This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A Prospective Study of Physicians on a Medical Service

Edward S. Wong, MD; Jennifer L. Stotka, MD; Vernon M. Chinchilli, PhD; Denise S. Williams, MT; C. Geri Stuart, MT; Sheldon M. Markowitz, MD

JAMA. 1991;265(9):1123-1128.

Abstract
Using a daily questionnaire, we prospectively studied 277 physicians from two hospital medical services for incidents of exposure to blood and body fluids and barrier use before and after the implementation of universal precautions. We found that implementation significantly increased the frequency of barrier use during exposure incidents from 54% before implementation to 73% after implementation of universal precautions. Implementation led to a decrease in the number of exposure incidents that resulted in direct contact with blood and body fluids (actual exposures), from 5.07 to 2.66 exposures per physician per patient care month, and to an increase in averted exposures in which direct contact was prevented by the use of barrier devices, from 3.41 exposures per patient care month before implementation to 5.90 exposures per patient care month after implementation. Implementation affected neither the types of body fluid or procedures involved nor the overall rate of exposure incidents (8.5 per patient care month) but, through an increase in barrier use, it did prevent direct contact with blood and body fluids and thus converted what would have been an actual exposure into an averted one. We conclude that universal precautions were effective in reducing the risk of occupational exposures among physicians on a medical service.

(JAMA. 1991;265:1123-1128)

Author Affiliations
From the Hospital Epidemiology Unit (Dr Wong and Ms Stuart) and the Infectious Diseases Section, Medical Service, Hunter Holmes McGuire Department of Veterans Affairs Medical Center (Drs Wong, Stotka, and Markowitz and Mss Williams and Stuart), and the Medical College of Virginia, Virginia Commonwealth University (Dr Chinchilli), Richmond.

Footnotes
Presented in part at the National Meeting of the American Federation for Clinical Research, Washington, DC, May 5, 1989.

Reprint requests to Infectious Diseases Section (111-C), Hunter Holmes McGuire Department of Veterans Affairs Medical Center, 1201 Broad Rock Blvd, Richmond, VA 23249 (Dr Wong).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Occupational Exposure to Potentially Infectious Biological Material in a Dental Teaching Environment
Machado-Carvalhais et al.
J Dent Educ 2008;72:1201-1208.
ABSTRACT | FULL TEXT  

Relative Effectiveness of Worker Safety and Health Training Methods
Burke et al.
AJPH 2006;96:315-324.
ABSTRACT | FULL TEXT  

Universal precautions: A review of knowledge, compliance and strategies to improve practice
Gammon and Gould
Journal of Research in Nursing 2005;10:529-547.
ABSTRACT  

Occupational Human Immunodeficiency Virus Exposure Among Residents and Medical Students: An Analysis of 5-Year Follow-up Data
Radecki et al.
Arch Intern Med 2000;160:3107-3111.
ABSTRACT | FULL TEXT  

Risk and Management of Blood-Borne Infections in Health Care Workers
Beltrami et al.
Clin. Microbiol. Rev. 2000;13:385-407.
ABSTRACT | FULL TEXT  

Cost-effectiveness of Chemoprophylaxis After Occupational Exposure to HIV
Pinkerton et al.
Arch Intern Med 1997;157:1972-1980.
ABSTRACT  

Viral Hepatitis in Health Care Personnel at The Johns Hopkins Hospital: The Seroprevalence of and Risk Factors for Hepatitis B Virus and Hepatitis C Virus Infection
Thomas et al.
Arch Intern Med 1993;153:1705-1712.
ABSTRACT  

The Risk of Occupational Human Immunodeficiency Virus Infection in Health Care Workers: Italian Multicenter Study
Ippolito et al.
Arch Intern Med 1993;153:1451-1458.
ABSTRACT  

The Risk of Exposure of Third-Year Surgical Clerks to Human Immunodeficiency Virus in the Operating Room
Vergilio et al.
Arch Surg 1993;128:36-39.
ABSTRACT  

Effect of Educational Program on Compliance With Glove Use in a Pediatric Emergency Department
Friedland et al.
Arch Pediatr Adolesc Med 1992;146:1355-1358.
ABSTRACT  

Impact of Human Immunodeficiency Virus on Medical and Surgical Residents
Hoffman-Terry et al.
Arch Intern Med 1992;152:1788-1796.
ABSTRACT  

Risk of Needlesticks and Occupational Exposures Among Residents and Medical Students
O'Neill et al.
Arch Intern Med 1992;152:1451-1456.
ABSTRACT  

HIV-Infected Surgeons: Behringer v Medical Center
Orentlicher
JAMA 1991;266:1134-1137.
 

Do Universal Precautions Reduce Needlestick Injuries?
Jagger and Pearson
JAMA 1991;266:359-360.
ABSTRACT  

CDC Guidelines on HIV or HBV-Positive Health Care Professionals Performing Exposure-Prone Invasive Procedures
Gostin
J Law Med Ethics 1991;19:140-143.