Preventing bloodborne pathogen transmission in community nursing practice
Abstract
Community nurses face challenges while caring for patients with complex conditions, post-hospital recovery needs, or palliative care requirements, which increases their exposure to bloodborne pathogens. Inoculation injuries can transmit viruses such as hepatitis B (HBV), hepatitis C (HCV), and HIV. The risk of transmission depends on several factors, including the healthcare worker's immune status and vaccination history. Despite the high incidence of these injuries, the majority of those exposed do not develop serious illnesses. However, the financial impact of these injuries on the healthcare system is substantial, including both direct costs (such as treatment and testing) and indirect costs like staff absenteeism. Preventive measures, such as proper use of personal protective equipment, prompt reporting and post-exposure prophylaxis are essential to minimise the risk of transmission.
Community nursing teams face a range of serious occupational hazards (Chalupka et al, 2008). Working in the community poses additional risks of inoculation injuries because of limited space, poor lighting, lack of hygiene facilities and environmental challenges such as the presence of pets and children. These unpredictable conditions can render staff susceptible to inoculation injuries.
An inoculation injury can be a percutaneous wound caused by a sharp object, such as a needlestick injury (NSI), or a mucocutaneous injury resulting from exposure to body fluids through a bite, scratch or splash. Such injuries can happen during various stages of patient care, including administering injections, incorrectly disposing of sharp objects or handling contaminated waste (Royal College of Nursing, 2023).
The NHS is experiencing mounting pressure, with a growing number of patients receiving care outside of hospital settings. Community healthcare workers bear the greatest burden, caring for patients with complex and chronic illnesses, supporting post-hospitalisation recovery and providing palliative care (Department of Health and Social Care, 2024). This escalating workload can increase the risk of exposure to a bloodborne pathogen, leading to increased worry and stress among healthcare workers (Health and Safety Executive, 2013). While the number of injuries reported each year is high, only a small percentage of those exposed to a bloodborne pathogen are known to have developed serious illnesses as a result (Cheetham et al, 2021).
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