Olubuyide I O, Olawuyi F
Department of Medicine, University College Hospital, Ibadan, Nigeria.
J R Soc Health. 1995 Aug;115(4):235-6, 241-3. doi: 10.1177/146642409511500408.
An anonymous survey of 149 resident doctors was conducted to estimate the extent of accidental exposures to blood and body fluids of patients over a one-year period. There was a total of 1142 exposures. Ninety-three percent of respondents reported one or more exposure incident(s). Analysis of events and procedures leading to accidental exposures revealed that recapping needles was involved in 17%, suturing accounted for 14%, setting up intravenous lines 11%, cuts with scalpel 9% and phlebotomy 9%. Surgical residents had a threefold greater risk of exposure compared with medicine residents. No trend was found for accidental exposures by level of residency training. Seventy-four percent of the residents used universal precautions 50% or less of the time. Only half of the doctors could recall formal instruction on correct course of action after exposure and 5% of them had as undergraduates hepatitis B vaccine prior to the commencement of venepuncture duties. All but one of the residents' exposures were not reported to the Staff Medical Services Department. The doctor who reported was neither tested for hepatitis B virus or human immunodeficiency virus nor was he properly treated. Only 5 (4.6%) of the contaminating patients were evaluated serologically for their status of these viruses. These data emphasize the need for increased efforts toward improved early and continuing education, prevention and correct management of accidental exposures to blood or body fluids of patients by resident doctors in Nigeria. No recent study exists that exclusively addresses this problem in doctors in tropical Africa.
对149名住院医生进行了一项匿名调查，以评估他们在一年时间内意外接触患者血液和体液的情况。总共发生了1142次接触。93%的受访者报告了一起或多起接触事件。对导致意外接触的事件和操作进行分析后发现，重新盖帽针头占17%，缝合占14%，建立静脉输液管占11%，手术刀切割占9%，静脉穿刺占9%。外科住院医生接触的风险是内科住院医生的三倍。未发现按住院医师培训水平划分的意外接触趋势。74%的住院医生在50%或更少的时间内使用了通用预防措施。只有一半的医生能回忆起接触后正确处理方法的正规培训，其中5%的医生在开始静脉穿刺工作前作为本科生接种过乙肝疫苗。除一名住院医生外，其他人的接触事件均未报告给医务人员服务部。报告的那名医生既没有接受乙肝病毒或人类免疫缺陷病毒检测，也没有得到妥善治疗。只有5名（4.6%）受污染患者接受了这些病毒感染状况的血清学评估。这些数据强调，尼日利亚的住院医生需要加大力度，加强早期和持续教育、预防以及对意外接触患者血液或体液的正确管理。目前尚无专门针对热带非洲医生这一问题的近期研究。
