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1.
PLoS One ; 15(6): e0233599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555636

RESUMO

Increasing intensification in swine production has led to new and specialized technologies, but the occupational health and safety impacts are rarely quantified in the business plans for adoption. Needle-less injection has potential to increase productivity and eliminate needle stick injury in workers, but it is not clear whether these benefits offset high capital investment and potential increases in musculoskeletal loads. This economic evaluation employed probabilistic scenario analysis using injury, cost, and production data gathered from interviews with swine producers in Manitoba and Saskatchewan. After adoption of needle-less injection, rates of needle-stick injury went down with no measureable effect on upper limb musculoskeletal disorders, resulting in lower health and safety costs for needle-less injectors. Needle-less injection duration was 40% faster once workers acclimatized, but large start-up costs mean economic benefits are realized only after the first year. The incremental benefit cost ratio promoted adoption of needle-less injectors over conventional needles for the base case of a 1200 sow barn; the conventional method is beneficial for barns with 600 sows or less. Findings indicate that well-designed technologies have the potential to achieve the dual ergonomics goals of enhancing human wellbeing and system performance. We anticipate that the economic and decision models developed in this study can be applied to other new technologies in agriculture and animal production.


Assuntos
Criação de Animais Domésticos/organização & administração , Injeções a Jato/veterinária , Saúde do Trabalhador/economia , Local de Trabalho/organização & administração , Criação de Animais Domésticos/economia , Criação de Animais Domésticos/estatística & dados numéricos , Animais , Análise Custo-Benefício , Eficiência Organizacional , Humanos , Injeções a Jato/economia , Manitoba , Ferimentos Penetrantes Produzidos por Agulha/economia , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Doenças Profissionais/economia , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Saúde do Trabalhador/estatística & dados numéricos , Saskatchewan , Sus scrofa , Suínos , Doenças dos Suínos/tratamento farmacológico , Doenças dos Suínos/prevenção & controle , Fatores de Tempo , Indenização aos Trabalhadores/economia , Indenização aos Trabalhadores/estatística & dados numéricos , Local de Trabalho/economia
2.
J Surg Res ; 255: 66-70, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32543380

RESUMO

BACKGROUND: Blood-borne pathogen exposures (BBPEs) pose a risk to health care workers (HCWs). Needlestick injuries (NSIs) have declined overall, but not for surgical HCWs. There are limited data regarding BBPEs among medical students (MSs) in their clinical years. We aimed to quantify this risk for third- and fourth-year MSs. METHODS: A literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The PUBMED database was searched to identify studies of third- and fourth-year MSs using the terms BBPE, NSI, and MS. Studies of other HCWs were excluded if MS data were not extractable. Additional studies were identified from references. Descriptive analysis was performed. RESULTS: Seven of 171 articles published from 2002 to 2018 met study criteria. All used self-reported data from surveys/questionnaires. One-third of MSs reported BBPEs (n = 194/600, 32.3%) with a mean of 1 in 3.09 and a median of 1 in 3.53 (range: 1 in 1.9-8.3 students). Most events were NSIs (144/194, 74%) with a mean of 1 NSI per 4.05 MSs and median of 1 in 4.625 (range: 1 in 2.47-10.71). The remaining BBPEs reported included blood and bodily fluid splashes (n = 37, 19%), other mucocutaneous exposures (n = 7, 3.6%), and uncategorized injuries (n = 2, 1%). CONCLUSIONS: One-third of senior MSs reported BBPEs during clinical rotations. Most BBPEs were NSIs. Quantifying this risk allows for anticipatory education and protocol development to protect students and other new HCWs. Educational efforts focused on NSI prevention before and during clinical rotations may help reduce BBPEs.


