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PURPOSE: Occupational exposure is a long-standing public health concern, which has drawn more and more attention in recent years to the problem of how to carry out occupational protection effectively. Gloves are regarded as the most critical protective equipment for cytotoxic medications. However, there is still little research conducted on the protective performance of gloves made of different materials and the optimal glove combination for cytotoxic agents. METHODS: In this research, a specific instrument intended for glove permeation experiment was designed, with various methods of liquid chromatography-tandem mass spectrometry (LC-MS/MS) developed and validated. By using the specific instrument and LC-MS/MS methods, a study was conducted on the permeation ability of eight selected cytotoxic drugs (fluorouracil, epirubicin (EPI), docetaxel (DCT), methotrexate (MTX), cyclophosphamide (CTX), etoposide (ETP), vincristine sulfate (VCR), and cisplatin derivatives Pt-(DDTC)3) into five kinds of gloves (rubber (RB), nitrile (NT), chlorinated polyethylene (CPE), low-density polyethylene, and polyvinylchloride (PVC) resin) given different contact times. Then, the experimental data were analyzed through a generalized estimation equation and Pearson correlation analysis. RESULTS: The results show that within a short period of time (less than five minutes), ETP, CTX, fluorouracil, DCT, and cisplatin passed through five types of gloves but the level of MTX, VCR, and EPI permeation was minimal, despite the duration of contact between the three drugs and the gloves reaching as long as three hours. Furthermore, the permeation of DCT and ETP was found to be positively correlated with time. CONCLUSIONS: Chlorinated polyethylene and PVC resin perform well in protecting against most cytotoxic drugs and are recommendable for clinical practice. Due to the poor protective ability, RB gloves are not recommended for this purpose. Based on the performance of various gloves in offering protection, the protection grade of two gloves can be deduced. Chlorinated polyethylene + PVC resin, CPE + NT glove combination shows good protective performance against most target drugs and can be recommended for clinical practice.
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Antineoplásicos , Exposición Profesional , Humanos , Guantes Protectores , Cromatografía Liquida , Cisplatino , Espectrometría de Masas en Tándem , Antineoplásicos/química , Goma , Exposición Profesional/prevención & control , Etopósido , Docetaxel , Fluorouracilo , Permeabilidad , PolietilenosRESUMEN
AIM: To conduct a quality evaluation of the literature for the prevention of skin damage caused by personal protective equipment among healthcare workers and to summarise the best-evidence practice strategies to prevent it. DESIGN: Review. METHODS: Two researchers retrieved the literature from Web of Science, Public Medicine, etc., from the establishment of the database until 24 June 2022. Appraisal of Guidelines, Research and Evaluation II was used to assess the methodological quality of the guidelines. Expert consensus was assessed by the 2016 version of the Australian Joanna Briggs Institute Evidence-based Health Care Center corresponding evaluation standards. By tracking the original study, the quality of practice recommendations and best-practice evidence information sheets were evaluated by the 2016 version of the Australian Joanna Briggs Institute Evidence-based Health Care Center corresponding evaluation standards. The classification of evidence and recommendation level adopted the 2014 version of the Australian Joanna Briggs Institute evidence pre-grading and recommending level system. RESULTS: A total of 5476 studies were retrieved after duplications were eliminated. After the quality evaluation, 10 qualified studies were finally included. All consisted of two guidelines, one best practice information sheet, five practice recommendations, and one expert consensus. The evaluation results of the guidelines were both B-level recommendations. The consistency strength of expert consensus was moderate (Cohen's kappa coefficient = .571). Thirty best-evidence practised strategies were compiled for four elements, including cleaning, moisturising, prophylactic dressings and others. CONCLUSION: Our study evaluated the quality of the included studies and summarised the preventive measures of PPE-related skin lesions according to the recommendation level. The main preventive measures were divided into 4 parts and 30 items. However, the associated literature was rare, and the quality was slightly low. More high-quality research is needed to focus on healthcare workers' health and not just skin in the future.
