Blood Exposure Incidence Rates From the North Carolina Study of Home Care and Hospice Nurses

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BackgroundHome care/hospice nurses may be at elevated risk of blood exposure because of the nature of their work and work environment. However, little is known about the incidence of blood exposure in this population.MethodsA mail survey (n=1,473) was conducted among home care/hospice nurses in North Carolina in 2006.ResultsThe adjusted response rate was 69%. Nine percent of nurses had at least one exposure/year. Overall incidence was 27.4 (95% confidence interval: 20.2, 34.6)/100,000 visits. Nurses who had worked in home care ≤5 years had higher exposure rates than other nurses—seven times higher for needlesticks and 3.5 times higher for non-intact skin exposures. Nurses who worked part time/contract had higher exposure rates than nurses who worked full time—seven times higher for needlesticks and 1.5 times higher for nonintact skin exposures. The rates for part-time/contract nurses with ≤5 years experience were extremely high. Sensitivity analysis showed that it is unlikely that response bias had an important impact on these results.ConclusionsApproximately 150 North Carolina home care/hospice nurses are exposed to blood annually. If these results are representative of other states, then approximately 12,000 home care/hospice nurses are exposed each year nationwide. Improved prevention efforts are needed to reduce blood exposure in home care/hospice nurses.

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