Perceptions that influence occupational exposure reporting

AORN Journal,  August, 2003  by Sonya Osborne

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Of the 227 perioperative nurses who responded to the questionnaire, 27% acknowledged incurring a percutaneous occupational exposure, and 5% acknowledged incurring a mucocutaneous exposure in the past 12 months (Figure 2). Although intention to report both percutaneous exposures and mucocutaneous exposures was high (92% and 87%, respectively), the mean compliance rates for actually reporting exposures incurred was considerably lower (Figure 3). Additionally, when conditions were added, a small number of respondents were identified who would only report percutaneous or mucocutaneous exposures under certain conditions, for example if they considered the patient to be high risk or the exposure to be serious (Figure 4).

Contingency tables and chi square analysis were used to determine whether a relationship existed between demographic variables and compliance with occupational exposure reporting. There was no significant difference in reporting either percutaneous or mucocutaneous exposures between genders, nurse classifications, education, years of postregistration experience, or years of scrub nurse experience. Compliance with mucocutaneous exposure reporting was significantly lower for nurses working in smaller, private facilities and those working in facilities with fewer ORs (Table 2).

Significant low to moderate correlations were found between perceptions of risk of acquiring a bloodborne infection and compliance with occupational exposure reporting. This was particularly true when respondents were asked about the high chance of acquiring hepatitis B or C and the likelihood of acquiring hepatitis B or C if an occupational exposure occurred. A significant low correlation was found between the perception of severity of problems following disease transmission lasting a long time and reporting a mucocutaneous exposure. A significant low correlation also was found between reporting an occupational exposure and the perception of benefits of reporting to prevent future problems (Table 3). The most consistently significant correlations were found between reporting occupational exposures and the perception of barriers, particularly with reporting mucocutaneous exposures. Significant low to moderate correlations were found between reporting exposures and the time consuming nature of reporting, embarrassment of reporting, paperwork involved, and inconvenience involved.

DISCUSSION

Previous studies have used varying methods to analyze data on compliance with occupational exposure reporting. Consequently, there is little agreement in the literature on actual compliance rates. One fact that pervades previous studies and is supported by this study is that compliance with occupational exposure reporting is less than 100%. An additional finding of this study is the significance of the perception of barriers to occupational exposure reporting among this high-risk group.

Although this study revealed high mean compliance rates with intention to report occupational exposures, the mean compliance rate for actually reporting exposures incurred was considerably lower. This low rate of actual reporting is cause for concern. Without accurate data on the incidence of occupational exposures, the incidence of exposures may be inaccurately perceived as low and, thus, not treated as a priority in the development of strategic infection control plans. (33) It also must be reiterated here that previous research comparing self-report data and observed data questions the reliability of self-report data; (15) thus, the self reported data here may be an overestimation of actual reporting in practice.