Describing nurses’ awareness of biological risk in delivering care for renal-dialysis patients: an Italian pilot survey: Nurses’ awareness about biological risk in dialysis setting

Describing nurses’ awareness of biological risk in delivering care for renal-dialysis patients: an Italian pilot survey

Nurses’ awareness about biological risk in dialysis setting


  • Cristiano Magnaghi a:1:{s:5:"en_US";s:80:"RN, MSN, Dialysis and Nephrology Unit, IRCCS San Raffaele Hospital, Milan, Italy";}
  • Rosario Caruso Head of Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
  • Elena Brioni Genomic of Renal Disease and Hypertension Unit, IRCCS San Raffaele Hospital, Milan, Italy
  • Luigi Apuzzo Coronaric Intensive Care Unit, AORN S’Anna e San Sebastiano, Caserta, Italy. SIAN. Research Center, Bologna, Italy
  • Marilena Galli RN, Simple Training Structure, ASU Friuli Centrale, Palmanova, Italy. SIAN. Secretary, Bologna, Italy.
  • Cristiano Massari Oncohematology, ASST Niguarda, Milan, Italy.
  • Marco Del Pin Dialysis and Nephrology Unit, ASU Friuli Centrale, Palmanova; Italy, SIAN. Webmaster, Bologna, Italy.
  • Arianna Magon Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
  • Giuseppe Vezzoli Nephrology and Dialysis Unit, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
  • Giulia Villa Unit of Urology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Duilio Manara School of Nursing, Vita-Salute San Raffaele University, Milan, Italy.


biological risk; renal-dialysis care; nursing; survey


Background and aim of work. Despite national descriptions of awareness, knowledge, and perceptions about the exposure to the biological risk among nurses employed in renal-dialysis care are pivotal to increase work safety, there is a paucity of data on these descriptions in the Italian context. This study aimed at describing Italian nurses’ awareness and knowledge about biological risk in delivering care for renal-dialysis patients, and their experiences of biological accidents.

Methods. A pilot survey using cross-sectional data collection and convenience sampling procedure. 124 nurses were enrolled receiving a 7-item questionnaire: Questions 1, 2, and 7 were referred to the awareness about educational learning needs, questions 3 and 4 explored nurses’ knowledge about biological risk, questions 5 and 6 collected accident-related information.

Results. Overall, nurses’ awareness and knowledge about biological risk appeared almost limited. Surprisingly, 52% of the enrolled nurses experienced a biological accident, and 29.5% reported to know colleagues who developed work-related disease after a biological accident. We found positive significant associations between awareness and knowledge.

Conclusions. This pilot study highlighted the need to further describe Italian nurses’ awareness and knowledge about biological risk in delivering care for renal-dialysis patients, as well as the need of up-to-date epidemiological description about biological accidents. Accordingly, future studies are highly recommended to provide robust evidence aimed at supporting policy makers, educators, clinicians, regulators, and managers.


Marković-Denić L, Branković M, Maksimović N, Jovanović B, Petrović I, Simić M, Lesić A. Occupational exposures to blood and body fluids among health care workers at university hospitals. Srp Arh Celok Lek 2013, 141(11-12): 789-93.

Sidwell RU, Green JS, Novelli V. Management of occupational exposure to HIV--what actually happens. Communicable Disease and Public Health 1999, 2(4): 287-290.

May D, Brewer S. Sharps injury: prevention and management. Nursing Standard (Royal College of Nursing (Great Britain):1987) 2001, 15(32): 45-52.

Lombardi M, Cerrai T. Prevenzione della diffusione dell'HCV in emodialisi [Prevention of HCV infection in the hemodialysis setting]. G Ital Nefrol 2007, 13: 419–21.

Brewczyńska A, Depczyńska D, Borecka A, Winnicka I, Kubiak L, Skopińska-Różewska E, Niemcewicz M, Kocik J. The influence of the workplace-related biological agents on the immune systems of emergency medical personnel. Cent Eur J Immunol 2015, 40(2): 243-8.

Voide C, Darling KE, Kenfak-Foguena A, Erard V, Cavassini M, Lazor-Blanchet C. Underreporting of needlestick and sharps injuries among healthcare workers in a Swiss University Hospital. Swiss Med Wkly 2012, 142: w13523.

Serdar T, Đerek L, Unić A, Marijančević D, Marković D, Primorac A, Petrovečki M. Occupational Exposures in Healthcare Workers in University Hospital Dubrava - 10 Year Follow-up Study. Cent Eur J Public Health 2013, 21(3): 150-154.

Kebede A, Gerensea H. Prevalence of needle stick injury and its associated factors among nurses working in public hospitals of Dessie town, Northeast Ethiopia, 2016. BMC Res Notes 2018, 11(1): 413.

Reis RK, Gir E, Canini SR. Accidents with biological material among undergraduate nursing students in a public Brazilian university. Brazilian Journal of Infectious Diseases 2004, 8(1): 18-24.

Barbato D, De Lillo F, La Torre G, Cardoni F, De Giusti M. Validation of a questionnaire about knowledge and perception of biological risk among biomedical students of Sapienza University of Rome. Clin Ter 2019, 170(6): 430-434.

Bush C, Schmid K, Rupp ME, Watanabe-Galloway S, Wolford B, Sandkovsky U. Bloodborne pathogen exposures: Difference in reporting rates and individual predictors among health care personnel. Am J Infect Control 2017, 45(4): 372-376.

Kessler CS, McGuinn M, Spec A, Christensen J, Baragi R, Hershow RC. Underreporting of blood and body fluid exposures among health care students and trainees in the acute care setting: a 2007 survey. Am J Infect Control 2011, 39(2): 129-34.

