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接受培训的医疗保健专业人员针刺伤的跨学科差异:提高情景意识以预防高风险伤害。

Interdisciplinary differences in needlestick injuries among healthcare professionals in training: Improving situational awareness to prevent high-risk injuries.

作者信息

Katsevman Gennadiy A, Sedney Cara L, Braca Iii John A, Hatchett Lena

机构信息

Department of Neurological Surgery, West Virginia University, Morgantown, WV, USA.

Department of Neurological Surgery, Indiana University, Indianapolis, IN, USA.

出版信息

Work. 2020;65(3):635-645. doi: 10.3233/WOR-203118.

Abstract

BACKGROUND

Needlestick injuries among healthcare professionals continue to be an occupational hazard, frequently and incorrectly regarded as low-risk, and exacerbated by underreporting. We aimed to investigate rates of needlestick injury, reasons for underreporting, and how explicit announcements that patients are "high-risk" (i.e., human immunodeficiency virus, hepatitis, or intravenous drug abuse history) might affect the actions of those at risk of sustaining an injury.

METHODS

A cross-sectional survey was administered to medical students (MS), nursing students (NS), and residents.

RESULTS

30/224 (13%) of MS, 6/65 (9%) of NS, and 67/126 (53%) of residents experienced needlestick injuries. 37% of MS, 33% of NS, and 46% of residents attributed "lack of concentration" as cause of injury. Residents had the lowest percentage of underreporting (33%), with rates of 40% and 83% among MS and NS, respectively. Top reasons for non-reporting included the injury being perceived as "trivial" (22%) and patient being "low-risk" (18%). A majority stated pre-operative "high-risk" announcements should be required (91%), and would promote "culture of safety" (82%), reporting of injuries (85%), and increased concentration during procedures (70%).

CONCLUSIONS

We recommend routine announcements during pre-operative time-out and nursing/resident hand-offs that state a patient is "high-risk" if applicable. We hypothesize such policy will promote a "culture of safety," situational awareness, and incident reporting.

摘要

背景

医护人员的针刺伤仍然是一种职业危害,常常被错误地认为风险较低,且因报告不足而加剧。我们旨在调查针刺伤的发生率、报告不足的原因,以及明确告知患者为“高风险”(即有人类免疫缺陷病毒、肝炎或静脉药物滥用史)如何影响有受伤风险人员的行为。

方法

对医学生、护理学生和住院医师进行了一项横断面调查。

结果

医学生中有30/224(13%)、护理学生中有6/65(9%)、住院医师中有67/126(53%)经历过针刺伤。37%的医学生、33%的护理学生和46%的住院医师将“注意力不集中”归因于受伤原因。住院医师的报告不足率最低(33%),医学生和护理学生的报告不足率分别为40%和83%。未报告的主要原因包括认为损伤“轻微”(22%)和患者“低风险”(18%)。大多数人表示应要求在术前进行“高风险”告知(91%),这将促进“安全文化”(82%)、损伤报告(85%)以及手术过程中注意力的提高(70%)。

结论

我们建议在术前暂停及护理/住院医师交接班时,如有适用情况,常规宣布患者为“高风险”。我们推测这样的政策将促进“安全文化”、情境意识和事件报告。

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