1. The presentation is solely meant for
Academic purpose

3.  Knowledge about blood and body fluid
exposure
 Personal protective equipment
 Periodic immunization
 Safe equipment
 Reporting of exposure
 PEP
 Isolation precaution – MRSA, TB, H1N1,
chicken pox

4.  Sharp injuries
 Blood and body fluid exposure
 Deficiency in PEP
 Deficiency in PPE
 Care of HCWs dealing with patients under
isolation
 Radiation safety
 Infrastructural safety

5.  Globally a serious problem
 6 to 8 L in US, 6 L in Germany
 Indian data ?
 3 HCW/ 10,000
 3.5 million HCWs
 115 L estimated injuries
Fortis Jan 2010 5

8. Job categories injured
Others Doctors
16% 10%
Housekeeper
19%
Nurses
55%

9. Data A Data B Total data
Yes 83 (49.1) 254 (51) 337 (55)
No 66 (39) 182 (48) 248 (41)
Unknown 14 (8.2) 0 14 (2.3)
N-A 6 (3.5) 0 6 (1)

10.  Accountability towards nurses and
technicians
 Budgeting expenses - HIPAC
 Change attitude of ‘super’ HCWs
◦ Waste disposal
◦ Appropriate handing over of sharps
◦ Sharp disposal units
◦ Personal protection equipment
◦ Educate and re educate

11.  Education of nurses, doctors and technicians
 Providing sharp disposal in the bedside
 Cheaper sharp disposals
 Surveillance of waste disposal
 Interventions
 Use of safety device
 Making sharp injury reporting more friendly

12.  What’s that?

13. correct segregation wrong segregation
20%
80%

14. 97.48
100
90
78.66
80
Percentage of compliance
70 63.26
60
50 42.3
40
30 24.09
20
10
0
surgeon anesthetist technician nurse House keeping staff
Profession

15. Surgeon Anesthetist
Technician Nurse
Housekeeping staff
19%
33%
7%
26%
15%

16. Data A Data B Total data
Safety Design (SEMD)
34 (20.1) 19 (3.9) 53 (8)
Not a Safety Design
114 (67.5) 467 (95.3) 581 (88.2)
Unknown
11(6.5) 4 (0.8) 15 (2.3)
N-A
10 (5.9) 0 10 (1.5)

17. Only from hospital A and B

18.  Prevalence of Hep B among the general
population ranges from 2 to 8%,
 Among healthcare workers seroprevalence is
two to four times higher than that of the
general population.
 NY compensation board “compensable
occupational hazard.”
 1% HCWs HBsAg – positive

19.  In the US, 57 HIV sero conversion in 2001
alone
 2000/ yr infected Hep C
 400 contract hepatitis B.
 More than 20 infections
 Exposure to HIV, HBV or HCV also has
implications on personal relationships, future
employment, and even insurance coverage.

20. Hep B vaccination
• Nursing 98%
• Doctors: 75%
• Technicians: 98%
• Housekeeping- 60%

21. A1 A2 B1 B2 C1 C2 D1 D2 E1 E2
Yes, partially, 1 or
2 doses 48 24 3 27 5 17 2 16 5 28
No 62 31 12 17 1 7 0 5 3 7
N-A 0 1 0 0 0 0
10
Total234 118 48 146 14 63 2 53 24 9 234

22. • Masks, caps, gowns, gloves – available mostly
• N95 masks, disposable gowns, goggles – not
common
• Even if provided,
compliance to use low

25.  Uncommon
 Reprimanded and location of work changed
 Asked to quit
 Looked down upon
 Avoiding PEP
 Approx 15k per HCW

26. Laboratory testing Costs
HIV(Elisa) Rs.300 x 5 =
Immediately after injury,6 weeks,3 months,6 1500
months & 12 months later
HIV(Western Blot) Rs. 2000
HBV(Elisa) Rs. 450
HCV(Elisa) Rs. 500
PCR test Rs. 2000
HBSAg (antibody testing) Rs. 750
HCV(antibody testing) Rs. 750
26

27.  Miserable
 No statutory requirement
 Unknown in many un-accredited hospitals
 Under reporting – prevalent
 Encouraged by administration
 No insurance cover for these shots
 Even decent facilities shun away when it
comes to interferons

28.  Farrell GA, Shafiei T, Chan SP. Patient and
visitor assault on nurses and midwives: An
exploratory study of employer 'protective'
factors. Int J Ment Health Nurs. 2012 Dec 20.

30.  Nurses are most
compliant!
 Housekeeping staff are
next
 Doctors are very poor
icons
 They think they know,
but neither they think
nor they know.
 Too proud to attend
sessions run by nurses

31.  Healthcare worker safety is in jeopardy
 Every healthcare worker to prioritize issues
regarding safety
 Set targets
 Strive working ambience safe
Fortis Jan 2010 31