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Personal de Salud , Equipo de Protección Personal , Humanos , Australia , Equipo de Protección Personal/efectos adversos , Pandemias/prevención & controlRESUMEN
INTRODUCTION: Medical personnel should be in close proximity and high frequency of contact with patients, and be exposed to physical, biological and chemical risk factors for a long time. The incidence of various occupational exposures is high. however, there is still a lack of the medical staff Occupational Protection Core Competence Evaluation Index system with high reliability and validity. AIM: Based on the theory of knowledge, attitude, and practice, the evaluation system of occupational protection ability of medical personnel was established, and the current situation of occupational protection ability of medical personnel at different levels was investigated, so as to take targeted training and intervention measures to improve the occupational protection ability of medical personnel and reduce the incidence of occupational exposure. METHODS: Based on the knowledge, attitude, and practice theory, the index system of occupational protection core competence of medical personnel was initially constructed by literature retrieval, expert consultation, group discussion, semi-structured interview and other qualitative and quantitative methods, and the reliability and validity of the index system was tested by Delphi expert consultation method. By convenient cluster sampling method, from March to September 2021, the current status of occupational protection core competence of medical personnel was investigated among medical staff from one Class III Grade A hospital and two medical schools in Jinan City, Shandong Province, China. RESULTS: The evaluation system for medical staff's occupational protection ability included 3 first-level indexes, 11 second-level indexes, and 109 third-level indexes. A total of 684 valid questionnaires were collected from Grade III, Class A hospital medical staff and two medical school students in clinical practice in Shandong, China. Kruskal Walls test showed that there were significant differences in the overall distribution of occupational protection knowledge, attitude, and practice among registered nurses, nursing students, registered physicians, and physician students (H = 70.252, P < 0.001; H = 76.507, P < 0.001; H = 80.782, P < 0.001); there were statistical significance in the knowledge/ attitude/ practice of nursing and physician students at different levels (H = 33.733, P < 0.001; H = 29.158, P < 0.001; H = 28.740, P < 0.001). CONCLUSION: The results of the evaluation system for the medical staff's occupational protection ability are reliable and can provide a reference for training the medical staff's occupational protection ability. Managers should strengthen the training of theoretical knowledge of occupational protection ability of medical staff.
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This article investigated an occupational chronic benzene poisoning incident that occurred in a sealing material factory in Hebei Province in September 2019, analyzed the clinical data of workers, to explore the causes of occupational chronic benzene poisoning, and summarize the diagnosis and treatment characteristics and treatment outcome. According to GBZ 68-2013 "Diagnosis of Occupational Benzene Poisoning", a total of 12 cases of occupational chronic benzene poisoning were diagnosed among the 20 workers, including 2 cases of occupational chronic mild benzene poisoning, 7 cases of moderate benzene poisoning, and 3 cases of severe benzene poisoning. Both mild and moderate poisoning patients had recovered after treatment. Severely poisoned patients had recovered more slowly, and the white blood cell count was still 2.0×10(9)-3.0×10(9)/L during the 1-year follow-up. This benzene poisoning incident was caused by illegal operations. The responsibility of the employer, the supervision of the administrative agency, and the awareness of personal protection of employees should be strengthened to avoid or reduce the occurrence of poisoning incidents and ensure the health of workers.
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Enfermedades Profesionales , Exposición Profesional , Intoxicación , Accidentes de Trabajo , Benceno/análisis , Enfermedad Crónica , Humanos , Recuento de Leucocitos , Enfermedades Profesionales/epidemiología , Exposición Profesional/análisisRESUMEN
There are many occupational risk factors in operating room work. Polymethyl methacrylate (PMMA) , as a kind of common bone filling and repairing material, is widely used in the fixation of artificial joints, oral braces and orthopedic prosthesis. However, PMMA will release methyl methacrylate (MMA) monomer when it is implanted into human tissues and polymerized to harden, which is toxic to the body. This paper analyzes harmful factors in using PMMA bone cement, and then explores corresponding occupational protection knowledge, in order to reduce the occurrence of occupational hazards related to PMMA bone cement and enhance the self-protection ability of the operation room medical staff.