Assuntos
Patógenos Transmitidos pelo Sangue , Líquidos Corporais/microbiologia , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Humanos , Ferimentos Penetrantes Produzidos por Agulha/microbiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/prevenção & controle , Profilaxia Pós-Exposição , Medição de Risco , Autorrelato/estatística & dados numéricos , Precauções Universais
3.
Work ; 65(3): 635-645, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116282

RESUMO

BACKGROUND: Needlestick injuries among healthcare professionals continue to be an occupational hazard, frequently and incorrectly regarded as low-risk, and exacerbated by underreporting. We aimed to investigate rates of needlestick injury, reasons for underreporting, and how explicit announcements that patients are "high-risk" (i.e., human immunodeficiency virus, hepatitis, or intravenous drug abuse history) might affect the actions of those at risk of sustaining an injury. METHODS: A cross-sectional survey was administered to medical students (MS), nursing students (NS), and residents. RESULTS: 30/224 (13%) of MS, 6/65 (9%) of NS, and 67/126 (53%) of residents experienced needlestick injuries. 37% of MS, 33% of NS, and 46% of residents attributed "lack of concentration" as cause of injury. Residents had the lowest percentage of underreporting (33%), with rates of 40% and 83% among MS and NS, respectively. Top reasons for non-reporting included the injury being perceived as "trivial" (22%) and patient being "low-risk" (18%). A majority stated pre-operative "high-risk" announcements should be required (91%), and would promote "culture of safety" (82%), reporting of injuries (85%), and increased concentration during procedures (70%). CONCLUSIONS: We recommend routine announcements during pre-operative time-out and nursing/resident hand-offs that state a patient is "high-risk" if applicable. We hypothesize such policy will promote a "culture of safety," situational awareness, and incident reporting.


Assuntos
Internato e Residência/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Centros Médicos Acadêmicos , Estudos Transversais , Infecções por HIV , Hepatite , Humanos , Incidência , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Fatores de Risco , Abuso de Substâncias por Via Intravenosa , Inquéritos e Questionários
4.
PLoS One ; 15(3): e0229853, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32176715

RESUMO

OBJECTIVE: Needlestick and sharp injuries (NSIs) experienced by physicians have been identified as a major occupational hazard. Blood-borne pathogens resulting from the NSIs experienced by physicians pose severe physical and psychological threats to them, as well as people who are around them. However, there is little research focusing on physicians' behaviours to prevent NSIs. In the present study, we investigated the roles of safety climate, job demands experienced by physicians, and physicians' self-efficacy in affecting physicians' behaviours to prevent NSIs. METHODS: 401 physicians from four teaching hospitals in Northern Taiwan were recruited to participate in an anonymous survey. Among them, 189 physicians returned the completed survey with a response rate of 47.1%. RESULTS: Overall, respondents reported frequently engaging in NSI prevention behaviours. As expected, safety climate in hospitals and physicians' self-efficacy to prevent NSIs were significantly related to their behaviours to prevent NSIs (r = 0.22 and r = 0.33, respectively). The moderating analysis also revealed that physicians with high self-efficacy tended to engage in NSI prevention behaviours regardless of levels of job demand they experienced. In contrast to our expectation, however, physicians with low self-efficacy engaged in more NSI prevention behaviours when job demands were high than when the demands were low. CONCLUSIONS: Our findings show the important roles safety climate, job demands and self-efficacy play in shaping physicians' NSI prevention behaviours. Hospitals may consider improving safety climate via strengthening management commitments to NSIs prevention, reducing job demands by training physicians to proactively redesign their own jobs, and increasing physicians' self-efficacy via well-designed skill-based training.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Exposição Ocupacional/prevenção & controle , Médicos/psicologia , Feminino , Hospitais , Humanos , Masculino , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/psicologia , Inquéritos e Questionários , Taiwan/epidemiologia
5.
Cien Saude Colet ; 25(2): 715-727, 2020 Feb.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-32022211

RESUMO

This was a cross-sectional study to start a cohort in two University Hospitals of two countries - Brazil and Colombia - for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Doenças Profissionais/prevenção & controle , Adulto , Idoso , Patógenos Transmitidos pelo Sangue , Brasil , Estudos de Coortes , Colômbia , Estudos Transversais , Feminino , Fidelidade a Diretrizes , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto Jovem
6.
J Educ Eval Health Prof ; 17: 1, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31955547

