately 1/3 the rate experienced by RNs providing home care (8.1 and 26.7 per 100 full time equivalent (FTE), respectively), and the majority of PCA contact episodes did not involve direct sharps handling. However, for PCAs who performed work activities such as handling sharps and changing wound dressings, activities much more frequently performed by RNs, PCAs were at increased risk of injury when compared with RNs (OR = 7.4 vs. 1.4) and (OR = 6.3 vs. 2.5), respectively.

Conclusion

Both PCAs and RNs reported exposures to sharps, blood, and body fluids in the home setting at rates that warrant additional training, prevention, and protection. PCAs appear to be at increased risk of injury when performing nursing-related activities for which they are inexperienced and/or lack training. Further efforts are needed to protect home care workers from blood exposure, namely by assuring coverage and enforcement of the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard [Occupational Safety and Health Administration. 1993. Frequently Asked Questions Concerning the Bloodborne Pathogens Standard. Available at: http://www. osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS &p_id=21010#Scope. Accessed May 30, 2008]. Am. J. Ind. Med. 52:563–570, 2009. © 2009 Wiley-Liss, Inc.

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