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Biomedical subjects

M M Jackson

Publications and source records attributed to M M Jackson.

At least 19 recordsLinked to original sources
PubMed1995

Development of a numeric Health Care Worker Risk-Assessment Scale to evaluate potential for blood-borne pathogen exposures.

BACKGROUND: An attempt to develop a Health Care Worker Risk Assessment Scale to evaluate potential for exposure to blood-borne pathogens was made in late 1989 through 1990. The research questions were as follows: (1) Can a scale be developed to assign weights to variables that influence health care workers' risk of exposure to blood-borne pathogens? (2) If so, what variables would be included? METHODS: A five-round Delphi technique was used with 26 panel members from 15 U.S. states and the United Kingdom who were recognized experts in strategies to reduce health care workers' risk of exposure to blood-borne pathogens. The scale included four elements, each scored up to 40 points. Elements were as follows: (1) potential route of exposure, (2) experience of health care worker and cooperation of patient, (3) prevalence of blood-borne pathogens, and (4) difficulty in managing the situation. A minimum score of 20 indicated an extremely low-risk situation; a maximum score of 160 indicated an extremely high-risk situation. RESULTS: Consensus was achieved among the panel members in identifying the elements that contributed to risk for exposure to blood-borne pathogens and in applying the scale to carefully worded vignettes. This required several modifications of both the scale and the vignettes to ensure consistent interpretation of the terms used. In all vignette situations, the risk-abatement strategy was specific to the situation depicted in the vignette and not to the task itself; the value of a numeric scale is thus questionable. CONCLUSIONS: Even with the participation of 26 expert panelists, we were unable to develop a numeric scale to objectively quantify risk in such a way that risk-reduction strategies could be based on the scale rather than on the specific risk elements in a situation. Instead of attempting to use a scale such as this to quantify risk objectively, educators or clinicians may be better advised to teach health care workers the four scale elements so that health care workers can subjectively use these elements to evaluate and modify their own risk situations.

Blood-Borne Pathogens↗
PubMed1992

Intensive surveillance for infections in a three-year study of nursing home patients.

The authors report the results of a 3-year (August 1984-May 1987) prospective study of intensive surveillance for nursing home-associated infections in 666 patients in a 300-bed nursing home in San Diego, California. Ninety-three percent (666 of 714) of the eligible subjects enrolled; 75% were women. The mean age of the subjects was 81.6 years. Lengths of stay ranged from 1 day to 1,025 days, with a mean of 166 days; the cumulative length of stay for all subjects was 110,746 days (303 years). Operational definitions that were heavily dependent on evaluation of clinical signs and symptoms were used by nurse practitioners in weekly or biweekly assessments of all patients to identify infections. The overall incidence of nursing home-associated infection was 7.1 infections/1,000 patient-days. Many of the infections would not have been recognized by persons less skilled than nurse practitioners. Among the 788 nursing home-associated infections identified, 362 (47%) were in the respiratory tract (286 lower respiratory and 76 upper respiratory); 200 (25%) were associated with skin and subcutaneous and mucous membranes; 140 (18%) were symptomatic urinary tract infections; 13 (2%) were bacteremia; and 73 (9%) were other infections.

Adult↗
PubMed1992

Infection prevention and control.

Nurses are clearly at risk for exposure to HIV through blood and body fluids, and they frequently use needles and sharp objects. In addition, critical care patients are at high risk for nosocomial infections due to other etiologic agents. This article addresses reducing the risk of infection for both nurses and patients using a variety of strategies.

AIDS-Related Opportunistic Infections↗
PubMed1992

The facts about methicillin-resistant Staphylococcus aureus.

1. Staphylococcus aureus is a gram-positive organism that can be cultured from the anterior nares of 30% to 40% of the general population. S aureus causes about 10% of all nosocomial infections, and is the leading cause of surgical wound infections. 2. Several factors can influence the recovery of MRSA from specimens, including mixed cultures in the person, a person who is an intermittent carrier, and a culture that is taken or transported incorrectly. 3. Two approaches can be used to reduce the risk of cross-transmission of organisms among patients and health-care workers: a generic infection precautions strategy for all patients, and identifying patients infected or colonized with MRSA and treating them differently than other patients.

