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ANNEX 5 THE DATA COLLECTION PROCESS
1 For each incident notified to an OH department that involved occupational exposure to blood or body fluids, a standardised Incident Report Form ( IRF) (Annex 1) was completed by the OH nurse adviser (in the police) or OH clinician (in the SPS) who dealt with the case. A tick-box format was used so that data could be collected easily and consistently. Following requests from panel members after the IRFs were printed, a supplementary sheet (Annex 2) was produced to collect a small amount of additional information on each case. The numbered IRFs and supplementary sheets were printed as carbonised 2-set pads, with personal details blanked from the carbon copy to be sent to the researchers.
2 The exposed member of staff was asked by OH to consent to the anonymised details of the case being included in the study. He/she was given or sent an information leaflet about the evaluation, and was asked to complete a consent form. Those who agreed were told that they would also be asked to complete a questionnaire about 4 weeks after the incident, again anonymously (study numbers only being used to link the two questionnaires). When the OH nurse adviser (or OHSAS or SALUS administrator) received written consent, they sent the carbonised copy of the IRF to the researchers.
3 If there were any missing or unclear answers on the IRF, the researchers sought clarification from the OH member of staff who had collected the data.
4 Each completed IRF was then copied for the Incident Review undertaken by the expert panel, omitting any details of the exposed person and the force or prison. Any other information known to the researchers which might aid panel members' understanding was added, e.g. procedures in the given OH unit.
5 The 12 experts were grouped into 2 sub-panels (A and B), which were matched in terms of disciplines. Each sub-panel reviewed half the incidents, and the cases sent to each group were matched as far as possible by i) the type of exposure, ii) the first point of medical contact, and iii) the OH unit.
6 The cases were sent to panel members for review in 5 batches. (One panel member was unable to evaluate batches 4 and 5.) With the final batch, panel members were asked if they would note any overall impressions of post-incident management from all the cases they had reviewed and any general recommendations.
7 For each incident received, the researchers prepared a pack containing a follow-up Staff Evaluation Questionnaire ( SEQ) marked with the study number, the date of the incident and the suggested 4-week 'completion date' together with a covering letter, information leaflet, and reply-paid envelope addressed to the researchers. The blank envelope was marked with the study number only, and was sent to the relevant OH contact person 20 days after the incident, with a request to forward it to the exposed individual.
8 If a completed questionnaire had not been received by the researchers 2 weeks after the 'completion date', the OH contact person was asked if they would remind the exposed individual about the evaluation. If the member of staff had mislaid the questionnaire, a second copy was sent, again via OH. In cases where the questionnaire could not be sent out at the appropriate time, either because the IRF had not been received by the researchers within 20 days, or because the questionnaire had to be re-sent, the recipient was asked to complete it as soon as possible.
9 Copies of all the study materials required by OH, including information leaflets for OH staff, were sent to the designated police OH nursing advisers, and to OHSAS and SALUS managers for distribution, ahead of data collection. Information leaflets for SPS H&S and HR staff were sent to OH&W for distribution. Copies of these materials are in Annex 7.
10 OH staff were sent written guidelines about the data collection process. These included 'inclusion criteria', to try to ensure that (a) all OH units acted consistently and (b) all cases dealt with by OH were included, even if the risk of exposure was deemed to be negligible, since the evaluation was investigating anxiety. It was recognised that perceptions of 'occupational exposure' could vary, and that there might be differences - between police and prison services and between police forces - in the type of incident normally reported to OH. The inclusion criteria were:
- All cases of occupational exposure to blood and/or body fluids which were reported to OH and which involved contact via:
- mucous membranes ( e.g. eyes, nose, mouth), and/or
- puncture wound/scratch, and/or
- non-intact/broken skin;
and
- Any other cases of occupational exposure to blood and/or body fluids which were reported or forwarded to - and/or dealt with by - Occupational Health, and which involved the allaying of any anxiety reported by the exposed individual, even if the exposure involved blood and/or body fluid contamination only of intact skin and/or clothes, and even if no further action or follow-up was felt to be necessary;
and
- If in doubt, include the case in the evaluation.
11 OH staff were asked if they would record the total number of occupational exposure incidents reported to them over the study period, including cases where the exposed person did not wish the details to be included in the evaluation, or did not return the consent form, and any cases where, for any reason, an exposed individual had not been invited to participate. OH staff were also asked if they would collect any information about follow-up treatment not recorded on the IRF; however, none was reported.
12 Close cooperation between the researchers and OH staff was crucial to the success of the evaluation. OH nursing advisers were encouraged to contact the researchers at any time. At the start of the evaluation the researchers telephoned the OH contacts monthly to ask if they were experiencing any problems and to determine response rates.
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