Blood and body fluid exposures: consent for source patient testing

Area of Science:

• Occupational Health
• Infectious Disease Prevention
• Healthcare Safety

Background:

• Blood and body fluid (BBF) exposure poses significant occupational risks to healthcare workers.
• UK guidelines recommend routine source patient testing for blood-borne viruses post-exposure.
• Barriers to source patient testing, including consent and procedural compliance, require further understanding.

Purpose of the Study:

• To determine the frequency of serological testing in identified source patients following BBF exposure.
• To identify the reasons why source patients are not tested, including consent issues and refusals.

Main Methods:

• A retrospective review of BBF exposure incidents reported to Sheffield Occupational Health Service from January 1, 2009, to December 31, 2009.
• Analysis of source patient identification and testing rates across different healthcare staff groups.

Main Results:

• Source patients were identified in 87% of 490 reported BBF exposure incidents.
• Source patient serological testing occurred in 56% of incidents.
• Testing rates varied significantly by staff type: medical (76%) and nursing (69%) staff had higher rates than non-clinical (36%) and dental (17%) staff.
• For 151 identified source patients not tested, reasons were unrecorded in 66%, incapacity to consent in 20%, and refusal in 5%.

Conclusions:

• Despite recommendations, routine source patient testing for BBF exposure is not consistently implemented.
• Incapacity to provide consent is a notable factor contributing to the lack of source patient testing.
• Further research is needed to explore other barriers to testing and inform policy development.