University of Illinois at Chicago Medical Center, Emergency Medicine, 820 S Damen Ave., Chicago, IL 60612, USA.
Am J Infect Control. 2011 Mar;39(2):129-34. doi: 10.1016/j.ajic.2010.06.023.
It has been estimated that more than 8 million health care workers (HCWs) in the United States may be exposed to blood and body fluids via sharp and mucocutaneous exposures.
An anonymous questionnaire was distributed among 505 HCWs. The target sample population included all the medical students; nursing professionals; dental professionals; and residents in internal medicine, emergency medicine, surgery, and obstetrics and gynecology at the University of Illinois Medical Center, Chicago, Illinois, a metropolitan tertiary care and referral center for Northern Illinois and Northwest Indiana. The sample was limited by the number of HCWs who were available to take the survey. The number and the characteristics of occupational exposures and reporting practices were recorded and compiled. Subsequently, a review of the English literature was performed using PubMed to analyze reasons for underreporting. Secondary and tertiary articles were located based on findings from the initial searches.
One hundred three of 455 (22.6%) HCWs reported a sharps exposure during their career, including their student years; thirty-four (33.0%) of these were not reported. One hundred five of 455 (23.1%) HCWs reported a mucocutaneous exposure during their career; 87 (82.9%) of these were not reported. The most common year of exposure was the intern year. The most common reason for not reporting was the belief that the exposure was not significant, followed by the combination of believing the exposure was not significant and being too busy.
Underreporting of blood and body fluid exposures is common because of a belief that most exposures are not significant. More education of HCWs is needed to change this perspective.
据估计,美国有超过 800 万名医护人员(HCWs)可能通过锐器和黏膜接触暴露于血液和体液中。
我们向伊利诺伊大学医学中心(芝加哥,伊利诺伊州)的 505 名 HCWs 分发了匿名问卷。目标样本人群包括所有医学生、护理专业人员、牙科专业人员以及内科、急诊医学、外科和妇产科的住院医师。该样本受到可接受调查的 HCWs 数量的限制。记录并编译了职业暴露和报告实践的数量和特征。随后,我们使用 PubMed 对英文文献进行了回顾,以分析报告不足的原因。根据初步搜索结果找到了二级和三级文章。
在职业生涯中,包括学生时代,有 103 名(22.6%)HCWs 报告了锐器暴露,其中 34 名(33.0%)未报告。在职业生涯中,有 105 名(23.1%)HCWs 报告了黏膜接触暴露,其中 87 名(82.9%)未报告。暴露最常见的年份是实习年。未报告的最常见原因是认为暴露不严重,其次是认为暴露不严重且太忙。
由于认为大多数暴露并不严重,因此血液和体液暴露的报告不足很常见。需要对 HCWs 进行更多的教育,以改变这种观念。