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Cementos para Huesos , Polimetil Metacrilato , Cementos para Huesos/efectos adversos , Humanos , Quirófanos , Polimetil Metacrilato/efectos adversosRESUMEN
Objective: To analyze the risk factors of blood-borne occupational exposure among medical staff and explore the relevant intervention measures. Methods: In June 2020, the data of blood-borne occupational exposure and related factors reported by medical staff in a grade â ¢, Grade A general hospital from 2011 to 2019 were analyzed by retrospective investigation. Results: Among 431 cases of blood-borne occupational exposure, 69.37% were nurses. It mainly occurred in medical staff with 0-4 years of service, accounting for 63.57%; The main place of occupational exposure was in the ward 47.56%; Sharp instrument injury was the main occupational exposure route 91.65%. Occupational exposure department was mainly surgery department 17.87%; The main source of exposure was hepatitis B virus (HBV) 37.12%, followed by treponema pallidum 20.19%. Statistical analysis results show that: Exposure sites (χ(2)=43.585, P<0.01) , exposure sources (χ(2)=22.693, P<0.01) , treatment methods after exposure (χ(2)=18.866, P<0.01) , Flushing (χ(2)=31.963, P<0.01) and disinfection (χ(2)=14.216, P<0.01) were significantly different. Conclusion: The effective measures to reduce blood-borne occupational exposure are to strengthen occupational protection training of medical staff, standardize operation procedures, strengthen supervision of key groups and departments, improve reporting, monitoring and follow-up systems to realize informatization, and do a good job in risk control.
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Lesiones por Pinchazo de Aguja , Exposición Profesional , Patógenos Transmitidos por la Sangre , Humanos , Cuerpo Médico , Exposición Profesional/prevención & control , Estudios Retrospectivos , Factores de RiesgoRESUMEN
PURPOSE: The aim of the study was to describe the use of masks among health care personnel (HCP) exposed to index cases of coronavirus disease 2019 (COVID-19), and to evaluate any association with infection rate. METHODS: We did a retrospective, observational study of HCP at Zhongnan Hospital of Wuhan University for the management of COVID-19 (before person-to-person transmission was official confirmed, no additional protection was provided). A questionnaire was given to all staff listed on the roster in the clinical regions providing care for index patients with COVID-19. All participants were surveyed regarding hand-washing and use of surgical masks and gloves and were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data were analysed (Student's t test and Pearson χ2 test) for an association between infection and use of personal protective equipment. RESULTS: Exposure of a total of 299 non-infected and 30 infected staff was confirmed. None of the 149 staff who reported use of all three preventative measures (hand-washing and use of gloves and masks) became infect-ed. In contrast, all 30 of the staff who became infected had omitted at least one of the measures. Fewer staff who wore surgical masks (P=0.000003) became infected compared with those who did not. Infections rates were significantly lower in HCP from the internal medicine departments, as these personnel generally wore masks. CONCLUSION: An association was found between SARS-CoV-2 infection of HCP and the non-use of masks when working with index cases in clinical settings. We recommend that all HCP follow the strict instructions for prevention and treatment of nosocomial infection during intimate contact with COVID-19, especially staff from surgical departments.
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COVID-19/prevención & control , Máscaras , Exposición Profesional/prevención & control , Equipo de Protección Personal , Médicos , SARS-CoV-2 , Adulto , COVID-19/transmisión , China , Atención a la Salud , Femenino , Guantes Quirúrgicos , Desinfección de las Manos , Personal de Salud , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
There are many aspects of radiological protection in medicine that are different from other areas of activity using ionising radiation. In this paper, the author presents and justify some of these differences and highlight the reasons for and benefits of this consideration for the medical field. It is important to understand the differences as we are all likely to be patients at some point in our lives and be exposed to ionising radiation for imaging procedures several times and, in some cases, for therapeutic indications. The work done by the International Commission on Radiological Protection and other international organisations to produce and recommend a consistent system of radiological protection in medicine for the safe use of ionising radiation in medical practices must be highlighted. We should understand why we do not apply dose limits and dose constraints to patients, as well as why we have three levels of justification when considering the use of ionising radiation for patients. We highlight the relevance of personalised radiation protection in parallel to personalised medical practice, and the importance of an integrated approach for occupational and patient protection, especially for interventional procedures. We also cover the differences between patients and volunteers in biomedical research, the importance of radiation safety in quality assurance programmes (including the consideration of unintended and accidental exposures) for some clinical practices, and the relevance of education and training in radiological protection for medical and health professionals and information on radiation risks for patients. Finally, the ethical issues with regard to the safe use of ionising radiation in medicine and the impact of new technology will be addressed.
