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

To evaluate whether implementation of a Quality Control Circle (QCC)-based bundled intervention, organized according to the hierarchy of controls and comprising engineering controls, administrative controls, and reinforcement of personal protective equipment practices, was associated with changes in reported occupational bloodborne pathogen (BBP) exposure events among healthcare workers. This single-center, quasi-experimental uncontrolled before-and-after study evaluated a bundled QCC intervention in a tertiary hospital. Historical surveillance covered January-December 2023.The formal baseline was January-June 2024; intervention implementation and evaluation occurred during July-December 2024, and maintenance monitoring covered January-June 2025. In hierarchy-of-controls order, the bundle comprised engineering controls (hospital-wide rollout of needle-free closed infusion connectors with a split septum and larger-opening, flip-top sharps containers), administrative controls (structured occupational-safety training and supervision), and reinforcement of personal protective equipment practices for splash-risk procedures. The primary outcome was the reported occupational BBP exposure event case rate, calculated as the number of confirmed reported events divided by the average number of healthcare workers on duty during each six-month period. Aggregate event counts were compared using chi-square or Fisher’s exact tests as appropriate, training scores and maintenance-period data were analyzed descriptively. Reported occupational BBP exposure events were 46/1,617 (2.84%) during baseline, 20/1,607 (1.24%) during intervention implementation and evaluation (χ² = 10.293, P = 0.001), and 19/1,656 (1.15%) during maintenance monitoring. Mean trainee assessment scores increased descriptively from 76.26 ( n = 103) before training to 97.40 ( n = 100) after training; inferential testing was not performed because individual matched data and dispersion measures were unavailable. Needle-free connector utilization increased from 17,022/56,162 (30.31%) to 23,960/59,337 (40.38%) (χ² = 1278.274, P < 0.001). QCC implementation was associated with a lower reported occupational BBP exposure event case rate and greater use of needle-free closed infusion connectors. Because the study lacked a concurrent control group and evaluated a bundled intervention, the findings do not establish causality or the independent effect of any individual component.