ObjectiveTo enhance the management of occupational exposure, improve post-exposure reporting, promote post-exposure follow-up, reduce blood-borne infections caused by exposure, and ensure occupational safety among medical staff by using comprehensive measures based on nosocomial infection management system.MethodsAll the reported cases of occupational exposure were retrospectively collected from August 2012 to July 2018. The cases were divided into the control group (from August 2012 to July 2015) in which the data were reported in paper, and the observation group (from August 2015 to July 2018) in which the data were reported by nosocomial infection management system. The report and follow up results of occupational exposure in the two groups were compared and analyzed.ResultsAfter three years application of nosocomial infection management system, the occupational exposure report increased 95.8% (increased from 16.7 cases per year to 32.7 cases per year); the follow-up ratio of occupational exposure after one month,3 months and 6 months increased from 65.0% to 93.3% (χ2=15.184, P<0.001), 45.0% to 73.3% (χ2=9.033, P=0.003), and 25.0% to 53.3% (χ2=8.522, P=0.004), respectively.ConclusionApplication of nosocomial infection management system can increase the report of occupational exposure and the follow-up ratio of occupational exposure significantly.
ObjectiveTo explore the risk factors and protective measures of the occupation exposure of probationer nurses in operation room. MethodsThe self-designed questionnaire was used to reveal the risk factors and protective measures of occupation exposure in probationer nurses worked at the operating room during January 2011 and December 2013. ResultsThe female probationer nurses in operating room accounted for 97.7%; the probationer nurses from the secondary specialized school accounted for 53.1%. All the nurses didn't received any occupational protection knowledge training in schools. The practical nurses who failed to follow the regulate operation accounted for 76.8%. The occupational exposure occurred in 457 nurses during the period, which accounted for 44.7% of all the probationer nurses surveyed; the biological occupational exposure accounted for 38.5%. ConclusionTo strengthen the occupation safety education of operation room nurses, strictly regulate the operation procedures, establish the consummation protection measures and regulations, and strengthen their self-protection awareness can effectively reduce the occupation exposure injury in the probationer nurses in operation room.
ObjectiveTo investigate the economic burden of the disposal of medical personnel after occupational exposure in medical institution.MethodA retrospective survey method was used to investigate and analyze the costs of inspection, treatment, and vaccination of 112 medical personnel after occupational exposure from January 2014 to December 2016.ResultsAfter the occupational exposure, the per capita economic burden on the medical institution for the exposed personnel was (331.80±66.16) yuan; the main expenditure item was the inspection expenses (93.53%); and the expenditure after the exposure of hepatitis B virus accounted for 75.40%, which ranked the top one in the expenditures of blood-derived infectious diseases. Occupational exposure was most likely to occur when dealing with sharps, and the cost of hospital spending accounted for 47.26%. After strengthening interventions such as standard prevention, the per capita cost of occupational exposures in the hospital from 2015 to 2016 showed a downward trend (P<0.05).ConclusionsOccupational exposure of medical personnel may cause a certain economic burden on medical institution. It is necessary to strengthen occupational protection, raise awareness of standard prevention, and reduce occupational exposure.
Objective To explore the influencing factors of medical staff’s preventive behaviors of occupational exposure using health belief model. Methods A questionnaire was used to investigate the health beliefs and prevention-related behaviors of medical staff in Shuguang Hospital Affilliated to Shanghai University of Traditional Chinese Medicine from July 2018 to June 2019. The preventive behaviors and health beliefs of health workers with different occupational categories and working years were analyzed descriptively, and the influence of health beliefs on preventive behaviors was analyzed with multiple linear regression. Results There were 400 copies of questionnaire dispatched and 384 recovered. Among the survey respondents, 258 (67.19%) were females, 169 (44.01%) were aged 20-30 years, and 203 (52.86%) had worked for 5 or less years; 158 (41.15%) had sharp injury experience, 171 (44.53%) had experience of exposure to blood or body fluids, and 290 (75.52%) were actively immunized by injecting vaccines. The total score of compliance with standard preventive behaviors of the 384 respondents was 6.94±3.12. The scores of perceived susceptibility, perceived severity, perceived barriers, perceived benefits, and perceived self-efficacy were 24.87±4.56, 31.27±5.92, 16.50±5.77, 36.06±5.60, and 15.27±2.98, respectively. The total score of health beliefs was 123.97±15.91. The compliance with standard preventive behaviors and total score of health beliefs of logistics staff were lower than those of other respondents (P<0.05). The scores of perceived barriers of medical technicians and clinicians were significantly higher than that of nurses (P<0.05). The scores of perceived benefits and perceived self-efficacy of clinicians were lower than those of nurses (P<0.05). Respondents who had worked for 6-10 years had better compliance with standard preventive behaviors than interns and the ones who had worked for 11-15 years (P<0.05), and had a lower total score of health beliefs than the ones who had worked for over 16 years (P<0.05). Respondents who had worked for over 16 years had better scores of perceived benefits and perceived self-efficacy (P<0.05), and had a lower score of perceived barriers (P<0.05). The results of multiple linear regression analysis showed that gender [nonstandardized partial regression coefficient (b)=–0.644, 95% confidence interval (CI) (–1.162, –0.125), P=0.015], educational background [b=1.367, 95%CI (1.245, 1.587), P<0.001], and score of perceived barriers [b=0.044, 95%CI (0.004, 0.084), P=0.031] were influencing factors of medical staff’s preventive behavior compliance. Conclusions The score of perceived barriers is a main factor that prevents medical staff from implementing standard preventive measures. In the occupational exposure training program, it may be effective to help medical staff establish good standard prevention habits by improving the awareness of obstacles.
