Assessment of Knowledge, Attitude and Practices among Healthcare Workers in a Tertiary Care Hospital on Needle Stick Injury

Purpose: Needle-stick injury (NSI) is one of the most potential occupational hazards for healthcare workers because of the transmission of blood-borne pathogens. As per recent data, around 30 lakh healthcare workers sustain Needle stick injuries each year. This study was conducted to assess healthcare workers’ knowledge, attitude and practices regarding needle stick injury. Materials & Methods: A cross-sectional study was conducted in a Tertiary Care Hospital over the period of 3 months. The study population consisted of Intern Doctors, Post Graduate resident Doctors, Staff Nurses, laboratory technicians of Government Medical College and New Civil Hospital, Surat (n = 300). The data were collected using a self-administered questionnaire via the means of Google Forms. Questionnaire was made with prior review literature. The data obtained were entered and analysed in Microsoft Excel. Results: The prevalence of NSI in our study was 46%, with a higher prevalence among the PG residents (72%). Overall scores regarding knowledge and attitude were better in PG residents (knowledge score > 7 in 71% and Attitude Score > 7 in 68% of PG Residents). Even though the PG residents scored highest in the knowledge category, the majority of them suffered needle stick injuries as a result of poor practice scores. Among those who had NSI (n = 139/300), 70% of study participants had superficial injuries, only 9% reported the incident, 18% got medical attention within 2 hours of the incident, and 7% followed up to recheck their viral markers status. Most incidents of NSI were due to hypodermic needles while recapping needles. Conclusion: Exposure to needle stick injuries and their underreporting remains a common problem. It is imperative that healthcare workers receive regular training on the proper handling of sharp objects. We can also draw the conclusion that preventing NSIs requires putting knowledge into practice.

Association of overtime work and obesity with needle stick and sharp injuries in medical practice

BACKGROUND Needle stick and sharps injuries(NSIs)may cause infections among medical personnel.Obesity and overtime work among medical personnel increase the incidence of work injuries.AIM To investigate whether overtime work and obesity increase the risk of NSIs.METHODS This cross-sectional study used the data of 847 hospital personnel,including 104 doctors,613 nurses,67 medical laboratory scientists,54 specialist technicians,and nine surgical assistants.Of them,29 participants notified the hospital of having at least one NSI in 2017.The data collected included age,overtime work,body mass index,medical specialty such as doctor or nurse,and professional grade such as attending physician or resident.Theχ2 and Fisher’s exact tests were used to compare categorical variables.Multiple logistic regression analysis and the Sobel test were used to assess the risk of NSIs.RESULTS Overtime work,body weight,and medical specialty were significantly associated with NSIs(P<0.05).After adjustment for risk factors,heavy overtime work was an independent risk factor for NSIs,and healthy body weight and nursing specialty were independent protective factors against NSIs.After adjustment for risk factors,medical personnel with healthy body weight has half as many NSIs as those with unhealthy body weight;the proportion of NSIs in doctors with healthy body weight was 0.2 times that in doctors with unhealthy body weight;the proportion of injuries among residents was 17.3 times higher than that among attending physicians;the proportion of injuries among junior nurses was 3.9 times higher than that among experienced nurses;the proportion of injuries among nurses with heavy overtime work was 6.6 times higher than that among nurses with mild overtime work;and the proportion of injuries among residents was 19.5 times higher than that among junior nurses.Heavy overtime work mediated the association of medical specialty with NSIs.CONCLUSION In addition to promoting the use of safety needles and providing infection control education,managers should review overtime schedules,and medical personnel should be encouraged to maintain a healthy weight.

Sustained viral response of a case of acute hepatitis C virus infection via needle-stick injury

A 29-year-old nurse with a hepatitis C virus （HCV） infection caused by needle-stick injury was treated with interferon-beta starting about one year after the onset of acute hepatitis. The patient developed acute hepatitis C with symptoms of general fatigues, jaundice, and ascites 4 wk after the needle-stick injury. When these symptoms were presented, the patient was pregnant by artificial insemination. She hoped to continue her pregnancy. After delivery, biochemical liver enzyme returned to normal levels. Nevertheless, HCV RNA was positive and the pathological finding indicated a progression to chronicity. The genotype was lb with low viral load. Daily intravenous injection of interferon-beta at the dosage of six million units was started and continued for eight weeks. HCV was eradicated without severe adverse effects. In acute hepatitis C, delaying therapy is considered to reduce the efficacy but interferon-beta therapy is one of the useful treatments for hepatitis C infection in chronic phase.