RESUMO

PURPOSE: Senior nursing and medical interns' lack of familiarity and confidence with respect to practicing universal precaution for the prevention of occupational needle stick (NSI)/sharp (SI) injuries may harm themselves. Trainees' self-reported NSI/SI rate was known to be especially high during the first two months of internship in Taiwan. This prospective cohort study aimed to know the effect of new developed (virtual reality (VR) game, which uses the Gangne's learning model to improved universal precaution for NSI/SI prevention and decrease the rates of needle stick/sharp injuries in new-coming medical and nursing interns in Taiwan. . METHODS: From 2017 to 2019, the VR system was developed and applied in training of 59 new-coming nursing and 50 medical interns. Occupational NSI/SI prevention was sought to be achieved through a game of right and wrong choices for safe or unsafe universal precaution behaviors. RESULTS: In comparison with medical interns, a higher proportion of nursing interns have had the past experiences of deep occupational NSI/SI. Before VR training, the familiarity and confidence for NSI/SI prevention were higher among nursing interns than medical interns. Trainees with past experiences of deep NSI/SI exhibited better performance on the accuracy rate and time need for complete 20 decisions than those without past experiences in VR practice. The performances of all trainees were improved after VR training. A high proportion of trainees reported that the VR-based training significantly decreased their anxiety about NSI/SI prevention. CONCLUSION: This self-developed VR game system using Gangne's flow improved universal precaution for NSI/SI prevention and reduced the NSI/SI rates in the first two months of nursing and medical internship.


Assuntos
Educação em Enfermagem , Internato e Residência/métodos , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Realidade Virtual , Educação em Enfermagem/métodos , Pessoal de Saúde , Humanos , Estudantes de Medicina , Estudantes de Enfermagem
7.
Unfallchirurg ; 123(3): 216-224, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-31428806

RESUMO

BACKGROUND: Needlestick injuries (NSI) are potentially infectious injuries from sharp or pointed medical instruments and through contact with blood on mucous membranes or nonintact skin. Although the European Union (EU) Council directive 2010/32/EU on the prevention of NSI was implemented in EU countries in 2013, information on the effectiveness of the measures is limited. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a safety concept according to the EU Council Directive 2010/32/EU on prevention of NSI. MATERIAL AND METHODS: In 2016 the NSI safety concept at a large regional hospital was improved according to 2010/32/EU, specifically by an update of blood screening profiles and standard operating procedures (SOP), better dissemination of information to employees and complete conversion to safety cannulas and scalpels. The medical records of all NSIs from 2015-2017 were retrospectively anonymized and evaluated and a cost analysis was performed. RESULTS: The number of NSIs in 2017 was significantly reduced by 48.4% as compared to 2016 and NSIs with scalpels were completely prevented. The proportion of employees with NSIs who were adequately immunized against hepatitis B was significantly increased to 84.1% in 2017. Furthermore, identification of the index patient was significantly increased to 82.5% in 2017. The cost of avoiding NSIs increased by a total of 24.1% in 2017 as compared to 2015 before introduction of the safety concept. CONCLUSION: Implementation of the EU Council directive 2010/32/EU, resulted in an almost 50% reduction in NSIs over 1 year, including the complete prevention of NSIs due to scalpels. In addition, the anamnestic presence of immunization against hepatitis B and index patient identification were significantly increased.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha , União Europeia , Hospitais , Humanos , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Estudos Retrospectivos , Segurança
8.
Occup Med (Lond) ; 70(1): 38-44, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-31876940

RESUMO

BACKGROUND: Healthcare workers are at risk of blood and body fluid exposures (BBFE) while delivering care to patients. Despite recent technological advances such as safety-engineered devices (SEDs), these injuries continue to occur in healthcare facilities worldwide. AIMS: To assess the impact of an education and SEDs workplace programme on rates of reported exposures. METHODS: A retrospective cohort study, utilizing interrupted time series analysis to examine reported exposures between 2005 and 2015 at a 600-bed hospital in Perth, Western Australia. The hospital wards were divided into four cohorts. RESULTS: A total of 2223 records were available for analysis. The intervention was most effective for the first cohort, with significant improvements both short-term (reduction of 12 (95% CI 7-17) incidents per 1000 full-time equivalent (FTE) hospital staff) and long-term (reduction of 2 (CI 0.6-4) incidents per 1000 FTE per year). Less significant or consistent impacts were observed for the other three cohorts. Overall, the intervention decreased BBFE exposure rates at the hospital level from 19 (CI 18-20) incidents per 1000 FTE pre-intervention to 11 (CI 10-12) incidents per 1000 FTE post-intervention, a 41% reduction. No exposures resulted in a blood-borne virus infection. CONCLUSIONS: The intervention was most effective in reducing exposures at a time when incidence rates were increasing. The overall effect was short-term and did not further reduce an already stabilized trend, which was likely due to improved safety awareness and practice, induced by the first cohort intervention.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Exposição Ocupacional/prevenção & controle , Recursos Humanos em Hospital/estatística & dados numéricos , Equipamentos de Proteção , Adulto , Líquidos Corporais , Estudos de Coortes , Feminino , Hospitais de Ensino/estatística & dados numéricos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Recursos Humanos em Hospital/educação , Estudos Retrospectivos , Austrália Ocidental
11.
BMJ Open ; 9(11): e030576, 2019 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-31748292

