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印度那格浦尔一家三级护理中心护士关于针刺伤、艾滋病毒和乙肝预防的知识、态度及实践:一项横断面研究

Knowledge, Attitudes, and Practices of Nurses Regarding Needle Stick Injuries, HIV, and Hepatitis B Prevention in a Tertiary Care Center in Nagpur, India: A Cross-Sectional Study.

作者信息

Sain Sanjay, Ramasamy Nishaant, Verma Ishan, Tripathy Jaya Prasad, Narang Udit, Kumbhalkar Sunita, Dube Amol H, Nagpure Keshao B

机构信息

General Medicine, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.

Community Medicine, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.

出版信息

Cureus. 2025 Jul 2;17(7):e87160. doi: 10.7759/cureus.87160. eCollection 2025 Jul.

DOI:10.7759/cureus.87160
PMID:40655069
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12246879/
Abstract

Introduction Needlestick injuries (NSIs) pose serious health risks to healthcare workers, especially nurses, due to the potential transmission of HIV and Hepatitis B. Despite available guidelines for vaccination and post-exposure prophylaxis (PEP), awareness and adherence remain low, particularly in developing countries like India. Nurses face high NSI risk due to their frontline role in patient care, yet limited Indian studies assess their knowledge, attitudes, and practices (KAP) on this issue. This cross-sectional study was conducted among nurses at a tertiary care hospital in Nagpur using a validated questionnaire to evaluate KAP regarding NSI prevention and management. The findings aim to highlight existing gaps and support targeted interventions to reduce NSI-related infections and improve occupational safety among nurses. Methods A cross-sectional analytical study was conducted at a tertiary care hospital in Nagpur City, situated in the central part of India, from December 2023 to February 2024. Based on an assumed 50% prevalence, the calculated sample size was 216 nurses. A validated, self-administered online questionnaire assessing KAP related to needlestick injuries, HIV, and Hepatitis B was distributed via Google Forms (Google, Mountain View, California, US) to 500 nurses; 227 responded. Responses were scored and categorized into good, average, or poor knowledge. Data were analysed using Stata version 18 (StataCorp LLC, College Station, TX, US) with appropriate statistical tests. Ethical approval was obtained for the study. Results The prevalence of NSIs was 40.5% (92 out of 227 participants; 95% CI: 34.1%-47.2%). Good knowledge was observed in 203 (89.4%) for NSI, 159 (70%) for HIV, and 211 (93%) participants for Hepatitis B. However, 68 participants (30%) had only average or poor knowledge of HIV. No significant association was found between NSI occurrence and age, gender, experience, or marital status. Similarly, knowledge levels for NSI, HIV, and Hepatitis B were not significantly influenced by demographic factors. Attitudes were largely positive: 203 participants (92.6%) perceived the NSI risk as serious, and 214 (97.7%) believed NSIs are preventable. Most supported immediate reporting and PEP for HIV (204; 94.4%) and Hep B (201; 93%). Despite this, only 27 of 87 (31%) received PEP after injury. NSIs frequently involved hypodermic needles or lancets and occurred during disposal or recapping. However, unsafe practices persisted, with 53 of 219 (24%) of nurses recapping needles, a behaviour significantly associated with NSI incidence (p = 0.045). The most cited barriers to NSI reporting were time constraints (166; 78.3%) and lack of awareness about reporting procedures (98; 46%). Conclusion This study highlights that nurses possess good knowledge and positive attitudes toward NSI, HIV, and Hepatitis B. However, gaps remain in translating knowledge into safe practices and consistent PEP adherence. Strengthening training, reinforcing safety protocols, and fostering a supportive institutional environment are essential to reduce occupational risks and enhance healthcare worker safety.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36e3/12246879/2b40fa4b80fb/cureus-0017-00000087160-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36e3/12246879/2b40fa4b80fb/cureus-0017-00000087160-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36e3/12246879/2b40fa4b80fb/cureus-0017-00000087160-i01.jpg
摘要

引言

针刺伤(NSIs)对医护人员,尤其是护士构成严重的健康风险,因为存在感染艾滋病毒和乙型肝炎的潜在风险。尽管有可用的疫苗接种和暴露后预防(PEP)指南,但认知度和依从性仍然很低,特别是在印度等发展中国家。护士因其在患者护理中的一线角色而面临较高的针刺伤风险,但印度针对护士在此问题上的知识、态度和行为(KAP)的研究有限。本横断面研究在那格浦尔的一家三级护理医院对护士进行,使用经过验证的问卷来评估关于针刺伤预防和管理的KAP。研究结果旨在突出现有差距,并支持有针对性的干预措施,以减少与针刺伤相关的感染,提高护士的职业安全性。

方法

2023年12月至2024年2月,在位于印度中部那格浦尔市的一家三级护理医院进行了一项横断面分析研究。基于假定的50%的患病率,计算出的样本量为216名护士。通过谷歌表单(谷歌,美国加利福尼亚州山景城)向500名护士发放了一份经过验证的、自我管理的在线问卷,评估与针刺伤、艾滋病毒和乙型肝炎相关的KAP;227人回复。对回复进行评分,并分为知识良好、中等或较差。使用Stata 18版本(美国德克萨斯州大学站StataCorp有限责任公司)进行适当的统计测试对数据进行分析。该研究获得了伦理批准。

结果

针刺伤的患病率为40.5%(227名参与者中有92人;95%置信区间:34.1%-47.2%)。203名(89.4%)参与者对针刺伤、159名(70%)对艾滋病毒、211名(93%)对乙型肝炎有良好的认知。然而,68名参与者(30%)对艾滋病毒的知识仅为中等或较差。未发现针刺伤的发生与年龄、性别、经验或婚姻状况之间存在显著关联。同样地,针刺伤、艾滋病毒和乙型肝炎的知识水平也未受到人口统计学因素的显著影响。态度大多是积极的:203名参与者(92.6%)认为针刺伤风险严重,214名(97.7%)认为针刺伤是可预防的。大多数人支持对艾滋病毒(20个4;94.4%)和乙型肝炎(201个;93%)立即报告并进行暴露后预防。尽管如此,87名受伤护士中只有27名(31%)接受了暴露后预防。针刺伤经常涉及皮下注射针或采血针,且发生在处置或重新盖帽过程中。然而,不安全行为仍然存在,219名护士中有53名(24%)重新盖帽,这种行为与针刺伤发生率显著相关(p = 0.045)。针刺伤报告中最常提到的障碍是时间限制(166个;78.3%)和对报告程序缺乏认知(98个;46%)。

结论

本研究强调护士对针刺伤、艾滋病毒和乙型肝炎拥有良好的知识和积极的态度。然而,在将知识转化为安全行为以及持续坚持暴露后预防方面仍存在差距。加强培训、强化安全规程以及营造支持性的机构环境对于降低职业风险和提高医护人员安全性至关重要。

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