Aigbodion Sunday J, Motara Feroza, Laher Abdullah E
Department of Emergency Medicine, Far East Rand Hospital, Johannesburg, South Africa.
Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
South Afr J HIV Med. 2019 May 22;20(1):958. doi: 10.4102/HIVMED.v20i1.958. eCollection 2019.
Healthcare workers (HCWs) are constantly vulnerable to occupational blood and body fluid exposures (OBBFEs). Exposed HCWs experience emotional, physical and psychological trauma. Less experienced HCWs, such as intern doctors, are more prone to OBBFEs.
The aim of this study was to investigate the prevalence and practices pertaining to OBBFEs amongst a select group of intern doctors in the Gauteng province of South Africa.
A quantitative cross-sectional descriptive study using a questionnaire based on a practical model was used. Intern doctors were recruited from four major hospitals in Gauteng.
A total of 175 intern doctors participated in the study. There was a total of 182 (mean = 1.04, standard deviation [s.d] 0.88) reported OBBFEs amongst 136 (77.7%) subjects. The exposures occurred predominantly whilst subjects were working in surgery ( = 50, 27.5%), obstetrics and gynaecology ( = 49, 26.9%) and internal medicine ( = 48, 26.4%) departments; were superficial wounds ( = 69, 37.9%); were acquired during vascular puncture or intravenous line insertion ( = 69, 37.9%); and occurred when subjects were working >12 h shifts ( = 101, 55.5%). Human immunodeficiency virus (HIV) post-exposure prophylaxis (PEP) was initiated in 141 (77.5%) out of the 182 exposures. Only 90 (63.8%) subjects completed the recommended 28-day course of PEP. Two (1.1%) subjects reported that they had acquired HIV infection as a consequence of the OBBFE.
Occupational blood and body fluid exposures are common amongst intern doctors. It is recommended that regular training, health education and monitoring compliance should be incorporated during the induction of medical intern doctors in hospitals. The availability of PEP regimens with better tolerability will encourage compliance.
医护人员一直面临职业性血液和体液暴露(OBBFE)的风险。暴露的医护人员会经历情感、身体和心理创伤。经验不足的医护人员,如实习医生,更容易发生职业性血液和体液暴露。
本研究旨在调查南非豪登省一组选定的实习医生中职业性血液和体液暴露的发生率及相关情况。
采用基于实用模型的问卷进行定量横断面描述性研究。从豪登省的四家主要医院招募实习医生。
共有175名实习医生参与了研究。136名(77.7%)受试者共报告了182次职业性血液和体液暴露(平均 = 1.04,标准差[s.d.] 0.88)。暴露主要发生在受试者在外科(= 50,27.5%)、妇产科(= 49,26.9%)和内科(= 48,26.4%)科室工作时;为浅表伤口(= 69,37.9%);在血管穿刺或静脉置管期间发生(= 69,37.9%);且发生在受试者轮值超过12小时时(= 101,55.5%)。182次暴露中有141次(77.5%)启动了人类免疫缺陷病毒(HIV)暴露后预防(PEP)。只有90名(63.8%)受试者完成了推荐的28天PEP疗程。两名(1.1%)受试者报告他们因职业性血液和体液暴露而感染了HIV。
职业性血液和体液暴露在实习医生中很常见。建议在医院实习医生入职培训期间纳入定期培训、健康教育和监测依从性。提供耐受性更好的PEP方案将鼓励依从性。