Blood and body fluid exposures in 2020: Results from a survey of RCN members

Summary

Sharps injuries (SI) and mucocutaneous exposures (MCE), collectively termed “blood and body fluid exposure” (BBFE), pose a diseases-transmission risk and a psychological stress to health care workers and a responsibility on employers to prevent their occurrence. However, little UK national data is published on their incidence. 

The Royal College of Nursing (RCN) present results from a survey of their members.

Content

7,571 members responded to the survey (approximately 1.7% of RCN members). Results found:

• Exposure rates – 96% of members have a BBFE risk; 63% had SI in their career; 15% had SI and 21% had MCE in last year. Incidence of SI and MCE were 20.3 and 56.9/100 FTE respectively.
• Last SI – 29% before procedure; 26% during procedure; 21% during disposal; 11% improper disposal; 8% after device activation; 5% during device activation. 49% were with sterile needle. 97% encouraged bleeding, rinsed under running water; 35% were using a safer sharp.
• Reporting SI – 71% officially reported SI; 12% reported it to manager/colleague; 17% did not report their SI to anyone. Top 3 reasons: thought injury low risk (39%); told manager/colleague instead (19%); no benefit reporting (15%)
• Follow-up – 48% staff attended follow-up meeting. 40% did not receive medical advice. Contributing factors to SI: fatigue 27%; lack of safety equipment 25%; lack of space 21%; poor lighting 12%; staffing levels 12%; lack of training 9%; wearing PPE 9%.
• Staff opinions – 82% perceived disease-risk from SI as Nil to Low, 85% have Nil to Little fear of SI. 7% felt poorly supported by employer; 8% felt employer did not offer safe, reliable devices. 15% said access to safer sharps was nil to poor. 23% did not always have nearby sharps bin.
• Training – 25% had no training on safe sharps use. 21% had no education on reporting SI. 38% had no training on all the safer sharps they used.
• The recalled incidence of SI was 7x that of international incidence.
• The recalled incidence of MCE was 47x that of 2018 U.S. incidence. Compared to RCN 2008 Survey, members in 2020:
• had significantly more SI in career and in last 12mths (fewer members had >1 SI)
• reported their SI less frequently. Top reason was identical (thought injury low risk)
• attended follow-up meeting and received advice on BBP disease risk less frequently
• thought BBP disease risk lower, feared SI less, and felt less supported by employer
• received more training in safe sharps use and greater access to safer sharps; but some still had nil to poor access to safer sharps and no training in how to use safer sharps.