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医学生的职业性血液接触。

Occupational exposure to blood in medical students.

作者信息

Rabbitts Jennifer Anne

机构信息

Faculty of Health Sciences, University of Stellenbosch, Tygerberg, W Cape.

出版信息

S Afr Med J. 2003 Aug;93(8):621-4.

Abstract

OBJECTIVE

To determine the extent of occupational exposure to blood in medical students, details of the circumstances surrounding the incidents and the subsequent experiences of the student.

DESIGN

Prospective cohort study.

SETTING

Tygerberg Hospital, the Health Sciences Faculty of the University of Stellenbosch during a 15-week period from 4 February to 19 May 2002.

SUBJECTS

One hundred and thirty-six student interns (SIs), i.e. final-year medical students.

METHOD

All Sis received a questionnaire and a letter motivating them to participate in the study and explaining the procedure. Regular class meetings enabled continuous motivation and ongoing update. In the case of an incident during the 15-week period, the SI filled in the form and placed it in a sealed drop-off box.

OUTCOME MEASURES

Specific focus on the preceding events and the situation in which the incidents occurred (department, time of day, procedure performed, and whether the student was on call), exposure to HIV (patient's retroviral status), use of post-exposure prophylaxis (PEP) (whether used, when initiated), and the consequences of the exposure (emotional, on sexual behaviour during the window period, and on career choice).

RESULTS

During the 15-week period, 19 incidents were reported; the majority occurred while students were on call, almost half occurred after hours, and a disproportionate number occurred in three departments.

CONCLUSIONS

Occupational blood exposure is a very real problem and poses a significant risk. SI suggestions should be considered in improving the prevention and management of such incidents.

摘要

目的

确定医学生职业接触血液的程度、事件发生的具体情况细节以及学生随后的经历。

设计

前瞻性队列研究。

地点

泰格堡医院,斯泰伦博斯大学健康科学学院,时间为2002年2月4日至5月19日的15周期间。

研究对象

136名实习医学生,即医学专业最后一年的学生。

方法

所有实习医学生都收到一份问卷和一封信,鼓励他们参与研究并解释研究程序。定期的班会能持续给予鼓励并不断更新信息。在15周期间若发生事件,实习医学生填写表格并放入密封的投递箱。

观察指标

特别关注事件发生前的情况以及事件发生的场景(科室、一天中的时间、所进行的操作以及学生是否在值班)、接触艾滋病毒的情况(患者的逆转录病毒状态)、使用暴露后预防措施(PEP)的情况(是否使用、何时开始使用)以及暴露的后果(情绪方面、窗口期内的性行为以及职业选择方面)。

结果

在15周期间,共报告了19起事件;大多数事件发生在学生值班时,近一半发生在工作时间之外,且三个科室发生的事件数量不成比例。

结论

职业性血液暴露是一个非常现实的问题,且构成重大风险。在改进此类事件的预防和管理方面应考虑实习医学生的建议。

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