College of Human and Health Science, Swansea University, United Kingdom.
Int J Nurs Stud. 2012 Aug;49(8):953-68. doi: 10.1016/j.ijnurstu.2012.03.001. Epub 2012 Mar 27.
Occupational acquisition of blood-borne infections has been reported following exposure to blood or body fluids. Consistent adherence to standard precautions will reduce the risk of infection.
To identify: the frequency of self-reported adverse exposure to blood and body fluids among surgeons and scrub nurses during surgical procedures; contributory factors to such injuries; the extent of compliance with standard precautions; and factors influencing compliance with precautions.
A multi-site mixed methods study incorporating a cross-sectional survey and interviews.
Six NHS trusts in Wales between January 2006 and August 2008.
Surgeons and scrub nurses and Senior Infection Control Nurses.
A postal survey to all surgeons and scrub nurses, who engaged in exposure prone procedures, followed by face to face interviews with surgeons and scrub nurses, and telephone interviews with Infection Control Nurses.
Response rate was 51.47% (315/612). Most 219/315 (69.5%) respondents reported sustaining an inoculation injury in the last five years: 183/315 (58.1%) reported sharps' injuries and 40/315 (12.7%) splashes. Being a surgeon and believing injuries to be an occupational hazard were significantly associated with increased risk of sharps' injuries (adjusted odds ratio 1.73, 95% confidence interval 1.04-2.88 and adjusted odds ratio 2.0, 1.11-3.5, respectively). Compliance was incomplete: 31/315 (10%) respondents always complied with all available precautions, 1/315 (0.003%) claimed never to comply with any precautions; 64/293 (21.8%) always used safety devices, 141/310 (45.5%) eye protection, 72 (23.2%) double gloves, and 259/307 (84.4%) avoided passing sharps from hand to hand. Others selected precautions according to their own assessment of risk. Surgeons were less likely to adopt eye protection (adjusted odds ratio 0.28, 0.11-0.71) and to attend training sessions (odds ratio 0.111, 0.061-0.19). The professions viewed the risks associated with their roles differently, with nurses being more willing to follow protocols.
Inter-professional differences in experiencing adverse exposures must be addressed to improve safety and reduce infection risks. This requires new training initiatives to alter risk perception and promote compliance with policies and procedures.
职业性血液传播感染的发生是由于接触血液或体液所致。始终如一地遵守标准预防措施将降低感染风险。
确定：外科医生和刷手护士在手术过程中自我报告的不良血液和体液暴露的频率；造成此类伤害的促成因素；标准预防措施的遵守程度；以及影响预防措施遵守的因素。
一项多地点混合方法研究，包括横断面调查和访谈。
2006 年 1 月至 2008 年 8 月期间威尔士的六家国民保健服务信托。
外科医生和刷手护士以及高级感染控制护士。
对所有从事暴露风险手术的外科医生和刷手护士进行邮寄调查，然后对外科医生和刷手护士进行面对面访谈，并对感染控制护士进行电话访谈。
回复率为 51.47%（315/612）。大多数 219/315（69.5%）受访者在过去五年中报告发生了接种伤害：183/315（58.1%）报告锐器伤害和 40/315（12.7%）喷溅。作为外科医生和认为伤害是职业危害，与锐器伤害的风险增加显著相关（调整后的优势比 1.73，95%置信区间 1.04-2.88 和调整后的优势比 2.0，1.11-3.5）。遵守情况不完全：31/315（10%）受访者始终遵守所有可用预防措施，1/315（0.003%）表示从不遵守任何预防措施；64/293（21.8%）始终使用安全装置，141/310（45.5%）使用眼部保护装置，72（23.2%）使用双层手套，259/307（84.4%）避免将锐器从一只手传递到另一只手。其他人根据自己对风险的评估选择预防措施。外科医生不太可能采用眼部保护装置（调整后的优势比 0.28，0.11-0.71）和参加培训课程（优势比 0.111，0.061-0.19）。不同专业的人对其角色相关风险的看法不同，护士更愿意遵循协议。
必须解决外科医生和刷手护士之间不良暴露经历的差异，以提高安全性并降低感染风险。这需要新的培训举措来改变风险认知并促进政策和程序的遵守。