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Investigación Biomédica , Medicina , Protección Radiológica , Humanos , Agencias Internacionales , Radiación IonizanteRESUMEN
Occupational protection is still a challenge for interventional cardiology. One of the main problems is the occasional improper use of the ceiling suspended screen. We present a methodology to audit the correct use of the shielding using active electronic dosimeters. To improve the protection, we suggest the use of an alert based on the ratio between the occupational dose per procedure, measured by a personal electronic dosimeter over the lead apron, and the dose measured by an unshielded dosimeter, located at the C-arm. The new electronic dosimeters and the automatic dose management systems allow processing the dosimetric data for individual procedures and for the radiation events, sending the values (wireless) to a central database. We selected six interventional cardiologists and analysed 385 interventional procedures involving about 30 000 radiation events. Our results suggest that for individual procedures, standard values of the ratio between operator dose and the C-arm reference dose, should be between 1%-2% for a proper use of the shielding. Percentage values ≥5%-10% for individual procedures, require an analysis of the different radiation events to identify the lack of occupational protection and suggest corrective actions. In our sample, half of the operators should improve the use of the shielding in around 20% of the procedures. Using this ratio as an alert to operators allows optimising occupational radiation protection and discriminating between high occupational doses derived from complex procedures and high doses due to the improper use of the protective screen.
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Cardiología , Exposición Profesional , Protección Radiológica , Exposición Profesional/análisis , Dosis de Radiación , Radiografía Intervencional/efectos adversos , Radiología IntervencionistaRESUMEN
Objective: To investigate a new method for occupational protection training for medical staff, and to improve the awareness of occupational protection among medical staff. Methods: In August 2018, convenience sampling was performed to select 171 new medical workers in a grade A tertiary teaching hospital as subjects. The subjects were trained according to the requirements for occupational protection knowledge and training objectives. A questionnaire was distributed before training, and the scores were collected as control group; the subjects were trained using the conventional PPT theory, a questionnaire was distributed after training, and the scores were collected as trial group 1; the subjects were trained using the conventional PPT theory combined with the situational simulation teaching method, a questionnaire was distributed after training, and the scores were collected as trial group 2. A total of 171 questionnaires were distributed and collected for each survey, with a questionnaire recovery rate of 100%. Continuous data were expressed as mean±SD and were evaluated by an analysis of variance; categorical data were expressed as rate (%) , and the chi-square test was used for analysis. Results: A total of 171 medical workers, aged 22-33 years (mean 23.63±2.33 years) , participated in the study, among whom 127 (74.27%) were nurses, 146 (85.38%) were female workers, and 93 (54.39%) had a college degree. The awareness rate of occupational protection knowledge was 24.56%-70.18% in the control group, 63.16%-96.49% in the trial group 1, and 86.55%-99.42% in the trial group 2. There was a significant difference in the awareness rate of occupational protection knowledge among all the groups (P<0.01) , and there were also significant differences in theoretical test score, skill assessment score, and total score among all the groups (F=116.342, 189.424, and 304.904, P<0.01) . Theoretical test score, skill assessment score, and total score tended to increase after the training based on the conventional PPT theory or the training based on the conventional PPT theory and situational simulation (F=125.042, 352.025, and 444.073, P<0.01) . Conclusion: The situational simulation teaching method for the training of occupational protection knowledge for medical staff has a marked training effect and can significantly improve the theoretical and skill levels of medical staff.
