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基于医院状况和个人防护设备使用情况,在 COVID-19 大流行前后医院工作人员暴露事件的发生频率:一项具有历史对照组的描述性研究。

Frequency of exposure incidents in hospital workers before and during the COVID-19 pandemic based on the hospital status and the use of personal protective equipment: a descriptive study with a historical comparison group.

机构信息

Dubrava University Hospital, Zagreb, Croatia.

Centre for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, Zagreb, Croatia.

出版信息

BMC Infect Dis. 2024 Sep 18;24(1):995. doi: 10.1186/s12879-024-09911-y.

Abstract

BACKGROUND

An occupational exposure, i.e. exposure incident (EI), is contact with potentially contaminated material that may contain bloodborne pathogens and that occurs during occupational activities inside or outside a health care facility, either during direct work with a patient or during contact with a patient's body fluids and tissues. This study aimed to compare the frequency of EIs in a university hospital before and during the Coronavirus Disease 2019 (COVID-19) pandemic.

METHODS

This was a descriptive study with a historical comparison group conducted at the Dubrava University Hospital (DUH) in Zagreb, Croatia. We compared the frequency of EIs among healthcare and non-healthcare workers before (from March 11, 2018, to March 10, 2020) and during (from March 11, 2020, to March 11, 2022) the COVID-19 pandemic, expressed as the number of EIs per number of hospitalized patients and the total number of hospital activities. We analyzed data based on the status of the hospital (a COVID-19 hospital or not) and the use of personal protective equipment (PPE) as recommended by the World Health Organization.

RESULTS

During the total analyzed period, 241 EIs were reported in DUH. Before the pandemic, 128 EIs were reported, compared to 113 during the pandemic. Before the pandemic, 91% of EIs were recorded in healthcare workers, while during the pandemic, 96% of EIs were recorded in healthcare workers. Slightly more EIs were recorded during the period of mixed work form and de-escalation of PPE. The rate of EIs relative to the total number of hospital patients was significantly higher during the pandemic (3.9/1000) than in the pre-pandemic period (2.5/1000). The rate of EIs relative to the total number of hospital activities was significantly higher during the pandemic (0.4/1000) than in the pre-pandemic period (0.2/1000).

CONCLUSION

The rate of EIs relative to the total number of hospitalized patients and the total number of hospital activities in DUH was significantly higher during the pandemic, and the rate of total EIs increased among healthcare workers during the COVID-19 pandemic. The results of this study show that it is necessary to constantly and effectively work on the prevention of EI.

摘要

背景

职业暴露,即接触事件(EI),是指在医疗机构内外的职业活动中接触到可能含有血源性病原体的潜在污染材料,接触方式为直接接触患者或接触患者的体液和组织。本研究旨在比较一家大学医院在 2019 年冠状病毒病(COVID-19)大流行前后的 EI 发生率。

方法

这是一项在克罗地亚萨格勒布杜布拉瓦大学医院(DUH)进行的描述性历史对照研究。我们比较了 COVID-19 大流行前后(分别为 2018 年 3 月 11 日至 2020 年 3 月 10 日和 2020 年 3 月 11 日至 2022 年 3 月 11 日),每住院患者人数和总住院活动数所表示的医护人员和非医护人员的 EI 发生率。我们根据医院的状态(是否为 COVID-19 医院)和世界卫生组织推荐的个人防护设备(PPE)的使用情况对数据进行了分析。

结果

在总分析期间,DUH 报告了 241 例 EI。大流行前报告了 128 例,大流行期间报告了 113 例。大流行前,91%的 EI 发生在医护人员身上,而大流行期间,96%的 EI 发生在医护人员身上。在混合工作形式和 PPE 降级期间,记录的 EI 略多。大流行期间,EI 发生率与住院患者总数的比值(3.9/1000)明显高于大流行前(2.5/1000)。大流行期间,EI 发生率与总住院活动数的比值(0.4/1000)明显高于大流行前(0.2/1000)。

结论

在大流行期间,DUH 每住院患者人数和总住院活动数的 EI 发生率明显较高,COVID-19 大流行期间医护人员的总 EI 发生率增加。本研究结果表明,必须不断有效地开展预防 EI 工作。

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