在尼日利亚东南部一家三级医院的医护人员中，针和锐器伤及乙肝疫苗接种的流行情况。

Prevalence of Needle Stick and Sharps Injury and Hepatitis B Vaccination among Healthcare Workers in a South-East Nigerian Tertiary Hospital.

机构信息

Department of Paediatrics, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus.

Department of Applied Microbiology, Nnamdi Azikiwe University, Awka.

出版信息

West Afr J Med. 2022 Jan 31;39(1):24-30.

PMID:35156784

Abstract

BACKGROUND

Daily, HCWs are exposed to needle stick and sharps injury (NSSI) and associated risk of life-threatening infections.

AIM

A cross-sectional study was conducted to determine the prevalence of NSSI and HBV vaccination among 341 HCWs at NAUTH, Nnewi.

METHODS

Data was collected using a self-administered. questionnaire and interview of key staff.

RESULTS

The mean age of participants was 33.4±11.9 years while male: female ratio was 1:1.7. Prevalence of NSSI in the preceding 12 months was 25.5% with doctors (43.0% [34/79]), laboratory scientists (27.5%[14/51]) and nurses (21.8%[17/78]) leading (p=0.014). Noncompliance with standard precaution (SP) and non-display of relevant SP SOPs in prominent places were significantly associated with NSSI (p=0.001). Among those exposed to NSSI, only 33.7% (28/83) consulted a doctor, while 16.9%(14/83) took post-exposure prophylaxis. Two-third (68.8% [190/276]) of respondents correctly cited HBV/HCV as vaccine-preventable blood-borne healthcare-associated infection (HAI) while half (50.9% [161/316]) had received HBV vaccination. Profession (p=0.018), display of SOPs in prominent places (p=0.015), ability to cite HBV/HCV as vaccine-preventable blood-borne HAI (p=0.001), and compliance with SP (p<0.001) were significantly associated with HBV vaccination. Unit heads' responses implied lack of written policy on HBV vaccination, adequate training on NSSI prevention, and HBV vaccination support.

CONCLUSION

Among HCWs, NSSI is high but under-reported while HBV vaccination rate is unimpressive. Profession, display of relevant SOPs, and compliance with SP positively affected both NSSI occurrence and HBV vaccination while knowledge about vaccine-preventable blood-borne HAI also influence HBV vaccination status. Written policies on HBV vaccination and NSSI prevention/ management, their communication and enforcement among HCWs, adequate training/retraining, display of SOPs in prominent places, and free HBV vaccination are recommended.

摘要

背景

医护人员（HCWs）每天都面临针刺和锐器伤（NSSI）以及由此带来的危及生命的感染风险。

目的

本研究旨在通过横断面研究，确定在 NAUTH、Nnewi 的 341 名 HCWs 中，NSSI 的流行率以及乙型肝炎病毒（HBV）疫苗接种率。

方法

通过自填式问卷和对关键人员的访谈收集数据。

结果

参与者的平均年龄为 33.4±11.9 岁，男女比例为 1:1.7。在过去 12 个月中，NSSI 的发生率为 25.5%，其中医生（43.0%[34/79]）、实验室科学家（27.5%[14/51]）和护士（21.8%[17/78]）发生率较高（p=0.014）。不遵守标准预防措施（SP）和未在显眼位置展示相关 SP 标准操作规程（SOP）与 NSSI 显著相关（p=0.001）。在暴露于 NSSI 的人群中，仅有 33.7%（28/83）咨询了医生，而 16.9%（14/83）接受了暴露后预防。三分之二（68.8%[190/276]）的受访者正确指出乙型肝炎/丙型肝炎（HBV/HCV）是可通过疫苗预防的血源性医源性感染（HAI），而一半（50.9%[161/316]）接受过 HBV 疫苗接种。职业（p=0.018）、在显眼位置展示 SOP（p=0.015）、能够正确指出乙型肝炎/丙型肝炎（HBV/HCV）是可通过疫苗预防的血源性 HAI（p=0.001）以及遵守 SP（p<0.001）与 HBV 疫苗接种显著相关。单位负责人的回应表明，该机构缺乏 HBV 疫苗接种书面政策、关于 NSSI 预防的充分培训以及对 HBV 疫苗接种的支持。

结论

在 HCWs 中，NSSI 发生率较高，但报告不足，而 HBV 疫苗接种率令人不满意。职业、展示相关 SOP 和遵守 SP 均对 NSSI 发生和 HBV 疫苗接种产生积极影响，而对疫苗可预防的血源性 HAI 的认识也影响 HBV 疫苗接种状况。建议制定 HBV 疫苗接种和 NSSI 预防/管理的书面政策、在 HCWs 中进行政策沟通和执行、提供充分的培训/再培训、在显眼位置展示 SOP 以及提供免费的 HBV 疫苗接种。