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Cuerpo Médico/educación , Salud Laboral/educación , Entrenamiento Simulado , Adulto , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Objective: To understand the status of blood-borne occupational exposure and protection among health care workers (HCWs) in dental practice, and provide evidence for making effective prevention. Methods: From April 1 to 15, 2019, a stratified random sampling method was conducted to investigate the data of blood-borne occupational exposure among 221 dental HCWs in 2018, and Chi-squared Test was used to evaluate the differences of status on occupational exposure and protection among different professionals, such as nurses, doctors and trainees, and among different-grade hospitals. Results: A total of 166 HCWs were exposed to occupational exposure 269 times, with the annual incidence of 75.11% (166/221) , and 37.55% (101/269) of exposures were reported. However, all source patients of exposures had failed to be traced. 89.59% (241/269) of exposures were sharp injuries. The top three instruments caused injuries were syringe/bilan needles, suture needles and vehicle needles, accounting for 35.68% (86/241) ã16.60% (40/241) and 16.18% (39/241) , respectively; and the top three exposure operations were removal/disposal of needles or instruments, suture/assisting suture and injection of anesthetic, accounting for 37.17% (100/269) ã22.30% (60/269) and 17.84% (48/269) , respectively. There were statistically significant differences among different professionals in occupational exposure frequency, reporting rate, the types of instruments caused injuries, exposure operations and hepatitis B vaccinated time (P<0.01) . The compliance rate of standard precautions, safe operation, post-exposure reporting and prevention, and training on occupational protection were generally poor among HCWs, with significant differences in different-grade hospitals (P<0.01) . Conclusion: There is a high incidence, low reporting rate and poor self-protection of blood-borne occupational exposure among dental HCWs. Strongly suggesting that standard precautions, safe use and disposal of oral instruments, active post-exposure report and prevention must be improved for everyone.
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Personal de Odontología/estadística & datos numéricos , Odontólogos/estadística & datos numéricos , Lesiones por Pinchazo de Aguja/epidemiología , Exposición Profesional , Patógenos Transmitidos por la Sangre , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a ProfesionalRESUMEN
Objective: To investigate blood-borne occupational exposure and related protection in the medical staff of a traditional Chinese medicine hospital, and to provide a reference for reducing the risk of blood-borne occupational exposure. Methods: Forty-eight medical workers with blood-borne occupational exposure in 2015 were selected to analyze the incidence of blood-borne occupational exposure, influencing factors, operations that caused blood-borne occupational exposure, pathogens, and occupational protection. Results: The incidence rate of blood-borne occupational exposure in the medical staff of the traditional Chinese medicine hospital in 2015 was 3.30% (48/1 455) , and the frequency was 0.04 time/person/year. The workers with blood-borne occupational exposure were mostly nurses, females, workers aged <30 years, workers with <5 working years, and workers with a junior professional title. There was a significant difference in the incidence rate of blood-borne occupational exposure between workers with different ages and working years. The main way of blood-borne occupational exposure was sharp injury (96.08%) . The main operations that caused blood-borne occupational exposure were covering or separating the syringe needle after injection and disposing used sharp instruments. The main exposure site was the hand (96.08%) , with the thumb and index finger for the left hand and the middle finger and index finger for the right hand; there was no significant difference in the exposure site distribution between the two hands (P<0.05) . The main pathogen that caused blood-borne occupational exposure was hepatitis B virus (68.96%) . The rate of correct local treatment for blood-borne occupational exposure was 88.24%. The rate of prophylactic medication was 74.51%, and hepatitis B immunoglobulin (HBIG) plus hepatitis B vaccine was the main way, followed by HBIG. In all workers with blood-borne occupational exposure, 62.74% did not wear gloves. Conclusion: The medical workers with few working years have a high risk of blood-borne occupational exposure, so the training on protection against blood-borne occupational exposure should be strengthened to reduce the risk of blood-borne occupational exposure and infection.
