BBP safety policies and practices in home care and hospice agencies in Maryland

Objectives. A telephone interview survey of Maryland home health care and hospice agencies was conducted to examine bloodborne pathogen (BBP) and sharps related exposure and safety practices. Through assessment of BBP risk exposure and safety practices, an education intervention is planned to help agencies and employees decrease risk exposure and improve safety practices. Methods. All Medicare-certified home health and hospice agencies in Maryland were contacted by telephone. The survey assessed employee risk plans, staff involvement, extent of BBP training, sharps disposal management, risk exposure, reported sharps and BBP exposure, and administrative confidence in staff use of personal protective equipment (PPE). Results. 30 interviews were completed (47.6% response rate) with administrative staff. Twelve agencies reported 18 sharps related incidents within the past 12 months with three of these incidents resulting in practice/procedure changes. Only 23.3% of the agencies reported extensive staff involvement in evaluation of their risk exposure plan. Responsibility for conducting education was delegated to people with no particular expertise in BBP safety. 73.3% of patient generated sharps are discarded in impermeable containers in household garbage. Administrative confidence (scale 0 to 10) in staff use of PPE varied from 9.4 (gloves) to 6.0 (goggles). Conclusions. This survey demonstrated BBP risk exposure by reported sharps injuries is low in home care and hospice organizations. The infrequent exposures are regarded as unique occurrences without subsequent analysis nor changes in practice. Agencies appear to need clearer direction in implementing blood borne pathogen programs in order to comply with the OSHA standard.