Staff infections a concern

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Many caregivers put themselves at risk for workplace injuries, or worse. Personal infection control measures are helping.

Despite a keen emphasis on infection control in the resident population, many long-term care employees are failing to give their own health equal consideration.

It's an irony that has some health officials increasingly concerned – both for the health of residents and workers.

The reasons for the oversight are as varied as the infection risks themselves. In some cases, inadequate training or a provider's failure to implement products and protocols that can slash infection risks are to be blamed. In other cases, the fault is with employee ambivalence or complacency.

"Whatever the reason behind it, it's a problem," said Adrian Camara, infection control nurse for Rhode Island Veterans Home in Bristol. "Healthcare workers need to recognize that their actions not only impact residents, but also themselves, their family members at home and others they come in contact with. If they aren't protecting themselves and they become infected as a result, that's a problem for everyone."

When looking at injury and illness statistics for nursing home employees, the need for greater diligence becomes clear. Nurses' injury rates are second only to truck drivers – primarily due to back problems. But the stress and strains of the job also lead to thousands of work-acquired infections.

"There are many potential infection risks for [long-term care] employees. That's why it is critical for facilities to not only have an exposure control plan in place to address these risks and minimize them, but also for them to be implementing the plan appropriately," said Dionne Williams, a senior industrial hygienist with OSHA.

Identifying key risks

Observers generally agreed that several infection risks pose the greatest threat to long-term care employees: 1) exposure to blood and body fluids, 2) influenza and 3) sharps injuries. 

Blood and body fluids may be the greatest threat.

"The risk is ever-present. Because of the incontinent resident population, nursing home employees are cleaning up a large number of spills of bodily fluids. If they don't use personal protective equipment appropriately, the risk for exposure can be very real," said Libby Chinnes, president of IC Solutions in Mt. Pleasant, SC.

Williams agreed, adding that failure to wear facemasks and other protective equipment when there's a potential for splashes can be especially risky.

"If a procedure is being performed on an uncooperative resident, such as drawing blood, it's important that employees properly protect themselves. Again, these types of situations should be outlined in the facility's exposure plan."

Nurses are at greatest immediate risk when it comes to sharps injuries. But they aren't alone.

Inappropriate sharps disposal can pose a threat to virtually all staffers, including nursing assistants, therapists and housekeeping and laundry personnel. Stray needles or sharps devices may be found in bedding, linens or undesignated waste receptacles.

The risk of needlesticks has diminished because of safety engineered sharps devices, but there are still providers out there who haven't fully adopted these products. And workers are failing to use the safety devices properly.

Various sources estimate the number of accidental needlesticks at 600,000 to 800,000 annually – or

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