Department of Infectious Diseases, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Department of Infectious Diseases, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Am J Infect Control. 2014 Feb;42(2):174-7. doi: 10.1016/j.ajic.2013.07.017. Epub 2013 Dec 20.
Health care workers are exposed to bloodborne pathogens through occupational injuries, and the replacement of sharps by safety-engineered devices has been recommended as a key preventive measure. This recommendation has been difficult to implement in Brazil.
We conducted a retrospective study of selected data from a database of blood and body fluid exposures reported from January 2007 through December 2011 in a public general hospital in Rio de Janeiro where, from the end of 2009, a safety lancet for blood glucose testing (BGT) was introduced. A log-binomial model was used to evaluate the effect of the introduction of the safety lancet on the proportion of percutaneous injuries (PIs) during BGT in the nursing staff.
Nursing staff had a significant reduction in rate of PIs per 100 full-time equivalents from 2007 to 2011 (P < .001), and medical residents had the highest rate throughout the same period. A reduction of PIs by small-gauge needles was observed since 2009, and injuries during BGT fell abruptly in 2010 and 2011 paralleling the number of purchased safety lancets (P < .001).
The adoption of a single safety device, which required no training, significantly reduced PIs among the nursing team.
医护人员通过职业伤害接触血源性病原体，而用安全工程设计的器械替代锐器已被推荐为一项主要的预防措施。这一建议在巴西难以实施。
我们对 2007 年 1 月至 2011 年 12 月期间在里约热内卢一家公立综合医院报告的血液和体液暴露的选定数据库中的数据进行了回顾性研究，在该医院，自 2009 年底以来引入了一种用于血糖检测的安全采血针。采用对数二项式模型评估在护理人员中引入安全采血针对血糖检测期间经皮损伤（PIs）比例的影响。
护理人员每 100 个全职等效人员的 PIs 发生率从 2007 年到 2011 年显著下降（P<.001），同期住院医师的发生率最高。自 2009 年以来，小口径针头导致的 PIs 减少，并且 2010 年和 2011 年 BGT 期间的伤害急剧下降，与购买的安全采血针数量呈平行关系（P<.001）。
采用无需培训的单一安全器械显著减少了护理团队中的 PIs。
