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Innovation & Growth Initiative: Montgomery County Benchmark
Learn about Abington's Next Century. To access a white paper that compares Abington to the rest of Montgomery County, click here >
Drug Users are a Public Health Risk
Intervenus Drug Users
Many of the high risk groups for hepatitis C are easily identified, due to practices resulting in frequent exposures to blood or risk factors for transmission. Intervenus (IV) drug users represent the largest single risk group. Hepatitis C infection among intravenous drug users occurs at an alarming rate. As with HIV, the sharing of contaminated needles and syringes increases the chance of infection dramatically: incidence of HCV antibody rates among I.V. drug users has surpassed 50 percent in many studies and almost reached 100 percent in others. Within only six months to a year after beginning intravenous drug use, 50-80 percent of drug users test positive for the hepatitis C antibody. I.V. drug users account for about 30-40% of all identified cases, and about 50 percent of all new cases of the disease.
Health-care workers who come in contact with blood are at risk for getting hepatitis C and should be tested. The most common cases of transmission occur in needle-sticks with large hollow-bore needles.
The risk of HCV transmission through a needlestick injury depends on the viral load of the source patient, the first aid administered and the instrument involved, for example a hollow bore needle. All nurses should have access to infection control guidelines that advise about the management of an occupational injury, including clear written instructions on the appropriate action to take in the event of a needlestick injury and other blood or body substance exposure. Nurses are encouraged to report occupational exposures
immediately and all testing procedures and follow-up treatment should be fully documented. Confidentiality should be maintained. In general, if an injury or incident occurs where blood or body substances come into contact with non-intact skin or membranes, the following action should be taken:
• Wash exposed membrane or injury with soap and water (an antiseptic could also be used on the skin)
• If eyes have been exposed, thoroughly rinse the eyes with tap water or saline while open
• If mouth has been exposed, thoroughly rinse the mouth with water and spit out
• Seek medical advice immediately for assessment of the nature of the exposure, the risk of transmission of blood-borne viruses, the need for HIV or HBV post-exposure prophylaxis (PEP) or other testing/management
• If the exposure is significant and the source patient is known, his or her consent for HIV antibody, HCV antibody and HBsAg testing should be sought
Source: Nurses and Hepatitis C (This supplement presents an update on hepatitis C and the National Hepatitis C Testing Policy.) Hepatitis C (HCV) is a significant public health issue
Study Shows Nurses are Exposed to Risks from Blood Exposure During Insertion and Removal of Peripheral IV Catheter
About one in two nurses experience blood exposure, other than from a needlestick, on their skin or in their eyes, nose or mouth at least once a month when inserting a peripheral intravenous (IV) catheter, according to a new study by the International Healthcare Worker Safety Center at the University of Virginia. Exposure to blood carries the risk of infection from pathogens such as human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV) and MRSA.
Healthcare workers place more than 300 million short peripheral intravenous catheters (SPIVCs) every year in the United States alone. The study shows nurses are at risk of exposure to blood pathogens in 128 of 100,000 IV catheter insertions. The more commonly recognized risk of exposure to bloodborne pathogens from a needlestick injury with non-safety catheters is 6.6 per 100,000 devices. The Centers for Disease Control and Prevention (CDC) define at-risk blood exposure as "contact of mucous membrane (MME) or exposed skin (chapped, abraded, or afflicted with dermatitis) with blood, tissue, or other body fluids that are potentially infectious."
Yet, the majority of such exposures go unreported. Of the total mucous membrane exposures (MMEs) sustained by respondents in this study, 69% were not reported. In comparison, the CDC's underreporting rate for sharps injuries is 57%.
Almost nine in 10 of those nurses who did not report the incident said they did not think the exposure was significant enough to report; more than one third said they were too busy, and 9% said they were concerned about others' perceptions.
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