Bacteriological Techniques↗
PubMed1992

The OSHA bloodborne pathogens standard.

1. The OSHA Standard is intended to reduce the risks to health-care workers of exposure to bloodborne pathogens. Because the patient's HIV or HBV status is often unknown, the Standard focuses on reducing the risks of exposure to blood and those body fluids to which universal precautions apply. 2. Engineering and work practice controls to reduce the risk of exposure include techniques for handling, cleaning, and decontaminating instruments with minimal hand contact; using containers to pass surgical instruments; wearing puncture-resistant gloves; and using forceps or clamps to remove scalpel blades from knife handles. 3. Employers must provide personal protective equipment at no cost. This equipment must prevent blood or other potentially hazardous materials from passing through or reaching employee's work or street clothes, skin, eyes, mouth, or other mucous membranes during normal conditions for the duration of time used.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Blood exposure and puncture risks for OR personnel.

1. Although all health-care workers are at risk for exposure to bloodborne organisms, OR personnel are the most intensively exposed to blood. Exposures to blood were noted in up to half of the procedures observed. 2. Risk-reduction strategies include using two pairs of puncture-resistant gloves and face protection for all procedures; wearing impermeable gowns during procedures with heavy blood loss; using surgical instruments and techniques that reduce the chance of percutaneous contacts; and adopting protocols for handling sharps, counting sponges, and cleaning the operating room. 3. Better and more comfortable personal protective equipment is needed. Manufacturers should develop risk-protective and cost-effective barriers that reduce risks for patients of surgical wound infections while reducing the risks for health-care workers of exposures to blood and bloodborne pathogens.

Acquired Immunodeficiency Syndrome↗
PubMed1991

A survey of nurses' knowledge, opinions, and reported uses of the Body Substance Isolation system.

The Body Substance Isolation (BSI) system was implemented at the University of California San Diego Medical Center in May 1987. About 2 years later, an evaluation was done of the long-term effects of BSI education and training on the knowledge, attitudes, and reported behaviors of nursing personnel. In June 1989, a questionnaire was sent to 600 nursing personnel, including all 100 nurses in the 20-bed surgical intensive care unit, all 66 charge nurses, and a random sample (434) of the remaining nursing staff (about 1000). Results from the 190 respondents (a response rate of 32%) indicated an understanding of the two purposes of BSI: (1) to reduce nosocomial infection risks to patients and (2) to reduce health care workers' risks of acquiring infections from patients. Over half of the respondents reported handling more than 11 needles per day and nearly half reported recapping contaminated needles two-handed "sometimes or often." Only 54% of the respondents reported they had received hepatitis B vaccine. Although more than two-thirds of the respondents had worked at the University of California San Diego Medical Center during the entire BSI system training, implementation, and follow-up period, there is still room for improvement in knowledge and use of the system, including issues related to the safe handling of sharps.

California↗
PubMed1991

What if the health-care worker is the one infected with HIV or HBV?

1. The recent limited number of reports of HBV transmission from HCWs to patients may reflect the adoption of universal precautions and increased use of HBV vaccine. 2. Since nurses rarely perform the types of exposure-prone procedures described by the CDC, a nurse would not likely be associated with transmission of HIV to a patient, and HBV transmission most likely would not occur. 3. Agencies employing HCWs who perform exposure-prone procedures should establish expert review panels.

American Nurses' Association↗
PubMed1991

Hepatitis A through E--current and future trends.

1. Five viruses have now been identified that each cause a different type of hepatitis, A through E. 2. The majority of people with viral hepatitis recover uneventfully; however, in some persons with HBV and HCV, a chronic carrier state develops that may persist for a lifetime. 3. Operating room nurses are at greatest risk for HBV if they are not immunized; they can prevent HBV by obtaining hepatitis B vaccine and adhering to standard OR practices plus using eye protection.

Hepatitis, Viral, Human↗