Yapıcı Gülçin, Kurt Ahmet Öner, Solmaz Elif Tuğçe, Yeniocak Tunç Aylin, Bozdağ Fatma, Buğdaycı Yalçın Bengü Nehir, Kaplan Ekin, Uğuz Burcu Ecem, Dülger Eray, Özkayalar Hülya, Aslan Gönül, Ersöz Gülden
Mersin University Faculty of Medicine, Department of Public Health, Mersin, Turkey.
Mersin University Hospital Infection Control Committee, Mersin, Turkey.
Mikrobiyol Bul. 2021 Apr;55(2):161-179. doi: 10.5578/mb.20219904.
Healthcare workers are the group with the highest risk of COVID-19 transmission. The illness of healthcare workers poses a risk to patients admitted to the hospital, colleagues and households besides their own health. In this study, it was aimed to determine the risk assessment and the factors associated with risk status of an university hospital healthcare workers after risky COVID-19 contact. The data of the descriptive study were obtained from 773 follow-up records of 555 healthcare workers who applied with COVID-19 risky contact between 06.04-10.05.2020. Employees who were positive for RT-PCR evaluated as "patients" and others as "risky contact". Risk assessment was classified as no risk, low, medium and high risk contact according to the "Algorithm of Assessment of Health Workers with COVID-19 Contact" of the Ministry of Health. The relationship between the risk levels of the participants and their demographic and workplace characteristics and their usage of personal protection were evaluated. Mean, standard deviation, percentage, chi-square and ANOVA tests were used in the analysis of the data. The average age of the healthcare workers was determined as 34.4 ± 7.6 years. It was determined that 56.2% of those who had contact were female, 62.9% were married and 17.5% had an additional disease. It was determined that 45.6% of the risky contacts were nurses, 18.4% were supportive personnel and 16.9% were doctors. While 46.5% of the contacts were found as medium, 28.0% low, 17.1% high risk and 8.4% risk free. 38.2% of risky contacts occurred while working in internal/surgical clinics. While 66.0% of the employees had risky contact during patient care and treatment, 25% had risky contact with colleagues in social settings. High-risk contact was higher in social relations between employees. The source of the contact was a colleague in 73.2% of the employees. The average age of high-risk employees was smaller than those of low-risk. While 54.5% of the employees wore surgical masks during contact, 67.8% of the patients did not have a mask. Of 555 employees followed, 37 (6.7%) were diagnosed as COVID-19; 48.6% of the patients were nurses and 18.9% were doctors. It was determined that 48.6% of the healthcare workers were working in the COVID-19 service, outpatient clinic or intensive care unit at the time of diagnosis. The source of the infection was thought to be a colleague in 51.6% of the patients. COVID-19 was more common in nurses and doctors. It was determined that risky contact also occurred in services other than the units where COVID-19 patients were treated and risky contact often took place while providing healthcare to the patients and during social relations between the employees. Unprotected contact of the employees with each other in the workplace was identified as an important risk source. Inadequate use of personal protective equipment by healthcare workers led to an increase in medium and high risk contacts. The use of masks by patients and their relatives during the health service delivery and the proper use of personal protective equipment by healthcare professionals will reduce the risk. With the physical improvement of the rest areas of the employees and the arrangement of the breaks, the risky contact between colleagues in the social areas will be reduced.
医护人员是新冠病毒传播风险最高的群体。医护人员感染新冠病毒不仅会对自身健康造成威胁,还会给住院患者、同事及家人带来风险。本研究旨在确定某大学医院医护人员在发生新冠病毒暴露风险接触后,其风险评估情况以及与风险状态相关的因素。描述性研究的数据来自于2020年4月6日至5月10日期间因新冠病毒暴露风险接触前来就诊的555名医护人员的773份随访记录。实时荧光定量聚合酶链反应(RT-PCR)检测呈阳性的员工被评估为“患者”,其他员工被评估为“风险接触者”。根据卫生部的《新冠病毒接触医护人员评估算法》,风险评估分为无风险、低风险、中等风险和高风险接触。对参与者的风险水平与其人口统计学和工作场所特征以及个人防护用品的使用情况之间的关系进行了评估。数据分析采用均值、标准差、百分比、卡方检验和方差分析。医护人员的平均年龄为34.4±7.6岁。接触者中56.2%为女性,62.9%已婚,17.5%患有其他疾病。风险接触者中45.6%为护士,18.4%为辅助人员,16.9%为医生。46.5%的接触被判定为中等风险,28.0%为低风险,17.1%为高风险,8.4%为无风险。38.2%的风险接触发生在内科/外科门诊工作期间。66.0%的员工在患者护理和治疗期间发生风险接触,25%在社交场合与同事发生风险接触。员工之间的社交关系中高风险接触更为常见。73.2%的员工接触源为同事。高风险员工的平均年龄低于低风险员工。54.5%的员工在接触时佩戴外科口罩,而67.8%的患者未佩戴口罩。在接受随访的555名员工中,37人(6.7%)被诊断为新冠病毒感染;48.6%的患者为护士,18.9%为医生。确诊时48.6%的医护人员在新冠病毒服务科室、门诊或重症监护病房工作。51.6%的患者感染源被认为是同事。新冠病毒感染在护士和医生中更为常见。研究还发现,除了新冠病毒患者治疗科室外,其他科室也存在风险接触,且风险接触通常发生在为患者提供医疗服务以及员工社交关系期间。员工在工作场所未采取防护措施相互接触被确定为重要风险源。医护人员个人防护用品使用不当导致中等和高风险接触增加。患者及其家属在医疗服务过程中佩戴口罩以及医护人员正确使用个人防护用品将降低风险。改善员工休息区域的条件并合理安排休息时间,将减少社交区域同事之间的风险接触。