Assessment of risk factors for transmission of bloodborne infections (hepatitis b, c and hiv) by intravenous catheter manipulation

Injections and infusions are a common cause of transmission of nosocomial bloodborne infections (hepatitis B, C and HIV). Venous catheters as the main venous access in oncohematological patients are the reason for high incidence of bloodborne infections in this group of patients.

The aim of the study was to determine the causes of transmission of bloodborne infections (hepatitis B, C and HIV) during manipulations with the central venous catheter (CVC).
A survey was conducted among 200 oncohematological nurses from «Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology» (Center) and regional oncohematological clinics. The purpose of the survey was to identify what errors and misconceptions healthcare workers have as regards manipulation with venous catheters.

In 27 % of cases, the nurses believed that it was impossible to infect patients with hepatitis B, C and HIV when working with CVC. In 65 % of cases, the respondents replied that in the absence of visible blood, there is no risk of transmission of bloodborne infections when working with CVC. The reuse of syringes, catheter plugs/caps, infusion lines and vials of drugs between patients was considered safe by 3, 4, 11 and 46 % of the nurses accordingly. Fifteen percent of the nurses considered it safe to take the drug from a multi-dose vial with a reused syringe. Use of a single work surface when working with CVC in several patients was considered safe by 36 % of the respondents; repeated use of gloves, by 13 %. Even repeated use of syringes for injections, provided that the needle was changed, was considered safe by 3 % of nurses.

This study showed a low level of knowledge and vigilance among the participating healthcare workers regarding transmission of bloodborne infections when working with intravenous catheters. The nurses' erroneous judgments regarding potential blood contamination were as follows: confidence in blood being absent in the catheter port (cannula); absence of blood reflux into areas of the infusion system remote from the patient (infusion line, vial) and safety of their repeated use in different patient;, absence of blood contamination on work surfaces and gloves.