Journal of the Academy of Hospital Administration

S. Basarkar

Dear Editor,

The occupational exposure, in the healthcare setting may put workers at risk of HIV/HBV infections through needle stick injury, contact of mucous membrane or damaged skin with blood or body fluid and in order to prevent themselves workers should strictly follow the universal precautions (UP). These are simple measures and should be practiced by all at all times though the risk of infection depends on amount of blood / body fluid, viral blood, depth of penetration, type of needle (hollow bore more dangerous)¹.

It has been estimated that prevalence of needle stick injury is 0.3% while risk of infections on occupation exposure of ENT is 1 in 1000 and with damaged skin 1in 1000, risk of HBV is 9-40% and that of HIV is 1-10%². The UP are important because exposure to infected body fluids and blood produce high risk and to prevent themselves workers should use this essential component of preventive strategy. It has been seen that unsafe infections are causing about 4 – 7% of new infections worldwide. If health care worker can protect himself from infection he can provide better care³.

In order to clear doubts, it is essential to know body fluids for which UP are mandatory and they are blood, semen, vaginal secretions CSF, synovial fluid, penitoneal, pericardial, amniotic fluid. Other body fluids like tear, sweat, nasal secretion, urine, vomitus does not pose high risk unless they are stained with blood or contain visible blood².

While following universal precautions the most important is the:

1. Knowledge about the risk and hazards of the risk and how to prevent such dreaded risks of fatal infections.
2. Skill development in such away that following UP becomes part of worker’s routine and follow them even in case of emergency.
3. Attitudinal or behavioral modification in Health Care Worker so they receive and respond to the concept of UP.

The objectives of following UP in healthcare setting is to prevent exposure to infections, create awareness and give responsibilities to further spread down the stream in the organization.

It is the duty of organization to ensure that every worker is protected from occupational risks and for that these steps can be followed in addition to universal precaution.

(a) Education, training and retraining of HCW about occupational risk and need to use UP with all patients, at all times regardless of diagnosis and place of work.

(b) Adequate supply should be made available especially protective equipments.

(c) Reduction in unnecessary procedures like autologous blood transfusion, injections, suturing etc.

(d) Regular monitoring and periodic evaluation of health care waste management system in the organisation.

(e) Adequate immunization of HC workers.

(f) Discourage reusable instruments as adequate sterilization is difficult to ensure³.

To conclude, at present universal precautions are the only effective way to prevent the serious blood and body fluid born occupational diseases, which are quite preventable through these simple measures. Address to knowledge, skill and attitude to the health workers can motivate them to follow these precautionary measures and save their and other’s life.

REFERENCES:

1. Surgery roles, med know 2003, 190-191.
2. Study material IGNOU BHM.001(3), 68-69.
3. http.//www.who.int.hiv/topics.

S. Basarkar is Asst. Med. Supdt., C.R. Gardi Hospital (R.D. Gardi Medical College), Agar Road, Surasa, Ujjain