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Do Universal Precautions Reduce Needlestick Injuries?-Reply

Edward S. Wong, MD; Sheldon M. Markowitz, MD; Hunter Holmes McGuire
JAMA. 1991;266(3):360. doi:10.1001/jama.1991.03470030059012.
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In Reply.  —We believe our choice of patient-care months as the denominator for occupational exposures is neither inappropriate nor misleading. In our study, we were interested in the difference in the frequency of occupational exposures before and after implementation of UPs and, specifically, with regard to needlestick injuries, the percent reduction as a result of UPs (ie, the rate of injuries after implementation divided by the rate of injuries before implementation). For this calculation, it is clear that the choice of denominators is irrelevant since they cancel out. We contend that the risk of needlestick injuries is procedure-dependent and the number of patients cared for on the study wards is the most important determinant of the number of procedures performed. Since we observed no variations in the month-to-month patient census or any changes in ward practices during the study period, we attributed the reduction in the frequency of exposures to


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