RESUMO

OBJECTIVE: Needlestick and sharps injuries (NSIs) involving healthcare workers (HCWs) are worldwide under surveillance since long time; the implementation of the European Directive 32/2010 regarding the mandatory use of safety-engineered devices (SEDs) seems to have reduced the number of these accidents. Our surveillance investigated the frequency and the modality of SED-related NSIs in the Piedmont region to verify changes in the epidemiology of these events. METHODS: We analysed the exposure records of NSIs, device usage data and structural data of 42 acute care hospitals and compared conventional and safety devices. We calculated the accident rates per 100 000 needles and, as a measure of SED efficacy, the relative risk between the use of safety and non-safety devices with a 95% CI. We also described the dynamics of the NSIs and the most involved professional groups of HCWs, procedures and devices. RESULTS: Total and specific device accident rates for 100 000 needles were lower with the use of SEDs. In 2015-2016, there were 1640 NSIs, with a decreasing absolute number during the observation period; 18% were SEDs related. Half of the total accidents with SEDs occurred in the patient's room, and nurses were involved in 78% of the cases. The most involved devices were the butterfly needles and peripheral venous catheters, and the most involved procedures were venous sampling (40%) and phlebotherapy (16%). The exposures occurred mostly during the procedure, and 45% of the SED-related injuries occurred during the disposal of the device; 92% of the SEDs involved had a manual activation mechanism. CONCLUSION: In agreement with the results of other European studies, our results show that SEDs reduce the risk of percutaneous exposure of HCWs, but in introducing SEDs, we must select those with a higher level of safety (with a passive activation mechanism) and improve the healthcare staff training programmes.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/prevenção & controle , Equipamentos de Proteção , Hospitais , Humanos , Itália
12.
J Appl Lab Med ; 3(5): 847-856, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31639759

RESUMO

BACKGROUND: Blood draws are a routine element of the pediatric patient experience. They are also associated with the greatest fear and pain for a child. Because of the limited literature regarding phlebotomists' knowledge, experience, training, or stress related to their use of comfort techniques during pediatric blood draws, this study explored current practices and training methods. Phlebotomist training tends to focus on clinical technique rather than pediatric or patient comfort support. The study includes aims to develop a measurement for phlebotomists' use of comfort techniques for pediatric blood draws. METHOD: Focus groups of parent advocates (n = 24) and pediatric phlebotomists (n = 11) reviewed the survey questionnaire, and it was revised before being e-mailed to hospital system phlebotomists (n = 128). RESULTS: Almost half of the sample group lacked training in child development. The most frequently used comfort measures were words of explanation and reassurance, positioning of the child, and distraction. Requesting child life specialist support and using pain management devices or topical anesthetics were used less often. Primary challenges to performing pediatric blood draws were anxious patients and parents. CONCLUSION: Phlebotomists' use of available comfort measures occurs infrequently. Including child development and comfort techniques in training programs is essential to providing pediatric patients with a more satisfactory experience.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Laboratório Médico/educação , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Manejo da Dor/métodos , Conforto do Paciente/estatística & dados numéricos , Satisfação do Paciente , Flebotomia/normas , Anestésicos Locais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoal de Laboratório Médico/normas , Pais/psicologia , Flebotomia/estatística & dados numéricos
15.
BMC Res Notes ; 12(1): 563, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500659

