Knowledge, Perceptions, Attitudes, and Behaviors of Healthcare Workers Regarding Blood and Body Fluid Exposure in a Tertiary Medical Center - The Impact of the COVID-19 Pandemic

Abstract Background Blood and body fluid exposure (BBFE) is a serious incident in healthcare practice, often leading to injuries from contaminated sharps, causing infections like Hepatitis B and Hepatitis C. Compliance with safety precautions and reporting the incident remains low despite many implemented measures. The COVID-19 pandemic improved infection control practices, particularly PPE use, and heightened infection transmission awareness. Our study aims to assess healthcare workers' (HCWs) knowledge, perceptions, attitudes, and behaviors regarding BBFE, identify predictors of BBFE and failure to report it, and compare these parameters before and after COVID-19. Methods This cross-sectional study utilized survey data collected from HCWs at AUBMC using an anonymous LimeSurvey during two time periods—2013–2014 and 2023–2024 which are pre and post COVID-19 pandemic period. Data included demographics and assessments of knowledge, perception, attitudes and behaviors toward BBFE. The data was analyzed using chi-square, the independent samples t-test, and regression analysis. Separate analyses were performed for different staff categories to account for variations in exposure and training. Results BBFE was reported by 31.1% of HCWs, with significant differences across roles (p < 0.001). Exposure and BBFE reporting did not differ between pre- and post-COVID cohorts. A low attitude/behavior score was a significant predictor of BBFE incidents among students, residents, and nurses (p = 0.013, aOR = 0.66), and a low perception score was a significant predictor of failure to report incidents (p < 0.001, aOR = 0.21) in the same group. Conclusion Obstacles like fear of career impacts and procedural issues may still affect fully reporting such incidents. Knowledge alone did not ensure better safety practices, but HCWs' perceptions and attitudes influenced reporting BBFE and its occurrence in the first place. The study calls for a comprehensive approach that addresses both perceptual and procedural barriers to improve safety and reporting, especially in the post-COVID-19 context, where stronger interventions are still needed.