ObjectiveTo know the status and risk factors of occupational exposure in a top-class hospital in Sichuan, and provide the basis for occupational safety and protective measures. Methods"Hospital Medical Staff Occupational Exposure Registration Form" was used in this retrospective study. Statistical analysis was performed on medical workers' exposure data between January 2011 and June 2014 in a top-class hospital in Sichuan Province. ResultsA total of 139 cases of occupational exposures were recorded in some of the medical staff. There were more females than males. Nurses had the most exposures (70.5%), and the exposure sources were mainly human immunodeficiency virus and hepatitis B virus (27.9% and 21.0%, respectively). The exposure type was mainly sharp injury (84.2%). Exposure occurred mainly in surgery (47.5%), and different job or places had different exposure types with significant differences (χ2=12.683, 20.897, P<0.05). Sharp injury was mainly caused by the scalp needle and syringe, and the injured sites were mainly upper limbs (98.3%). However, exposure to blood and body fluids occurred mainly on upper limbs (54.5%) or face (45.5%). ConclusionOccupational exposures are mainly sharp injuries, especially in surgeries. Women, nurses or medical staff with low qualifications had the highest exposure risk. Thus, occupational safety and protection training should be strengthened.
目的 了解医院内血源性职业暴露高风险人群，有针对性采取防护措施，降低血源性职业暴露的发生率。 方法 对2008年1月－2011年12月四川省妇幼保健院52例血源性职业暴露医务人员，按照暴露人群、暴露方式、暴露病种、暴露地点的不同进行调查分析。 结果 52例职业暴露人群中护士27例（占51.9%）；产房和手术室为高发职业暴露场所，共32例，分别为17例（占32.7%）和15例（占28.8%）；职业暴露病种主要为乙型肝炎，共27例（占51.9%）；暴露方式主要为针刺伤，共37例（占71.2%）。 结论 提高医务人员职业防护意识，规范操作流程，加强自身防护是减少职业暴露的根本所在。
ObjectiveTo evaluate the influence of personalized nursing intervention on the negative emotions after occupational exposure for nurses in the Emergency Department, in order to provide effective nursing intervention methods for relieving nurses' negative emotions after occupational exposure. MethodsTwenty nurses with occupational exposure between January and September 2013 were chosen to be the control group, and another 20 nurses with occupational exposure between October 2013 and October 2014 were designated as the personalized nursing group. The level of depression and anxiety was compared between the two groups by using the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) on the exposure day and 5 weeks after the exposure. ResultsBefore intervention, SDS score of the control group was 0.65±0.04 and of the personalized nursing group was 0.63±0.05, and there was no statistically significant difference between the two groups (t=0.59, P=0.44); SAS score of the control group was 51.98±6.77 and of the personalized nursing group was 50.73±10.03, and there was no statistically significant difference between the two groups (t=0.37, P=0.70). After the intervention, personalized nursing group had lower scores of SDS and SAS than the control group. SDS score was 0.64±0.11 in the control group and 0.50±0.09 in the personalized nursing group with a significant difference (t=5.11, P < 0.01); SAS score was 49.53±9.49 in the control group and 42.66±9.53 in the personalized nursing group, and the difference was statistically significant (t=4.10, P < 0.01). ConclusionThe personalized nursing intervention can effectively alleviate negative emotions after occupational exposure for nurses in the Emergency Department.