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Patógenos Transmitidos por la Sangre , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Cuerpo Médico , Lesiones por Pinchazo de Aguja , Exposición Profesional , Adulto , Femenino , Humanos , Masculino , Medicina Tradicional ChinaRESUMEN
To address the diesel particulate matter pollution problem at the 12,306 continuous mining face of Shangwan coal mine, the spatial and temporal evolution law of diesel particulate matter generated at the three locations of the shuttle car head tunnel, contact alley, and support tunnel under the pressure-in ventilation condition of the double lane of the continuous mining face was studied by numerical simulation. The results show that the highest diesel particulate matter concentration at the shuttle car discharge is about 144.17 mg/m3, which seriously affects the health of miners. The highest diesel particulate matter concentration at the shuttle car tunnel is 52.58 mg/m3, and at the contact alley, the diesel particulate matter diffusion space is limited by the compression of the space inside the contact alley by the shuttle car machine body and the alley wall, which makes the diesel particulate matter accumulate here, forming a high diesel particulate matter concentration distribution area with a concentration value of 112.75 mg/m3. When supporting the roadway at the shuttle, diesel particulate matter accumulates in the range of X = 55 m ~ 60 m, Y = 0 m ~ 4 m, and Z = 23.4 m ~ 29.4 m. According to the degree of DPM pollution in different areas, different individual protective equipment is used to obtain different levels of pollution protection.
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Contaminantes Ocupacionales del Aire , Exposición Profesional , Material Particulado/análisis , Contaminantes Ocupacionales del Aire/análisis , Exposición Profesional/análisis , Emisiones de Vehículos/análisis , Monitoreo del Ambiente/métodosRESUMEN
Aim: We performed a comparative study to investigate the efficacy of closed system transfer devices (CSTDs) on the safe handling of injectable hazardous drugs (HDs). Methods: The exposure assessments of cyclophosphamide and cytarabine were performed under traditional or CSTDs. For preparation activity, chemotherapy contamination samples on protective equipment (such as gloves and masks) were collected. The contamination analysis was performed by liquid chromatography with tandem mass spectrometry (LC-MS/MS). A 6-item form was distributed monthly (form M1-M6, total 6 months) to assess the pharmacists' experience on ergonomics, encumbrance, and safety impression. Results: Totally, 96 wiping samples were collected throughout the study. The numbers of contaminated cyclophosphamide samples reduced under CSTD were -37.8, -41.6, -67.7, -47.3, and -22.9% and cytarabine were -12.3, -12.1, -20.6, -69.6, and -56.7% for left countertop, right countertop, medial glass, air-intake vent and door handle, as compared to traditional devices. The reduction was similar to pharmacist devices, i.e., -48.2 and -50.0% for masks and gloves cyclophosphamide contamination, -18.0 and -42.4% for cytarabine. This novel system could improve contamination on dispensing table, transfer container, and dispensing basket by -16.6, -6.0, and -22.3% for cyclophosphamide and -28.5, -22.5, and -46.2% for cytarabine. A high level of satisfaction was consistently associated with ergonomics for CSTD during the compounding process. Meanwhile, a slightly decreased satisfaction on ergonomics, encumbrance, and safety impression was observed for the traditional system between M2 and M3. Conclusion: Closed system transfer devices are offering progressively more effective alternatives to traditional ones and consequently decrease chemotherapy exposure risk on isolator surfaces.
