医护人员对肺结核职业暴露的态度、知识和实践。
Attitudes, knowledge and practices of healthcare workers regarding occupational exposure of pulmonary tuberculosis.
作者信息
Bhebhe Lesley T, Van Rooyen Cornel, Steinberg Wilhelm J
机构信息
Department of Family Medicine, Faculty of Health Sciences, University of the Free State, South Africa.
出版信息
Afr J Prim Health Care Fam Med. 2014 Oct 17;6(1):E1-6. doi: 10.4102/phcfm.v6i1.597.
BACKGROUND
Healthcare-associated tuberculosis (TB) has become a major occupational hazard for healthcare workers (HCWs). HCWs are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Whenever there is a possibility of exposure, implementation of infection prevention and control (IPC) practices is critical.
OBJECTIVE
Following a high incidence of TB among HCWs at Maluti Adventist Hospital in Lesotho, a study was carried out to assess the knowledge, attitudes and practices of HCWs regarding healthcare-associated TB infection and infection controls.
METHODS
This was a cross-sectional study performed in June 2011; it involved HCWs at Maluti Adventist Hospital who were involved with patients and/or sputum. Stratified sampling of 140 HCWs was performed, of whom, 129 (92.0%) took part. A self-administered, semi-structured questionnaire was used.
RESULTS
Most respondents (89.2%) had appropriate knowledge of transmission, diagnosis and prevention of TB; however, only 22.0% of the respondents knew the appropriate method of sputum collection. All of the respondents (100.0%) were motivated and willing to implement IPC measures. A significant proportion of participants (36.4%) reported poor infection control practices, with the majority of inappropriate practices being the administrative infection controls (> 80.0%). Only 38.8% of the participants reported to be using the appropriate N-95 respirator.
CONCLUSION
Poor infection control practices regarding occupational TB exposure were demonstrated, the worst being the first-line administrative infection controls. Critical knowledge gaps were identified; however, there was encouraging willingness by HCWs to adapt to recommended infection control measures. Healthcare workers are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Implementation of infection prevention and control practices is critical whenever there is a possibility of exposure.
背景
医疗保健相关结核病（TB）已成为医护人员的主要职业危害。由于经常与未确诊且可能具有传染性的结核病患者互动，医护人员不可避免地会接触到结核病。只要存在接触的可能性，实施感染预防与控制（IPC）措施就至关重要。
目的
在莱索托马鲁蒂基督复临医院医护人员中结核病发病率较高之后，开展了一项研究，以评估医护人员对医疗保健相关结核病感染及感染控制的知识、态度和做法。
方法
这是一项于2011年6月进行的横断面研究；研究对象为马鲁蒂基督复临医院中接触患者和/或痰液的医护人员。对140名医护人员进行分层抽样，其中129人（92.0%）参与了研究。使用了一份自我填写的半结构化问卷。
结果
大多数受访者（89.2%）对结核病的传播、诊断和预防有适当的了解；然而，只有22.0%的受访者知道正确的痰液采集方法。所有受访者（100.0%）都有积极性并愿意实施IPC措施。相当一部分参与者（36.4%）报告感染控制措施执行不力，大多数不当措施是行政感染控制（>80.0%）。只有38.8%的参与者报告使用了合适的N-95口罩。
结论
研究表明在职业性结核病接触方面感染控制措施执行不力，最严重的是一线行政感染控制。发现了关键的知识差距；然而，医护人员有令人鼓舞的意愿去采用推荐的感染控制措施。由于经常与未确诊且可能具有传染性的结核病患者互动，医护人员不可避免地会接触到结核病。只要存在接触的可能性，实施感染预防与控制措施就至关重要。
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