Zafar Afia, Habib Faiza, Hadwani Roshan, Ejaz Muslima, Khowaja Khurshid, Khowaja Rozina, Irfan Seema
Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, Pakistan.
BMC Infect Dis. 2009 May 29;9:78. doi: 10.1186/1471-2334-9-78.
Accidental exposure to blood and body fluids is frequent among health care workers. They are at high risk of nosocomial transmission of blood borne pathogens due to injuries caused by used sharps. We are reporting impact of surveillance and educational program on the rate of needle stick injuries among health care workers at a tertiary care hospital in Pakistan.
At Aga Khan University Hospital sharp injuries are reported to infection control office. To reduce these incidents a quality improvement project was inducted in the year 2005. Health care workers were educated; surveillance data from 2002 to 2007 was analyzed and compared with various risk factors.
During study period 1382 incidents were reported. Junior doctors sustained highest number of injuries (n = 394; 28.5%) followed by registered nurses (n = 283; 20.4%). Highest number of incidents was reported during blood collection (19%). An increasing trend was observed in the pre intervention years (2002-04). However noticeable fall was noted in the post intervention period that is in year 2006 and 2007. Major decline was noted among nurses (from 13 to 5 NSI/100 FTE/year). By relating and comparing the rates with various activities directly linked with the use of syringes a significant reduction in incidents were found including; hospital admissions (p-value 0.01), surgeries and procedures performed (p = 0.01), specimens collected in the laboratory (p = 0.001) and patients visits in clinics (p = 0.01).
We report significant reduction in needle stick injuries especially during post intervention study period. This is being achieved by constant emphasis on improving awareness by regular educational sessions, implemented as a quality improvement project.
医护人员经常意外接触血液和体液。由于使用过的锐器造成的伤害,他们面临医院内血源性病原体传播的高风险。我们报告了在巴基斯坦一家三级护理医院开展的监测和教育项目对医护人员针刺伤发生率的影响。
在阿迦汗大学医院,锐器伤需报告给感染控制办公室。为减少这些事件,2005年启动了一个质量改进项目。对医护人员进行了教育;分析了2002年至2007年的监测数据,并与各种风险因素进行了比较。
在研究期间共报告了1382起事件。初级医生受伤次数最多(n = 394;28.5%),其次是注册护士(n = 283;20.4%)。采血期间报告的事件数量最多(19%)。在干预前的年份(2002 - 2004年)观察到上升趋势。然而,在干预后的2006年和2007年注意到明显下降。护士中的下降最为显著(从每年每100全时当量13起针刺伤降至5起)。通过将发生率与与注射器使用直接相关的各种活动进行关联和比较,发现事件发生率显著降低,包括:住院人数(p值 = 0.01)、进行的手术和操作(p = 0.01)、实验室采集的标本(p = 0.001)以及门诊患者就诊次数(p = 0.01)。
我们报告针刺伤显著减少,特别是在干预后的研究期间。这是通过作为质量改进项目定期开展教育课程不断强调提高意识来实现的。