Hospital Safety Circle Program Associated with Lower Reported Bloodborne Pathogen Exposures

Implementation of a Quality Control Circle bundled intervention at a tertiary hospital was associated with a significant reduction in reported occupational bloodborne pathogen exposure events among healthcare workers, with rates falling from 2.84 percent at baseline to 1.24 percent during intervention evaluation.

The single-center, quasi-experimental uncontrolled before-and-after study evaluated whether introducing a bundled Quality Control Circle intervention structured around the hierarchy of controls corresponded with changes in reported occupational exposures. The multi-component program incorporated engineering controls, administrative controls, and reinforced personal protective equipment practices across hospital departments.

Arranged in hierarchy-of-controls order, the engineering controls comprised a hospital-wide rollout of needle-free closed infusion connectors featuring a split septum alongside larger-opening, flip-top sharps containers. Administrative controls provided structured occupational-safety training and supervision, while personal protective equipment practices were specifically reinforced for procedures carrying splash risks.

The project timeline commenced with historical surveillance from January to December 2023, followed by a formal baseline measurement period from January to June 2024. Intervention implementation and evaluation took place from July to December 2024, followed by maintenance monitoring from January to June 2025. The primary outcome was defined as the confirmed reported bloodborne pathogen exposure case rate, calculated by dividing verified events by the average number of healthcare workers on duty in each six-month surveillance window.

During the baseline period, 46 exposure events were reported among an average of 1,617 healthcare workers (2.84 percent). During intervention implementation and evaluation, reported events dropped to 20 among 1,607 workers (1.24 percent; chi-square = 10.293, P = 0.001), and subsequently totaled 19 events among 1,656 workers (1.15 percent) during maintenance monitoring. In secondary assessments, utilization of needle-free connectors rose from 17,022 of 56,162 (30.31 percent) to 23,960 of 59,337 (40.38 percent; chi-square = 1278.274, P < 0.001). Trainee assessment scores increased descriptively from a mean of 76.26 (n = 103) before instruction to 97.40 (n = 100) afterward, with inferential testing omitted due to unavailable individual matched records and dispersion values.

Although Quality Control Circle execution was associated with lower reported occupational exposure rates and greater adoption of needle-free infusion connectors, researchers highlighted essential study limitations. Because the investigation evaluated a combined bundle without a concurrent control group, the findings do not demonstrate direct causality or isolate the independent protective effect of any single intervention component.

Subject of Research: Occupational bloodborne pathogen exposure prevention among healthcare workers

Article Title: Quality control circle implementation and reported occupational bloodborne pathogen exposure among healthcare workers: a single-center uncontrolled before-and-after study

Article References: Luo, H., Wang, X., Liu, K., Mo, H., Zhang, R., Pan, Y., & Zhang, Y. (2026). Quality control circle implementation and reported occupational bloodborne pathogen exposure among healthcare workers: a single-center uncontrolled before-and-after study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15945-6

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15945-6

Keywords: bloodborne pathogens, occupational exposure, healthcare workers, quality control circle, needle-free connectors, engineering controls, administrative controls, personal protective equipment, sharps containers, hospital safety, infection control, before-and-after study, quasi-experimental study, tertiary hospital, split septum connectors, occupational safety training, exposure surveillance, splash-risk procedures