170. Reduction in Bloodborne Pathogen Splash Exposures After Implementation of Universal Masking and Eye Protection for COVID-19

Background While splashes to the eyes, nose and mouth can often be prevented through appropriate personal protective equipment (PPE) use, they continue to occur frequently when PPE is not used consistently. Due to the COVID-19 pandemic, we implemented universal masking and eye protection for all healthcare personnel (HCP) performing direct patient care and observed a subsequent decline in bloodborne pathogen (BBP) splash exposures. Methods Our healthcare system, employing >12,000 healthcare personnel (HCP), implemented universal masking in April 2020 and eye protection in June 2020. We required HCP to mask at all times, and use a face shield, safety glasses or goggles when providing direct patient care. Occupational Safety tracked all BBP exposures due to splashes to the eyes, nose, mouth and/or face, and compared exposures during 2020 to those in 2019. We estimated costs, including patient and HCP testing, related to splash exposures, as well as the additional cost of PPE incurred. Results In 2019, HCP reported 90 splashes, of which 57 (63%) were to the eyes. In 2020, splashes decreased by 54% to 47 (36 [77%] to eyes). In both years, nurses were the most commonly affected HCP type (62% and 72%, respectively, of all exposures). Physicians (including residents) had the greatest decrease in 2020 (10 vs. 1 splash exposures [90%]), while nurses had a 39% decrease (56 vs. 34 exposures). Nearly all of the most common scenarios leading to splash exposures declined in 2020 (Table). We estimated the cost of each BBP exposure as &2,940; this equates to a savings of &123,228. During 2020, we purchased 65,650 face shields, safety glasses and goggles (compared to 5303 similar items in 2019), for an additional cost of &238,440. Specific activities identified as leading to bloodborne pathogen splash exposures, 2019 vs. 2020. Conclusion We observed a significant decline in splash-related BBP exposures after implementing universal masking and eye protection for the COVID-19 pandemic. While cost savings were not observed, we were unable to incorporate the avoided pain and emotional trauma for the patient, exposed HCP, and coworkers. This unintended but positive consequence of the COVID-19 pandemic exemplifies the need for broader use of PPE, particularly masks and eyewear, for all patient care scenarios where splashes may occur. Disclosures All Authors: No reported disclosures

Experience with Bloodborne Pathogen Exposures Among Operation Room Nurses in Korea: A Qualitative Study

Background: Operation room (OR) nurses are at a high risk for bloodborne pathogen (BBP) exposures because they are constantly in contact with blood and body fluid (BBF) through surgical sites, and they frequently use sharp surgical instruments and sutures during surgeries. We explored occupational experiences with BBP exposures among OR nurses in South Korea. Methods: With an institutional review board’s approval, this qualitative research was performed with 12 OR nurses who had worked for >3 months and had experienced BBP exposures. Based on the main research question “How is the experience of BBP exposure among OR nurses?” the semistructured questions for in-depth interview were prepared. Narrative data were collected through 1-hour individual interviews from June to September 2020 and were analyzed using a thematical analysis method. Results: The average age of the participants was 34.4 years with an average 9.75 years of clinical experience. The main theme extracted was “The nurses are alerted to their safety after experiencing the aftereffects and emotional trauma from BBP exposures,” with 4 subthemes and 14 concepts. The first subtheme, “OR nurses risking exposure to BBF,” included (1) hurried doctors and hasty nurses; (2) sharp surgical instruments everywhere; (3) deprioritized self-protection due to ongoing surgery; (4) inattentive to BBF risk; and (5) uncomfortable, foggy goggles and receded safety devices. The second subtheme, “BBP exposures occurred in a flash,” included (1) sharp injury occurred in a split second; (2) temporarily treat sharp wounds while hiding frightened feelings; and (3) OR nurses concentrated on surgery by suppressing anxiety and sharp wounds. The third subtheme, “Burdened time that could be overwhelmed alone,” included (1) BBP exposures moments that I wish to reverse; (2) anger over dangerous environments and the turmoil of anxiety; (3) exhausted body and facial discoloration due to taking postexposure prophylaxis; and (4) exposure to BBP that I want to hide from family and friends. The fourth subtheme, “Voice for everyone’s safety,” included (1) establishing a safety culture, which requires everyone’s efforts, and (2) necessity of practical resources for decreasing BBP exposures. Conclusions: The participating OR nurses felt that they were working with a high risk to BBF exposures and called for institutional interventions to reduce the risks, including surgeons’ attentive collaboration. Korean hospitals should make greater efforts to establish safety culture in ORs and to provide repeated, tailored education to prevent BBF exposures. They should also supply high-quality protective equipment and safety-engineered devices for OR nurses.Funding: NoDisclosures: None