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Antineoplásicos , Exposición Profesional , Antineoplásicos/análisis , Antineoplásicos/química , Cromatografía Liquida , Ciclofosfamida/análisis , Citarabina/análisis , Composición de Medicamentos/métodos , Exposición Profesional/análisis , Exposición Profesional/prevención & control , Equipos de Seguridad , Espectrometría de Masas en TándemRESUMEN
In this paper, we report a case of coronavirus disease 2019 (COVID-19) complicated with human immunodeficiency virus (HIV) infection. The 50-year-old male patient had unexplained "intermittent fever with sore throat" on February 9th, 2020. Chest computed tomography (CT) showed bilateral multiple patchy opacities and ground-glass opacities. A COVID-19 RNA test was positive. After admission, additional laboratory tests revealed the following: white blood cell (WBC) count, 4.7×109/L; neutrophil percentage, 85.1%; lymphocyte percentage, 12.3%; lymphocyte count, 0.59×109/L; hypersensitivity C-reactive protein, 5.52 mg/L; four coagulation factors, +; D-dimer, 1.32 mg/L; and procalcitonin, normal. He was HIV (+). The patient was diagnosed with COVID-19 complicated with HIV infection. The healthcare team administered symptomatic care, including nasal oxygen, oseltamivir, Lianhua Qingwen capsule, moxifloxacin, ribavirin, and thymus faxin, as well as nutritional support, mental care, diet and life management, and close monitoring. Moreover, the team implemented strict disinfection and quarantine and occupational protection. The patient's temperature returned to normal and sore throat significantly improved by day 10, and COVID-19 RNA tests were negative on February 19th, February 21st, and February 22nd. Reexamination by chest CT on February 22nd showed significant absorption of inflammation. After rounds by the chief physician and consultation with specialists, the patient was released from quarantine and discharged on February 23rd per the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 6). Patients with COVID-19 and HIV infection face both physical and mental challenges. More attention should be paid to nursing as we understand more about COVID-19. We hope to share our nursing experience through this case.
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COVID-19 , Infecciones por VIH , VIH , Humanos , Masculino , Persona de Mediana Edad , Cuarentena , SARS-CoV-2RESUMEN
Background: SARS-CoV-2 spreads rapidly around the world, and some patients present gastrointestinal symptoms. The existence of the virus in the gastrointestinal tract makes digestive endoscopy a high-risk operation, which associated with an increased risk of infection rate in healthcare workers. This study aimed at exploring current knowledge, practice and attitudes of healthcare workers in endoscopy units in China regarding the status of occupational protection during COVID-19 pandemic. Methods: A cross-sectional study of a national online survey involving 717 healthcare workers in endoscopy units from 94 medical structures in 24 provinces and municipalities around China was conducted online via a questionnaire platform called Wenjuanxing (wjx.cn). The data were analyzed using correlation approaches, Kruskal-Wallis test for independent samples, and linear regression models. Results: Most Chinese healthcare workers in endoscopy units had a good knowledge of COVID-19 (median: 10; range: 7-12), showed a strikingly positive attitude (median: 65; range: 39-65), and carried out good practice (median: 47; range: 14-50) in strengthening the protection, disinfection and management of COVID-19. In terms of attitudes, female staff was more concerned about protection against COVID-19 than male staff (KW = 8.146, P = 0.004). Nurses performed better in both attitude (KW = 2.600, P = 0.009) and practice (KW = 6.358, P < 0.001) than endoscopic physicians when carrying out personal protection, patient care and environmental disinfection against SARS-CoV-2 infection. More positive attitudes in protection were related to better protective behavior in endoscopic daily medical work (r = 0.312; P < 0.001). Conclusion: The findings of this study suggest that Chinese endoscopy healthcare workers have an excellent mastery of knowledge about COVID-19, which is transformed into positive beliefs and attitudes, contributing to good practice during daily endoscopic procedures. Medical staff may benefit from further education. With the gradual normalization amid the ongoing COVID-19 pandemic, protection and management in endoscopy units may be changed accordingly.
