Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle Upon Tyne, NE2 4AX, UK.
Faculty of Applied Medical Sciences, Qassim University, Qassim, Saudi Arabia.
Antimicrob Resist Infect Control. 2023 Jun 13;12(1):57. doi: 10.1186/s13756-023-01257-5.
Clinical laboratories provide diagnostic testing services to support the effective delivery of care in today's complex healthcare systems. Processing clinical material and the use of chemicals or radiation presents potential hazard to laboratory workers, from both biological and chemical sources. Nevertheless, the laboratory should be a safe workplace if the identification of possible hazards, clear guidelines, safety rules and infection prevention and control (IPC) precautions are applied and followed. The main aim of this systematic review was to identify, critically appraise and synthesise the research evidence to gain a clear explanation of the implementation and knowledge, attitude and practice (KAP) of IPC guidelines among hospital laboratory staff.
For this systematic review we searched MEDLINE, EMBASE, Scopus and CINAHL (EBSCO), PubMed, grey literature, reference lists and citations for studies published between database inception and November, 2021. All qualitative, quantitative and mixed-methods studies whose aim was to explore risk perception and KAP of IPC guidelines among laboratory staff in any healthcare setting were included, without language or date restrictions. Evidence was narratively synthesised into group of themes. The quality of the evidence was assessed with Joanna Briggs Institutes Critical Appraisal Tools.
After the full-text screening, a total of 34 articles remained and were included in the final review. Thirty papers were considered to be of high quality and the remaining four were considered to be of low quality. The available evidence shows that there was good knowledge, good attitudes and moderate immunisation status, but there was still poor practice of IPC precautions and an inadequate level of training among laboratory workers.
There is a gap among KAP related to the implementation of IPC guidelines, which indicates that laboratory staff may be at high risk of acquiring infections in the workplace. These findings suggest that training (including IPC precautions, safety policies, safety equipment and materials, safety activities, initial biohazard handling, ongoing monitoring and potential exposure) of laboratory staff to increase their knowledge about IPC precautions could improve their use of these precautions.
临床实验室为支持当今复杂医疗保健系统中的有效护理提供诊断检测服务。处理临床材料和使用化学物质或辐射会给实验室工作人员带来潜在危害，这些危害来自生物和化学两个方面。然而，如果识别可能的危害、制定明确的指南、安全规则以及感染预防和控制（IPC）预防措施，并加以应用和遵循，实验室应该是一个安全的工作场所。本系统评价的主要目的是确定、批判性评估和综合研究证据，以清楚地解释医院实验室工作人员对 IPC 指南的实施、知识、态度和实践（KAP）。
为了进行这项系统评价，我们在 MEDLINE、EMBASE、Scopus 和 CINAHL（EBSCO）、PubMed、灰色文献、参考文献和引文数据库中搜索了从数据库建立到 2021 年 11 月发表的研究。所有旨在探索任何医疗保健环境下实验室工作人员对 IPC 指南的风险感知和 KAP 的定性、定量和混合方法研究均被纳入，无语言或日期限制。证据被叙述性地综合成一组主题。使用 Joanna Briggs 研究所的批判性评估工具评估证据的质量。
经过全文筛选，共有 34 篇文章被保留并纳入最终综述。30 篇文章被认为是高质量的，其余 4 篇被认为是低质量的。现有证据表明，实验室工作人员的知识水平较高，态度良好，免疫状况中等，但 IPC 预防措施的实践较差，工作人员的培训水平不足。
IPC 指南实施方面的 KAP 存在差距，这表明实验室工作人员在工作场所可能面临较高的感染风险。这些发现表明，对实验室工作人员进行培训（包括 IPC 预防措施、安全政策、安全设备和材料、安全活动、初始生物危害处理、持续监测和潜在暴露），以提高他们对 IPC 预防措施的认识，可能会改善他们对这些预防措施的使用。
