Biomaterial Database

HIV prophylaxis for health care workers. 1997

L S Forst, and B Fletcher

Department of Emergency Medicine, School of Public Health, University of Illinois at Chicago 60612, USA.

The US Public Health Service (PHS) published new recommendations for preventing HIV seroconversion in health care workers suffering needle-stick injuries. In response, health care institutions across the United States are updating their internal protocols to meet the currently accepted standard of care in this area. We found the new guidelines lacking in critical definitions necessary to clarify practical applications in specific cases. We also found the recommendations of when to use one, two, or three drugs for post-exposure prophylaxis confusing. We report our university hospital's experience with needle-stick injuries over the past year. We propose modified guidelines that more finely stratify risk categories, define clinical variables which occur in practice, and simplify the algorithm for case management. The cost of managing our cases according to the modified guidelines are compared with management costs using the PHS guidelines. Potential costs of applying the PHS guidelines in our institution ranged from $68,994-$260,544; according to our modified guidelines, costs would range from $19,199-$54,749. We also present an analysis of the number of injured health care workers who need to be treated to prevent one case of seroconversion in the various risk stratifications.

UI	MeSH Term	Description	Entries
D009784	Occupational Diseases	Diseases caused by factors involved in one's employment.	Diseases, Occupational,Occupational Illnesses,Disease, Occupational,Illnesse, Occupational,Illnesses, Occupational,Occupational Disease,Occupational Illnesse
D006679	HIV Seropositivity	Development of neutralizing antibodies in individuals who have been exposed to the human immunodeficiency virus (HIV/HTLV-III/LAV).	AIDS Seroconversion,AIDS Seropositivity,Anti-HIV Positivity,HIV Antibody Positivity,HIV Seroconversion,HTLV-III Seroconversion,HTLV-III Seropositivity,AIDS Seroconversions,AIDS Seropositivities,Anti HIV Positivity,Anti-HIV Positivities,Antibody Positivities, HIV,Antibody Positivity, HIV,HIV Antibody Positivities,HIV Seroconversions,HIV Seropositivities,HTLV III Seroconversion,HTLV III Seropositivity,HTLV-III Seroconversions,HTLV-III Seropositivities,Positivities, Anti-HIV,Positivities, HIV Antibody,Positivity, Anti-HIV,Positivity, HIV Antibody,Seroconversion, AIDS,Seroconversion, HIV,Seroconversion, HTLV-III,Seroconversions, AIDS,Seroconversions, HIV,Seroconversions, HTLV-III,Seropositivities, AIDS,Seropositivities, HIV,Seropositivities, HTLV-III,Seropositivity, AIDS,Seropositivity, HIV,Seropositivity, HTLV-III
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000488	Allied Health Personnel	Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.	Child Life Specialist,Allied Health Professional,Healthcare Assistants,Healthcare Support Workers,Population Program Specialists,Allied Health Professionals,Assistant, Healthcare,Assistants, Healthcare,Child Life Specialists,Health Personnel, Allied,Health Professional, Allied,Health Professionals, Allied,Healthcare Assistant,Healthcare Support Worker,Personnel, Allied Health,Population Program Specialist,Professional, Allied Health,Professionals, Allied Health,Program Specialist, Population,Program Specialists, Population,Specialist, Child Life,Specialist, Population Program,Specialists, Child Life,Specialists, Population Program,Support Worker, Healthcare,Support Workers, Healthcare,Worker, Healthcare Support,Workers, Healthcare Support
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D012308	Risk Management	The process of minimizing risk to an organization by developing systems to identify and analyze potential hazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized. Effective risk management has its greatest benefits in application to insurance in order to avert or minimize financial liability. (From Slee & Slee: Health care terms, 2d ed)	Hospital Incident Reporting,Incident Reporting, Hospital,Hospital Incident Reportings,Incident Reporting,Incident Reportings, Hospital,Management, Risks,Reporting, Hospital Incident,Reportings, Hospital Risk,Voluntary Patient Safety Event Reporting,Hospital Risk Reporting,Hospital Risk Reportings,Incident Reportings,Management, Risk,Reporting, Hospital Risk,Reporting, Incident,Reportings, Hospital Incident,Reportings, Incident,Risk Reporting, Hospital,Risk Reportings, Hospital,Risks Management
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.
D016273	Occupational Exposure	The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation.	Exposure, Occupational,Exposures, Occupational,Occupational Exposures
D016602	Needlestick Injuries	Penetrating stab wounds caused by needles. They are of special concern to health care workers since such injuries put them at risk for developing infectious disease.	Needle Stick,Needle-Stick,Needlestick,Sharps Injuries,Injuries, Needlestick,Needle-Stick Injuries,Needle-Sticks,Needlesticks,Injuries, Needle-Stick,Injuries, Sharps,Injury, Needle-Stick,Injury, Needlestick,Injury, Sharps,Needle Stick Injuries,Needle Sticks,Needle-Stick Injury,Needlestick Injury,Sharps Injury,Stick, Needle,Sticks, Needle
D017410	Practice Guidelines as Topic	Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.	Clinical Guidelines as Topic,Best Practices,Best Practice