Occupational and Aviation Medicine, University of Otago, Wellington, New Zealand.
Saf Health Work. 2012 Sep;3(3):209-15. doi: 10.5491/SHAW.2012.3.3.209. Epub 2012 Aug 30.
Knowledge, attitudes, and practices of healthcare providers related to occupational exposure to bloodborne pathogens were assessed in a tertiary-care hospital in Middle East.
A cross-sectional study was undertaken using a self-administered questionnaire based on 3 paired (infectivity known vs. not known-suspected) case studies. Only 17 out of 230 respondents had an exposure in the 12 months prior to the survey and of these, only 2 had complied fully with the hospital's exposure reporting policy.
In the paired case studies, the theoretical responses of participating health professionals showed a greater preference for initiating self-directed treatment with antivirals or immunisation rather than complying with the hospital protocol, when the patient was known to be infected. The differences in practice when exposed to a patient with suspected blood pathogens compared to patient known to be infected was statistically significant (p < 0.001) in all 3 paired cases. Failure to test an infected patient's blood meant that an adequate risk assessment and appropriate secondary prevention could not be performed, and reflected the unwillingness to report the occupational exposure.
Therefore, the study demonstrated that healthcare providers opted to treat themselves when exposed to patient with infectious disease, rather than comply with the hospital reporting and assessment protocol.
评估中东一家三级保健医院的医疗保健提供者在职业性接触血源性病原体方面的知识、态度和实践。
采用基于 3 对(已知传染性 vs. 未知-疑似)病例研究的自我管理问卷进行横断面研究。在调查前 12 个月内,230 名受访者中仅有 17 人有接触史,其中仅 2 人完全遵守了医院的接触报告政策。
在配对病例研究中,参与的卫生专业人员的理论反应表明,当患者已知感染时,他们更倾向于自行开始抗病毒治疗或免疫接种,而不是遵守医院的方案。与接触已知感染患者相比,接触疑似血液病原体患者的做法差异在所有 3 对病例中均具有统计学意义(p < 0.001)。未能对感染患者的血液进行检测意味着无法进行充分的风险评估和适当的二级预防,这反映了不愿报告职业接触。
因此,该研究表明,医疗保健提供者在接触传染病患者时选择自行治疗,而不是遵守医院的报告和评估方案。