Perkin M R, Higton A, Witcomb M
Department of Child Health, St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK.
Occup Environ Med. 2003 Sep;60(9):699-700. doi: 10.1136/oem.60.9.699.
Nosocomial infections place a heavy burden on overstretched health services. An audit of junior doctors' sick leave behaviour was undertaken in 1993 and again in 2001. The object was to ascertain the level of common infectious illness and to investigate whether junior doctors were remaining at work inappropriately. The doctors were asked if any factors had influenced their decision to take sick leave or not. Between the two audits several initiatives have been introduced to improve the working conditions of junior doctors, including the New Deal to reduce hours of work. Eighty one junior doctors in a large teaching hospital participated in 1993 and 110 in 2001. The number reporting an infectious illness in the previous six months was similar (61.7% in 1993, 68.2% in 2001). There had been a significant increase in the percentage of infectious illness episodes for which the doctors took sick leave (15.1% in 1993, 36.8% in 2001, p < 0.001). The most common reason for taking less sick leave than was felt necessary was concern about colleagues having to do extra work (72% in 1993, 68% in 2001). Consultant pressure was cited by 26% (1993) and 20% (2001). Use of the staff occupational health unit was minimal, with none of the ill doctors contacting the department in 1993 and only three in 2001. Overall, despite the reduction in the number of infectious doctors not taking sick leave, the majority remained at work. Fundamental changes are needed if potentially infected doctors are not to present a risk of iatrogenic infection.
医院感染给不堪重负的医疗服务带来了沉重负担。1993年对初级医生的病假行为进行了一次审计,并于2001年再次进行。目的是确定常见传染病的发病水平,并调查初级医生是否不适当地坚持工作。医生们被问及是否有任何因素影响了他们请病假的决定。在两次审计之间,已经采取了多项举措来改善初级医生的工作条件,包括减少工作时间的新政。1993年,一家大型教学医院的81名初级医生参与了调查,2001年有110名。报告在过去六个月内患有传染病的人数相似(1993年为61.7%,2001年为68.2%)。医生因传染病发作而请病假的比例有了显著增加(1993年为15.1%,2001年为36.8%,p<0.001)。请病假天数少于认为必要天数的最常见原因是担心同事不得不承担额外工作(1993年为72%,2001年为68%)。1993年有26%的医生提到受到了顾问的压力,2001年为20%。员工职业健康部门的利用率极低,1993年没有生病的医生联系该部门,2001年只有三名。总体而言,尽管未请病假的感染医生人数有所减少,但大多数人仍坚持工作。如果潜在感染的医生不构成医源性感染风险,就需要进行根本性变革。