RESUMO

OBJECTIVES: Workplace health and safety is vital in every organization particularly in the healthcare settings. The aim was to assess the levels of knowledge, attitude, and practices of the healthcare professionals towards safety at Gondar University referral hospital. An institution based cross-sectional study was conducted from February to June 2018. Proportional random sampling technique was used to include 282 study participants and data were collected using a structured self-administered questionnaire and analyzed using SPSS version 20. RESULTS: Among 282 study participants, 230 (81.6%), 181 (64.2%), and 162 (57.4%) had adequate knowledge, favorable attitude, and adequate practice scores, respectively. More than half (55.3%) of the study participants were untrained. There was a high (26.6%) prevalence of needlestick injury; however, the use of post-exposure prophylaxis after potential exposures was very limited. Generally, the levels of knowledge, attitude, and practice scores among the study participants were low. Therefore, there should be adequate and consistent supply of personal protective devices and other materials used for infection prevention and control. In addition, there should be awareness raising mechanism, including the provision of job aids and periodic training. Further, comprehensive studies should be conducted by including different types and levels of health facilities.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Hospitais Universitários , Infecções/diagnóstico , Medicina Preventiva/métodos , Encaminhamento e Consulta , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Pessoal de Saúde/normas , Humanos , Infecções/epidemiologia , Masculino , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/diagnóstico , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
16.
Enferm Clin ; 29 Suppl 2: 803-807, 2019 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31371251

RESUMO

OBJECTIVE: This study analyzes the different rate of incidence and prevention behavior for needlestick injuries (NSIs). METHOD: This is a quantitative study using a cross-sectional design. Respondents were selected using a stratified sampling method. The total number of respondents taking part in this research is 258, consisting of 51 academic nursing students, 70 clinical nursing students, and 137 in-service nurses who were selected randomly. RESULT: A Kruskal-Wallis test indicates that there is no significant difference (p 0.162). Beliefs and values influence the practice of breastfeeding, but a chi-squared test indicates that there is a significant difference in the NSI (p<0.001) in the prevalence of NSI among academic nursing students, clinical nursing students, and in-service nurses. CONCLUSION: NSIs among nursing students and nursing staff can be minimized by adopting safer practices when handling hypodermic syringes. Supervision must be conducted to make sure that nursing students and nurses adopt safer behaviors.


Assuntos
Comportamentos Relacionados com a Saúde , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Estudantes de Enfermagem , Adulto , Estudos Transversais , Feminino , Humanos , Incidência , Indonésia , Masculino , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Adulto Jovem
17.
Occup Med (Lond) ; 69(5): 352-358, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31375827

RESUMO

BACKGROUND: The 2013 UK sharps safety regulations require healthcare facilities to use safety-engineered devices (SEDs) to protect staff. The recent increase in UK-reported occupational exposures could indicate increased reporting or increased exposures from suboptimal SED use. AIMS: To ascertain SED use through examination of sharps container contents in a sample of UK hospitals. METHODS: Reusable sharps containers (RSCs) were selected from seven UK hospitals in 2013 and seven different hospitals in 2016. At licensed processing facilities, the operator, wearing protective apparel, decanted RSCs, separated hollow-bore needles (HBNs) from other sharps and enumerated HBNs into capped/uncapped non-SEDs, activated/non-activated/tampered SEDs, and blunt draw-up SEDs. Probability, risk ratios (RRs) and 95% confidence limits (95% CLs) were calculated using WinPepi v2.78. RESULTS: In 2013 and 2016, respectively, 2545 HBNs were categorized from 22 RSCs versus 2959 HBNs from 33 RSCs; 70% of HBNs were SEDs versus 93% (P < 0.001; RR 1.33; CL 1.30-1.37); 32% of activatable HBNs were not activated versus 22% (<0.001; 0.67; 0.60-0.76); 41% of HBNs were discarded 'sharp' versus 20% (<0.001; 0.48; 0.44-0.52); 25% of HBNs were uncapped needles versus 6% (<0.001; 0.22; 0.19-0.26); 5% of HBNs were capped needles versus 1% (P > 0.05); and 1% of SEDs were tampered with in both years (P > 0.05). Hospital practices varied widely. CONCLUSIONS: SED use and activation have increased significantly since 2013. Of concern is that in 2016, 22% of SEDs were non-activated and 20% of sharps were discarded 'sharp'. Increased training in SED handling, assiduous adherence to safe sharps work practices and a higher level of individual safety-ownership are indicated.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Equipamentos de Proteção/estatística & dados numéricos , Segurança de Equipamentos , Hospitais/estatística & dados numéricos , Exposição Ocupacional/prevenção & controle , Reino Unido
18.
Occup Environ Med ; 76(10): 739-745, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31439689