Lauer AC, Reddemann A, Meier-Wronski CP, Bias H, Gödecke K, Arendt M, Peters H, Gross M. Needlestick and sharps injuries among medical undergraduate students. American Journal of Infection Control 2014, 42(3): 235–239.

Oh HS, Uhm D. Occupational exposure to infection risk and use of personal protective equipment by emergency medical personnel in the Republic of Korea. Am J Infect Control 2016, 44(6): 647-51.

Scaggiante R, Chemello L, Rinaldi R, Bartolucci GB, Trevisan A. Acute hepatitis C virus infection in a nurse trainee following a needlestick injury. World J Gastroenterol 2013, 19(4): 581-5.

Costigliola V, Frid A, Letondeur C, Strauss K. Needlestick injuries in European nurses in diabetes. Diabetes Metab 2012, 38: S9-14.

Rogowska-Szadkowska D, Stanisławowicz M, Chlabicz S. Risk of needle stick injuries in health care workers: bad habits (recapping needles) last long. Przegl Epidemiol 2010, 64(2): 293-5.

Grimmond T, Good L. Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015: A national survey of sharps injuries and mucocutaneous blood exposures among health care workers in US hospitals. Am J Infect Control 2017, 45(11): 1218-1223.

Jahic R, Piljic D, Porobic-Jahic H, Custović A, Petrovic J, Piljic D. Epidemiological Characteristics of the Accidental Exposures to Blood-Borne Pathogens Among Workers in the Hospital. Medical Archives (Sarajevo, Bosnia and Herzegovina) 2018, 72(3): 187-191.

H Muljono D, Wijayadi T, Sjahril R. Hepatitis B Virus Infection among Health Care Workers in Indonesia. Euroasian J Hepatogastroenterol 2018, 8(1): 88-92.

Senthil A, Anandh B, Jayachandran P, Thangavel G, Josephin D, Yamini R, Kalpana B. Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India. Int J Occup Environ Health 2015, 21(1): 74-81.

Powers D, Armellino D, Dolansky M, Fitzpatrick J. Factors influencing nurse compliance with Standard Precautions. Am J Infect Control 2016, 44(1): 4-7.

Porto JS, Marziale MH. Reasons and consequences of low adherence to standard precautions by the nursing team. Rev Gaucha Enferm 2016, 37(2): e57395.

Chow J, Rayment G, Wong J, Jefferys A, Suranyi M. Needle-stick injury: a novel intervention to reduce the occupational health and safety risk in the haemodialysis setting. J Ren Care 2009, 35(3): 120-6.

Amira CO, Awobusuyi JO. Needle-stick injury among health care workers in hemodialysis units in Nigeria: a multi-center study. Int J Occup Environ Med 2014, 5(1): 1-8.

Kabbash IA, El Sayed NM, Al Nawawy AN, El S Abou Salem M, El Deek B. Risk perception and precautions taken by health care workers for HIV infection in haemodialysis units in Egypt. EMHJ - Eastern Mediterranean Health Journal 2007, 13(‎2)‎: 392-407.

Petrosillo N, Puro V, Jagger J, Ippolito G. The risks of occupational exposure and infection by human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in the dialysis setting. Italian Multicenter Study on Nosocomial and Occupational Risk of Infections in Dialysis. Am J Infect Control 1995, 23(5): 278-85.

Bullock M, Panicker S. Ethics for all: Differences across scientific society codes. Sci Eng Ethics 2003, 9: 159–170.

Caruso R, Rocco G, Shaffer FA, Stievano A. Current data of foreign-educated nurses in Italy and the recognition of their professional qualifications. Nursing administration quarterly 2019, 43(1): 26-31.

Caruso R, Grugnetti AM, Pastore U, Dellafiore F, Pittella F, Ausili D, Arrigoni C. Modified Research Utilization Questionnaire: Development and Validation Study among Italian Nurses. Asian nursing research 2019, 13(1): 61-68.

Wiljer D, Tavares W, Mylopoulos M, Campbell C, Charow R, Davis D, Sockalingam S. Data and lifelong learning protocol: understanding cultural barriers and facilitators to using clinical performance data to support continuing professional development. Journal of Continuing Education in the Health Professions 2018, 38(4): 293-298.

Farnese ML, Zaghini F, Caruso R, Fida R, Romagnoli M, Sili A. Managing care errors in the wards: The contribution of authentic leadership and error management culture. Leadership and Organization Development Journal 2018, 40(1): 17-30.

Manandhar DN, Chhetri PK, Poudel P, Baidya SK, Agrawaal KK. Knowledge and Practice of Hemodialysis Amongst Dialysis Nurses. JNMA J Nepal Med Assoc 2017, 56(207): 346-51.

Elseviers MM, Arias‐Guillén M, Gorke A, Arens HJ. Sharps injuries amongst healthcare workers: review of incidence, transmissions and costs. Journal of renal care 2014, 40(3): 150-156.

Trim J.C. & Elliott T.S.J. A review of sharps injuries and preven‐tative strategies. Journal of Hospital Infection 2003, 53: 237–242.






Original articles: Health Professions 1/2021

How to Cite

Describing nurses’ awareness of biological risk in delivering care for renal-dialysis patients: an Italian pilot survey: Nurses’ awareness about biological risk in dialysis setting. Acta Biomed [Internet]. 2021 Mar. 25 [cited 2024 Jun. 17];92(S2):e2021003. Available from:

Most read articles by the same author(s)

1 2 > >>