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波兰医护人员对血液传播病原体危害的行为和态度:基于问卷调查的研究。

Behaviors and Attitudes of Polish Health Care Workers with Respect to the Hazards from Blood-Borne Pathogens: A Questionnaire-Based Study.

机构信息

Department of Hygiene and Health Promotion; Medical University of Lodz, 90-752 Lodz, Poland.

Department of Econometrics, University of Lodz, 90-214 Lodz, Poland.

出版信息

Int J Environ Res Public Health. 2019 Mar 12;16(5):891. doi: 10.3390/ijerph16050891.

Abstract

Blood-borne infections represent an important occupational health issue in health care settings. The aim of this study was to analyze behaviors of health care workers (HCWs) in the field of needlestick injuries (NSIs) as well as to learn about their attitudes to patients infected with blood-borne viruses. A total of 487 HCWs based at 26 hospitals in Poland completed an anonymous self-administered questionnaire in the period of October⁻December 2015. Data was analyzed using descriptive statistics and multiple logistic regression. Of the HCWs, 44.8% suffered superficial wounds, and 17.9% HCWs were cut deeply at least once. The most frequent causes of injuries were: rush (31.4%), unpredictable patient behavior (29%), and lack of attention (27%). The rate of underreporting NSIs was 45.2%. Males showed more than three times higher chance of not reporting injuries (odds ratio (OR) 3.495, 95% Confidence Interval (CI): 1.65⁻7.49). The nurses more often took off their protective gloves to make the procedure easier ( = 0.036). Taking off protective clothes was positively associated with long work experience (OR 1.16, 95% CI: 0.995⁻1.36). Recapping concerned 15.5% of doctors, 8.2% of nurses, and 11.2% of paramedics. 25.9% HCWs feared infection in the workplace, and every tenth HCW refused to help the infected patient. The longer the work experience, the greater the concern about the possibility of infection (OR 1.33, 95% CI: 0.99⁻1.78). Most HCWs were more cautious when dealing with an infected patient and in their opinion infected patients should be required to inform HCWs of their serological status and such information should be compulsorily transferred between different health institutions. The emphasis in the training of HCWs in the future should be on classes perfecting practical skills like paying more attention to reporting NSIs, improving occupational behaviors like avoiding needle recapping, and on the development of appropriate attitudes towards patients infected with HIV, HBV, or HCV.

摘要

血源性病原体感染是医疗保健环境中一个重要的职业健康问题。本研究的目的是分析医护人员(HCWs)在针刺伤(NSI)领域的行为,并了解他们对感染血源性病原体的患者的态度。2015 年 10 月至 12 月期间,共有 487 名 HCWs 在波兰 26 家医院完成了匿名自我管理问卷调查。使用描述性统计和多逻辑回归分析数据。44.8%的 HCWs 遭受过浅表伤口,17.9%的 HCWs 至少有一次被深度切割。受伤最常见的原因是:匆忙(31.4%)、不可预测的患者行为(29%)和缺乏注意力(27%)。NSI 漏报率为 45.2%。男性报告受伤的可能性高出三倍以上(比值比(OR)3.495,95%置信区间(CI):1.65-7.49)。护士更经常摘下防护手套以使操作更容易( = 0.036)。脱下防护服与较长的工作经验呈正相关(OR 1.16,95%CI:0.995-1.36)。重新套针帽涉及 15.5%的医生、8.2%的护士和 11.2%的护理人员。25.9%的 HCWs 担心在工作场所感染,每 10 名 HCW 中就有 1 人拒绝帮助感染患者。工作经验越长,对感染可能性的担忧就越大(OR 1.33,95%CI:0.99-1.78)。大多数 HCWs 在处理感染患者时更加谨慎,他们认为感染患者应告知 HCWs 其血清学状况,并且此类信息应在不同医疗机构之间强制转移。未来 HCWs 培训的重点应放在完善实践技能的课程上,例如更加注意报告 NSI,改善职业行为,如避免重新套针帽,并培养对感染 HIV、HBV 或 HCV 的患者的适当态度。

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