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COVID-19/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Exposición Profesional/prevención & control , Adulto , Anciano , China/epidemiología , Estudios Transversales , Endoscopía , Femenino , Unidades Hospitalarias , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Adulto JovenRESUMEN
OBJECTIVE: To understand the current cognition of acquired immunodeficiency syndrome (AIDS) occupational protection among the managers of multi-level stomatology medical institutions in efforts to provide a reference for formulating technical standards for occupational protection. METHODS: Eighteen managers of oral medical institutions were individually interviewed in-depth using asemi-structured questionnaire on issues related to AIDS occupational protection using the phenomenological research method. Nvivo 12.0 software was used to code and analyze the interview data, and relevant themes were extracted. RESULTS: Three themes were extracted from the data. Occupational protection measures for AIDS in dental medical institutions mainly based on the aspects of standardized operation, standardized prevention, and post-exposure treatment. However, the implementation of these protective measures was often inadequate. Occupational protection training for AIDS was carried out regularly at dental medical institutions, but the training effect was not generally tracked. Several limitations in AIDS occupational protection management; these limitations included the lack of a specific occupational protection system, the difficulty of AIDS screening for outpatients, and the difficulty of AIDS occupational protection supervision. CONCLUSIONS: Oral medical institutions should strengthen their occupational protection training and supervision approaches and formulate unified occupational protection standards to reduce occupational exposure and improve hospital management quality and efficiency.
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Síndrome de Inmunodeficiencia Adquirida , Exposición Profesional , Medicina Oral , Cognición , Humanos , Encuestas y CuestionariosRESUMEN
In early January 2020, the outbreak of the new corona virus pneumonia (Corona Virus Disease 2019, COVID-19) occurred. Wuhan, the capital city of Hubei province, became the epicenter of the disease in China. The rapid growth of patients had exceeded the maximum affordability of local medical resources. A large comprehensive gymnasium was converted into Wuchang Fangcang Shelter Hospital in order to provide adequate medical beds and appropriate care for the confirmed patients with mild to moderate symptoms. For these hospitalized patients with COVID-19, medication became the mainstay of therapy. From 5th February to 10th March, a team of pharmacists successfully completed drug supplies and pharmaceutical services for 1124 patients and approximately 800 medical staff, and, while doing so, received zero complaint, and experienced zero disputes and zero pharmacist infection. This paper summarizes the development and construction of the pharmacy, human resource allocation of pharmacists, pharmacy administration, and pharmaceutical services. It aims to review a 34-day period of pharmaceutical practice and serve as a reference for other health professionals working on COVID-19 prevention and treatment in other regions.
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Staff and employees "Zero infection" has been achieved during the whole medical activities in the COVID-19 Fangcang Shelter Hospital in Wuhan, China. This study analyses the personnel and environmental protection status of the East-West Lake Fangcang Shelter Hospital. The HCWs were mostly composed of national medical rescue teams, from different provinces in China. Before the COVID-19 outbreak, 82.64% of the HCWs had already known the proper procedure of wearing masks and other personal protective equipment (PPE). For the total of 634 participants entering the inpatient areas, 99.8% of them took occupational protection trainings via various methods. By carefully training and supervision, most of them were competent to work in the inpatient areas six hours/d, three-four times/week. Besides, 7.8% experienced different types of occupational exposure, which mainly caused by the damage of PPE. Once exposed, the HCWs would disinfect skin or mucous in time. No SARS-CoV-2 RNA was detected in 48 air and environmental samples after regular disinfection and cleaning. To conclude, the bundle including intensive training, strengthened personal protection, strict environmental disinfection and timely remedial measures for occupational exposure had ensured the safety of the East-West Lake Fangcang Shelter Hospital.
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Betacoronavirus/fisiología , Infecciones por Coronavirus/prevención & control , Personal de Salud/estadística & datos numéricos , Exposición Profesional/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Adulto , Betacoronavirus/genética , COVID-19 , China , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Femenino , Hospitales Especializados/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral , Neumonía Viral/transmisión , Neumonía Viral/virología , SARS-CoV-2 , Adulto JovenRESUMEN
Acquired immunodeficiency syndrome (AIDS) is an infectious disease caused by human immunodeficiency virus (HIV). The disease is highly infectious, quickly spreads, and has a high fatality rate. Hence, it is a major concern in public health, and an important subject in the prevention and treatment of infectious diseases. The medical staff of stomatological departments, which handle the diagnosis and treatment of oral diseases, are at particularly high risk of occupational exposure to HIV/AIDS. This study summarizes the HIV/AIDS epidemic status, disease transmission routes, oral lesions in HIV/AIDS patients, occupational exposure, and occupational protection in stomatological departments.