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埃塞俄比亚西北部医护人员针刺伤和锐器伤的患病率及相关因素

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia.

作者信息

Berhan Zemene, Malede Asmamaw, Gizeyatu Adinew, Sisay Tadesse, Lingerew Mistir, Kloos Helmut, Dagne Mengesha, Gebrehiwot Mesfin, Ketema Gebremariam, Bogale Kassahun, Eneyew Betelhiem, Hassen Seada, Natnael Tarikuwa, Yenuss Mohammed, Berhanu Leykun, Abebe Masresha, Berihun Gete, Wagaye Birhanu, Faris Kebede, Keleb Awoke, Ademas Ayechew, Woldeyohanes Akalu Melketsadik, Feleke Alelgne, Yayeh Tilaye Matebe, Chanie Muluken Genetu, Muche Amare, Dewau Reta, Fentaw Zinabu, Ayele Wolde Melese, Mebratu Wondwosen, Adane Bezawit, Tegegne Tesfaye Birhane, Addisu Elsabeth, Arefaynie Mastewal, Yalew Melaku, Damtie Yitayish, Kefale Bereket, Asfaw Zinet Abegaz, Andualem Atsedemariam, Tegegne Belachew, Belay Emaway, Adane Metadel

机构信息

Quality Improvement Unit, Finote Selam General Hospital, Finote Selam, Ethiopia.

Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

出版信息

PLoS One. 2021 Sep 24;16(9):e0252039. doi: 10.1371/journal.pone.0252039. eCollection 2021.

Abstract

BACKGROUND

Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia.

METHODS

An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs.

MAIN FINDINGS

The prevalence of NSSIs was 29.5% (95% CI: 24.2-35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18-4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10-5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13-4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14-4.41).

CONCLUSION

This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

摘要

背景

针刺伤和锐器伤(NSSIs)是医护人员(HCWs)中常见的问题。尽管埃塞俄比亚的多项研究已充分记录了与医护人员针刺伤相关的因素,但尚未有关于埃塞俄比亚西北部医院针刺伤的严重程度及相关因素的报道。

方法

2019年1月至3月,在南戈德尔地区八家医院中随机选取的三家医院的318名医护人员中开展了一项基于机构的横断面研究。样本量按比例分配到不同专业类别。研究参与者采用系统随机抽样方法选取,以每个职业的月薪工资单作为抽样框架。通过自填式问卷收集数据。本研究的结果是在数据收集前12个月内是否发生针刺伤和锐器伤。采用95%置信区间(CI)的二元逻辑回归模型进行数据分析。双变量分析中p值≤0.25的变量纳入多变量分析。在多变量分析中,p值小于0.05的变量被视为与针刺伤和锐器伤显著相关的因素。

主要发现

在调查前的12个月内,针刺伤和锐器伤的发生率为29.5%(95%CI:24.2 - 35.5%)。其中,46.0%的人报告其损伤为中度,浅表伤占33.3%,重伤占20.7%。约41.4%的损伤是由缝合针造成的。与针刺伤和锐器伤显著相关的因素包括护士职业(调整优势比[AOR]=2.65,95%CI:1.18 - 4.26)、在安全盒以外的地方处理锐器(AOR = 3.93,95%CI:2.10 - 5.35)、重新盖帽针头(AOR = 2.27,95%CI:1.13 - 4.56)以及工作时感到困倦(AOR = 2.24,95%CI:1.14 - 4.41)。

结论

本研究表明,近三分之一的医护人员遭受过针刺伤和锐器伤,这一比例较高。与针刺伤和锐器伤显著相关的因素包括护士职业、重新盖帽针头的习惯、在安全盒以外的地方处理锐器以及工作时感到困倦。在日常临床活动中对护士遵守适当且常规的通用预防措施,提供用于处理锐器的安全盒,采用机械方法重新盖帽针头,并通过减轻医护人员的工作负担来预防困倦,可能会降低针刺伤和锐器伤的发生率。

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