Mathews Rahel, Leiss Jack K, Lyden Jennifer T, Sousa Sara, Ratcliffe Jennifer M, Jagger Janine
Center for Health Research, Constella Group, LLC, Durham, NC 27713, USA.
Am J Infect Control. 2008 Dec;36(10):743-9. doi: 10.1016/j.ajic.2008.04.250. Epub 2008 Oct 3.
Paramedics are at risk for human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infection from occupational blood exposure. This study examined how often paramedics are provided with personal protective equipment (PPE), sharps containers, and selected safety devices by their employers; the frequency with which paramedics use sharps containers and these safety devices; and paramedics' attitudes regarding this equipment.
We conducted a mail survey among a nationally representative sample of certified paramedics. California was oversampled to allow for separate estimation of proportions for this population.
The final sample included 2588 paramedics, 720 of whom were from California (adjusted response rate, 55%). Paramedics in California were provided safety devices more often than paramedics in the United States as a whole. For each type of device, there was at least a 40% increase in use when the device was always provided compared with when it was not always provided. Eighty-four percent of paramedics thought that safety needles significantly reduce blood exposure, but substantial percentages thought that safety needles, eye protection, and masks interfere with some medical procedures. Approximately one fifth said that they need more training in the use of safety devices and PPE.
Lack of access to safety devices is the major barrier to their use, and the higher rates of provision and use in California may be the result of the state's early safety needle legislation. Increased provision, training, and improvement of safety equipment are needed to better protect paramedics from blood exposure.
护理人员因职业性血液暴露而面临感染人类免疫缺陷病毒、乙型肝炎病毒和丙型肝炎病毒的风险。本研究调查了雇主为护理人员提供个人防护装备（PPE）、锐器容器和选定安全装置的频率；护理人员使用锐器容器和这些安全装置的频率；以及护理人员对该设备的态度。
我们对全国具有代表性的注册护理人员样本进行了邮件调查。对加利福尼亚州进行了过度抽样，以便单独估计该人群的比例。
最终样本包括2588名护理人员，其中720名来自加利福尼亚州（调整后的回复率为55%）。加利福尼亚州的护理人员比美国整体的护理人员更常获得安全装置。对于每种类型的装置，与并非总是提供时相比，总是提供时的使用量至少增加了40%。84%的护理人员认为安全针头能显著减少血液暴露，但相当比例的人认为安全针头、眼部防护和口罩会干扰一些医疗程序。约五分之一的人表示他们需要更多关于安全装置和个人防护装备使用的培训。
无法获得安全装置是其使用的主要障碍，加利福尼亚州更高的提供率和使用率可能是该州早期安全针头立法的结果。需要增加安全设备的提供、培训并加以改进，以更好地保护护理人员免受血液暴露。
