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Identification of Risk Factors For Body Substance Exposures

Identification of Risk Factors For Body Substance Exposures. Data at a Multi-Site Hospital System. Copyright 2000 by Elizabeth Aton. Body Substance Exposure Risk Factors. Elizabeth Aton M.S. Victoria Fraser M.D. Washington University School of Medicine (Saint Louis, MO).

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Identification of Risk Factors For Body Substance Exposures

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  1. Identification of Risk Factors For Body Substance Exposures Data at a Multi-Site Hospital System Copyright2000 by Elizabeth Aton

  2. Body Substance Exposure Risk Factors • Elizabeth Aton M.S. • Victoria Fraser M.D. • Washington University School of Medicine (Saint Louis, MO)

  3. Four In-Patient Sites

  4. Barnes-Jewish Hospital • Teaching hospital • U.S. Top Ten • Urban setting

  5. Christian Hospitals • Suburban setting

  6. Missouri Baptist Medical Center • Suburban setting

  7. Boone Hospital Center • Mid-Missouri

  8. Large Hospitals = 4.6 Employees/Licensed Bed (Range 4.3--4.8) • Smaller Hospitals = 4.5 Employees/Licensed Bed (Range 2.2--7.2)

  9. Barnes-Jewish Hospital Occupational Health Database • AIHCE 94, 96, 98, 99

  10. BSE Section of OH Database Expanded in 1996 • Other BJC Sites • “Phase-In” Challenges

  11. BSE Database Caveats • Under-reporting of BSEs by employees • Differing levels of facility with coding and database entry • OHN concerns

  12. Large Hospital Data Set • 1st six calendar quarters of database collection • 1,127 BSEs • Cumulative Quarterly Rate = 6.07 BSEs/100 worker years

  13. BSE Exposure Risk Factors--Unsafe Condition? • 50.9% coded as  1 unsafe condition • Most common (19.1%) unsafe condition was sharp in improper place • 8.2% were agitated patient • 5.3% were equipment failure

  14. BSE Exposure Risk Factors--Unsafe Action? • 80.5% coded as  1 unsafe action • Most common (36.8%) unsafe action was inattention to surroundings or activity • 20.1% were placement of sharp in improper place • 12.2% were failure to use, or use of inappropriate PPE

  15. BSE Exposure AssessmentInterpretations • Larger hospitals in the BJC System may have BSE risks different from smaller hospitals • There is little difference in BSE rates among larger BJC hospitals during this study period

  16. BSE Exposure AssessmentInterpretations • Continuing study of the data is indicated, to assess success of intervention strategies • Impediments to under-reporting must be managed • Impediments to data collection must be managed

  17. BSE Exposure AssessmentNext Actions • Secure OHN collaboration • Database aggregation modifications to be done by consensus • Further stratification of data, for root cause analysis • Adding cost-center productive hours, to create true rate-based indicators

  18. Questions?

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