RESUMO

OBJECTIVES: Healthcare workers, in the course of their professional activity, are potentially exposed to chemical, physical and above all biological risks. The aims of our study were to investigate the extent and distribution of needle-stick and sharp injuries (NSIs) in healthcare students, the behaviours and circumstances most frequently associated with NSIs, the frequency of NSI reporting and the adherence to the post-exposure protocols. METHODS: This study involved, through an interviewer-administered structured questionnaire, undergraduate and postgraduate students attending postgraduate medical schools and healthcare professional schools who underwent occupational health visits between January 2015 and July 2018. RESULTS: Of the 642 students that participated in the study, 95 (14.8%) sustained an NSI during the traineeship and, of these, 59 (62.1%) reported the NSI to the occupational health service. NSIs were significantly more frequent in older subjects (χ²=9.853, p=0.020) and, among medical residents, in surgical residents (χ²=31.260, p<0.0001); moreover, occurrence of NSIs increased with increasing duration of traineeship (t=-2.051, p=0.041). Reporting of NSIs significantly increased with increasing age (χ²=12.543, p=0.006), with medical residents significantly under-reporting NSIs compared with undergraduate healthcare professional students (χ²=10.718, p=0.001) and among medical residents, those attending critical care units had the highest under-reporting (χ²=7.323, p=0.026). CONCLUSIONS: The study showed remarkable under-reporting, as well as a lack of preparedness of students for NSI preventive and post-exposure effective measures. Our findings underline that healthcare student education should be reinforced to ensure that safe practices are carried out when needles and sharps are involved, as well as stressing the importance of NSI reporting and adherence to post-exposure prophylaxis protocols.


Assuntos
Internato e Residência/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Exposição Ocupacional/prevenção & controle , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Profilaxia Pós-Exposição/estatística & dados numéricos , Inquéritos e Questionários
19.
Jt Comm J Qual Patient Saf ; 45(10): 662-668, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31451354

RESUMO

INTRODUCTION: The Surgical Safety Checklist (SSC) decreases patient morbidity and mortality and improves operating room (OR) communication. However, the SSC does not currently include any discussion on employee safety. One institution has implemented a blood-borne pathogen exposure (BBPE) checkpoint in the SSC in order to improve employee safety and to further improve communication. The aim of this study was to determine if the implementation of a BBPE checkpoint improved caregiver safety and communication in the OR. METHODS: This was a multidisciplinary prospective survey study in which an anonymous questionnaire was distributed to all OR personnel who handle sharps. Survey responses were analyzed for demographics and BBPE safety attitudes. The frequency of reported BBPE incidents collected from quality improvement data 12 months before and after the implementation of the BBPE checkpoint were reviewed. RESULTS: Caregivers feel safer in the OR with the BBPE checkpoint (p < 0.001). Communication was improved. Compliance in trauma surgeries was less than elective. Reported BBPE incidents were significantly decreased based on quality improvement data (p = 0.045). CONCLUSION: The BBPE checkpoint was implemented in the SSC at one institution in order to emphasize employee safety and improve communication. The results shed light on the attitudes of OR personnel by suggesting an improvement in safety and communication. In addition, there has been decrease of reported BBPE incidents among OR personnel. Universal implementation of a BBPE checkpoint could improve provider safety and communication in all ORs.


Assuntos
Patógenos Transmitidos pelo Sangue , Lista de Checagem/normas , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Salas Cirúrgicas/organização & administração , Gestão da Segurança/organização & administração , Adulto , Atitude do Pessoal de Saúde , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Salas Cirúrgicas/normas , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Gestão da Segurança/normas , Inquéritos e Questionários/normas
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