Temporal Association Between Implementation of Universal Precautions and a Sustained, Progressive Decrease in Percutaneous Exposures to Blood

TLDR

The study evaluated whether implementing universal precautions was temporally linked to a reduction in reported parenteral blood exposures. Data from 1985–1991 at the NIH Clinical Center were analyzed, including assessment of whether universal precautions combined with zidovudine postexposure prophylaxis reduced the time to reporting occupational exposures. Results showed a sustained, significant decline in percutaneous injuries temporally associated with universal precautions, a finding that remained significant across different denominators, with no improvement in reporting speed.

Abstract

To evaluate whether implementation of universal precautions was temporally associated with a decrease in reported parenteral exposures to blood, we analyzed data on self-reported parenteral injuries that were prospectively collected at the Clinical Center, National Institutes of Health (Bethesda, MD), from 1985 through 1991. We also assessed whether implementation of universal precautions, in concert with initiation of a program of postexposure chemoprophylaxis with zidovudine, was associated with decreased time to reporting of occupational exposures. Our data, possibly confounded by the occurrence of an occupational infection due to human immunodeficiency virus infection in 1988, nonetheless demonstrate a temporal association between a progressive, significant decrease in percutaneous injuries and the implementation of universal precautions that has been sustained through subsequent years. The analysis remains significant, regardless of the surrogate denominator chosen for analysis. No trend toward more rapid reporting of exposures was identified. Implementation of universal precautions appears to have contributed to decreased parenteral injuries in our hospital but did not affect reporting efficiency.