PENULARAN PENYAKIT TERHADAP PERAWAT AKIBAT KECELAKAAN KERJA

Rumah sakit merupakan suatu tempat yang berisiko terjadinya cedera. Hal ini disebabkan karena berbagai kegiatan dirumah sakit sangat berhubungan dengan penyakit-penyakit berbahaya, prosedur kritis dengan alat atau benda tajam. WHO (1995) memperkirakan 10% petugas kesehatan mengalami injury benda tajam. Kecelakaan dalam bekerja dapat diakibatkan oleh kelalaian pekerja, bekerja melebihi batas kemampuan atau ergonomis yang buruk dalam bekerja. Dalam bidang kesehatan, kelalaian dalam bekerja bisa terjadi apa saja. Salah satunya adalah tertusuk jarum atau benda tajam di rumah sakit. Jarum suntik dan alat medis yang tajam merupakan alat medis yang bersentuhan langsung dengan jaringan tubuh dan darah pasien. Tenaga kesehatan yang lalai dapat tertular melalui jarum suntik yang terkontaminasi cairan tubuh pasien yang terinfeksi. Petugas kesehatan berisiko terpapar darah dan cairan tubuh yang terinfeksi (bloodborne pathogen) yang dapat menimbulkan infeksi HBV (Hepatitis B Virus), HCV (Hepatitis C Virus) dan HIV (Human Immunodeficiency Virus) melalui berbagai cara, salah satunya melalui luka tusuk jarum atau yang dikenal dengan istilah Needle Stick Injury atau NSI (Hermana, 2006). Luka atau cidera akibat tertusuk jarum atau benda tajam lainnya merupakan hal yang sangat perlu diperhatikan. Apabila seorang petugas kesehatan tanpa sengaja terluka akibat tertusuk jarum yang sudah terkontaminasi cairan tubuh orang yang sakit maka beresiko terjadi penularan sekurang-kurangnya 20 patogen potensial. Dua patogen yang sangat berbahaya adalah Hepatitis B (HBV) dan Human Immunodefidiensy Virus (HIV). Hepatitis B (HBV) adalah infeksi pada hati atau liver. Penyakit ini sering ditemui dan penyebaran nya 100 kali lebih cepat dari HIV dan dapat menyebabkan kematian.

Scenario-Based, Interactive Infection Prevention and Control and Bloodborne Pathogen Education

Background: Infection prevention and control (IPAC) and bloodborne pathogen (BBP) education are required for all healthcare workers at least annually by the Occupational Safety and Health Administration and The Joint Commission. An inventory in 2016 at a large health system with >60,000 employees identified 46 different training modules used to fulfill this regulatory mandate. Objective: Using quality improvement tools and management, we sought to reduce duplication of effort, to enhance education, and to improve employee engagement. Methods: A multidisciplinary team that included IPAC, physician, nursing, educational designn and occupational safety was formed. The team reviewed regulatory standards, cross checked site-specific practices, and identified gaps in the current training structure. The goal was to create a module with multiple pathways that tailored regulatory content and delivery to the employee’s job responsibilities (Figs. 1 and 2). Results: The 46 individual training modules were replaced with 1 module that averaged 24.46 minutes to complete. Branching was incorporated that customized education to the employee’s role. The employee completion rate was 99% (n = 61,456). The scenario-based interactive approach engaged learners by challenging them to respond to real-life activities tailored to their level of risk. Most responders (87.4%) rated the learning activity as “good” or “excellent,” and 92.4% of responders agreed or strongly agreed that the activities in the course aided their learning. Conclusions: We leveraged adult learning principles and industry-proven instructional design activities to deliver interactive and relevant infection control training that met regulatory requirements and engaged employees through action-driven tasks. In 2018, the work group created fast paths for employees who had previously completed this module whereby they could revisit the original content and/or focus only on updates and targeted areas of interest. A pathway for laboratory workers involved in specimen handling and processing is planned next.Funding: NoneDisclosures: None

Biological hazards associated with microblading and evaluation of its infection control procedures and wound care

Background: Microblading is emerging as one of the fastest growing beauty trends, appearing in tattoo shops, hair salons, and even in private home studios. The procedure uses a tool with single blade to penetrate the upper layer of the dermis and deposit semi-permanent pigments to mimic hair-like strokes. This study compares the risks of microblading to those in tattooing and analyzes the similarities in order to determine the biological hazards associated with microblading. Currently, there is a lack of knowledge on microblading practices specifically, and the purpose of this study was to evaluate the level of infection control knowledge and practices in place, as well as the attitudes towards regulations in British Columbia. Method: Self-administered electronic surveys created on Google Forms were distributed to microblading establishments in B.C. through email. The survey assessed the knowledge, attitudes, and practices of microbladers in B.C. through a series of questions regarding demographics, infection control, and wound care. A list of 130 microblading establishments were contacted and asked to participate in the online survey. Results: Among the 130 microblading establishments contacted, 41 agreed to participate. The majority of microbladers had a college certificate or diploma, 1-5 years of experience, and have taken a bloodborne pathogen course. Over 31% of the participants operated both in microblading as well as permanent makeup, 27% operated solely as microbladers, and 22% of the participants had both microblading and spa operations. The most prevalent form of training was a microblading course that lasted a week or longer, and 78% of the participants felt that there should be more training required for becoming a microblader. There was no association between the years of experience and level of pathogen knowledge according to the Chi square test (p=0.78), and no association between the attitude towards regulations regarding microblading and the number of infection control measures in place (p=0.38). However, there was a statistically significant association between taking a bloodborne pathogen course and knowing the correct bloodborne pathogens of concern. Conclusion: Microbladers in British Columbia are fairly new and thus only have 1-5 years of experience, and minimal training of week-long microblading courses. A majority of them feel that more training or certification should be required and that there should be more regulations regarding microblading. The results indicated that education and training provide the most knowledge rather than years of experience. This suggests that health authorities should focus on providing more access to education for microblading, such as offering a TattooSafe program for tattooing microblading, and permanent makeup, similar to FoodSafe, and developing more material to inform microblading fact sheets.