USE OF PRECAUTIONS BY NURSE-MIDWIVES TO PREVENT OCCUPATIONAL INFECTIONS WITH HIV AND OTHER BLOOD-BORNE DISEASES

Authors

  • Nancy L. Loewen MS, CNM,

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    • Nancy Loewen received a BSN from Goshen College in 1974, a nurse-midwifery certificate in 1979, and an MS in 1988 from Georgetown University. She has practiced midwifery in Washington, D.C., and in Jamaica. She currently practices midwifery in Rhode Island with the Rhode Island Group Health Association in Providence.

  • Gita L. Dhillon BSN, MED, MA,

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    • Gita Dhillon received a BSN from the University of Madras through Christian Medical College, Vellore, India; and MEd from Teachers' College, Columbia University, and an MA in anthropology from American University in Washington, D.C. She is an Associate Professor of Nursing at American University and a student nurse-midwife at Georgetown University.

  • Mary E. Willy BSN, MPH,

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    • Mary Willy received a BSN from Case Western Reserve University. She received an MPH from Johns Hopkins University in 1983. She is a nurse epidemiologist for the Hospital Epidemiology Service at the Warren Grant Magnuson Clinical Center of the National Institutes of Health in Bethesda, Maryland.

  • Robert A. Wesley PHD,

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    • Robert Wesley received his PhD in Mathematical Statistics from Stanford University in 1978. Since then, he has been on the faculty of the Johns Hopkins University, has served as biostatistician in the intramural program of the National Cancer Institute at the National Institutes of Health, and has been president of a software company developing mathematical modelling software. He currently heads a section in the Warren Grant Magnuson Clinical Center of the National Institutes of Health providing statistical and computer support for departments in the hospital.

  • David K. Henderson MD

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    • David Henderson received his MD from the University of Chicago Pritzker School of Medicine in 1973. He is currently the Associate Director for Quality Assurance and Hospital Epidemiology at the Warren Grant Magnuson Clinical Center of the National Institutes of Health in Bethesda, Maryland.


RIGHA OB-GYN Department, 530 North Main Street, Providence, RI 02904.

ABSTRACT

A questionnaire was designed with these objectives: (1) to determine the frequency and type of adverse exposures experienced by certified nurse-midwives (CNMs); (2) to determine the extent to which CNMs used recommended precautions to prevent such incidents; and (3) to identify the sources used for obtaining information on AIDS. The questionnaire was mailed to all CNMs with the exception of associate and student members of the American College of Midwives. A response rate of 1,784/2,963 (60.2%) was obtained. These midwives reported frequent exposures to blood and body fluids. Sixty-five percent reported being soaked to the skin with blood or amniotic fluid; 50.7% had face-splashes with blood or amniotic fluid; and 24.0% experienced one or more needlestick(s). Only 55.1% reported using Universal Precautions (UP). Interference with the midwife-client relationship was identified most frequently as the reason for not using UP. Strategies need to be developed for midwives that will increase the use of UP and minimize the frequency of adverse exposures, while maintaining a caring midwife—client relationship.

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