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The purpose of this quasi-experimental pretest/posttest research study was to examine the effectiveness of an intervention designed through a participatory process to reduce blood and body fluid exposure among home care aides. Employer A, the intervention site, was a large agency with approximately 1,200 unionized home care aides. Employer B, the comparison group, was a medium-sized agency with approximately 200 home care aides. The intervention was developed in partnership with labor and management and included a 1-day educational session utilizing peer educators and active learning methods to increase awareness about the risks for occupational exposure to blood and body fluids among home care aides and a follow-up session introducing materials to facilitate communication with clients about safe sharps disposal. Self-administered preintervention and postintervention questionnaires identifying knowledge about and self-reported practices to reduce bloodborne pathogen exposure were completed in person during mandatory training sessions 18 months apart. Home care aides in the intervention group for whom the preintervention and postintervention questionnaires could be directly matched reported an increase in their clients' use of proper sharps containers (31.9% pre to 52.2% post; p = .033). At follow-up, the intervention group as a whole also reported increased use of sharps containers among their clients when compared to controls (p = .041).

This cross-sectional study of home care aides examines self-reported occupational exposure to blood and body fluids to determine if factors that place these workers at risk can be identified. Home care aides working for two agencies in the Chicagoland area were surveyed. A total of 62 (6.3%) of the home care aides reported instances of blood and body fluid exposure either via sharps or mucous membrane contact. Although few aides reported performing health care-related tasks such as colostomy care, caring for a urinary catheter, or bowel stimulation (which were outside their scope of duties), those who did were significantly more likely to experience blood and body fluid exposure (p≤.01). Level of assistance needed by clients in tasks such as feeding, laundry, and transportation was also found to be significantly associated with blood and body fluid exposure (p≤.01). These data highlight the importance of, and need for, home care aid training in the use of universal precautions.