Azar-Cavanagh Madelyn, Burdt Pam, Green-McKenzie Judith
University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Infect Control Hosp Epidemiol. 2007 Feb;28(2):165-70. doi: 10.1086/511699. Epub 2007 Jan 19.
To evaluate the effect of introducing an engineered device for preventing injuries from sharp instruments (engineered sharps injury prevention device [ESIPD]) on the percutaneous injury rate in healthcare workers (HCWs).
We undertook a controlled, interventional, before-after study during a period of 3 years (from January 1998 through December 2000) at a major medical center. The study population was HCWs with potential exposure to bloodborne pathogens. HCWs who sustain a needlestick injury are required by hospital policy to report the exposure. A confidential log of these injuries is maintained that includes information on the date and time of the incident, the type and brand of sharp device involved, and whether an ESIPD was used.
Introduction of an intravenous (IV) catheter stylet with a safety-engineered feature (a retractable protection shield), which was placed in clinics and hospital wards in lieu of other IV catheter devices that did not have safety features. No protective devices were present on suture needles during any of the periods. The incidence of percutaneous needlestick injury by IV catheter and suture needles was evaluated for 18 months before and 18 months after the intervention.
After the intervention, the incidence of percutaneous injuries resulting from IV catheters decreased significantly (P<.01), whereas the incidence of injuries resulting from suture needle injuries increased significantly (P<.008).
ESIPDs lead to a reduction in percutaneous injuries in HCWs, helping to decrease HCWs' risk of exposure to bloodborne pathogens.
评估引入一种预防锐器伤的工程设备（工程化锐器伤预防设备[ESIPD]）对医护人员经皮损伤率的影响。
我们在一家大型医疗中心进行了一项为期3年（从1998年1月至2000年12月）的对照、干预、前后对照研究。研究人群为有潜在血源性病原体暴露风险的医护人员。根据医院政策，发生针刺伤的医护人员需报告暴露情况。保存一份这些损伤的保密记录，包括事件发生的日期和时间、所涉及锐器的类型和品牌，以及是否使用了ESIPD。
引入一种具有安全设计特征（可回缩保护套）的静脉输液（IV）导管芯，将其放置在诊所和医院病房，以取代其他没有安全特征的IV导管设备。在任何时期，缝合针上均未配备保护装置。在干预前18个月和干预后18个月评估IV导管和缝合针导致的经皮针刺伤发生率。
干预后，IV导管导致的经皮损伤发生率显著下降（P<.01），而缝合针导致的损伤发生率显著上升（P<.008）。
ESIPD可降低医护人员的经皮损伤，有助于降低医护人员暴露于血源性病原体的风险。