Prevalence of Occupational Injury and Knowledge of Post-Exposure Prophylaxis Accessibility among Healthcare Workers in Mogadishu, Somalia

Introduction: Healthcare workers in Mogadishu, Somalia face significant occupational injury risks, particularly needle stick injuries, with 61.1% reporting incidents. This poses a serious threat to their health, leading to infections such as hepatitis B, hepatitis C, and HIV. Despite the high prevalence of injuries, awareness of Post-Exposure Prophylaxis (PEP) accessibility is relatively high, with 84.0% of respondents aware of it. However, there are gaps in knowledge and implementation, as evidenced by variations in availability of PEP. Improving workplace safety measures, providing comprehensive training on injury prevention and PEP protocols, and ensuring consistent availability of PEP in healthcare facilities are crucial steps to safeguard the well-being of healthcare workers in Mogadishu, Somalia. Methods: A cross-sectional study was conducted among hospital workers in Mogadishu, Somalia, focusing on professionals from various healthcare facilities. The study targeted nurses, doctors, laboratory personnel, and pharmacists. Purposive sampling was employed, resulting in a sample size of 383 calculated using Fisher’s sample size formula. Data were collected using coded questionnaires entered into Microsoft Excel 2019 and analyzed with SPSS software to generate frequencies and proportions, presented through frequency tables and pie figures. Results: The study in Mogadishu, Somalia, examined the prevalence of occupational injuries and knowledge of Post-Exposure Prophylaxis (PEP) accessibility among healthcare workers. Findings indicate a high prevalence of injuries, with 61.1% reporting incidents, predominantly needle stick injuries (60.6%). Despite the majority seeking prompt medical attention (72.0%), work-related illnesses affected 53.2% of respondents, notably work-related stress (59.5%). While most received training on injury and illness prevention (68.9%), gaps exist in PEP awareness, with 16.0% unaware of it. Nonetheless, 84.0% were aware, predominantly through health facilities (52.0%). Availability of PEP was reported by 71.3% in healthcare facilities, with variations in shift availability. The majority reported guidelines for PEP use (55.7%). Efforts are needed to bolster PEP awareness and ensure consistent availability in healthcare facilities to safeguard worker health. Conclusion: High prevalence of occupational injuries among healthcare workers, with needle stick injuries being the most common (60.6%). Despite this, 84.0% of respondents were aware of Post-Exposure Prophylaxis (PEP), primarily learning about it from health facilities (52.0%). While 71.3% reported the availability of PEP in their facility, 28.7% noted its unavailability. These results emphasize the need for improved education and accessibility of PEP to mitigate occupational injury risks.

Hepatitis B Vaccination in Medical and Dental Students: A Cross-Sectional Study

Background: Medical and dental students are at risk of Hepatitis B Virus (HBV) infection. The study aimed to assess the vaccination status against Hepatitis B Virus of students in clinical and non-clinical years of a private medical and dental college, and their knowledge, attitude, and awareness about the subject. Methods: A cross-sectional study was conducted using a pretested, self-administered questionnaire among 203 medical and dental students of CMH Lahore Medical College and Institute of Dentistry (CMH LMC & IOD) in Lahore, Pakistan. Participants were evaluated for their knowledge and vaccination status against Hepatitis B Virus. Students were considered to be fully vaccinated (recipients of 3 doses), partially vaccinated (recipients of 1 or 2 doses), and unvaccinated. Comparisons were made between students of clinical and non-clinical years. Data was entered and analysed using Statistical Package for the Social Sciences (SPSS) version 23. Results: Only 66% (n = 134) of the 203 participants had ever received a Hepatitis B Virus vaccine out of which a meagre 17.2% (n = 35) were fully vaccinated. No significant difference was found in vaccine uptake between students of clinical and non-clinical years (p-value = 0.181) despite significant differences seen in the knowledge of vaccination schedule (p-value = 0.001), the prevalence of needle-stick injuries (p-value = 0.001), and knowledge of protocols to be followed after a needle-stick injury (p-value = 0.001). Conclusion: Our study found that a large proportion of the student population is vulnerable to HBV infection. There is a need to create awareness regarding the subject to increase vaccine uptake. HBV vaccination should be offered to all currently enrolled students and be made mandatory at the time of admission in the future.

Practice and Evaluation : Management of Acupuncture Needle Disinfection and Sterilization

Objective： To investigate the necessity and importance of enhancing the sterilization management of acupuncture needles. Methods： Traditionally, acupuncture needles were cleaned manually without thermal disinfection, which often caused needle-stick injuries. To solve the problems, a special cleaning case for acupuncture needles was designed and built to help achieve optimization of the processing flow if the case is used correctly in the process of recycling, cleaning, and package checking. Results： Closed treatment of acupuncture needles reduced the percentage of needle-stick injuries to zero, and centralized management raised patients＇ satisfaction rate from 93% to 98%. Conclusions： Effective sterilization of acupuncture needles is a precondition for the safe treatment of patients. Optimization of the processing flow can ensure the safety of medical personnel and patients; safety is stipulated by relevant regulationsconcerning sterilization and disinfection standards.

六西格玛理念下分级管理模式对降低实习护生针刺伤发生率的影响

目的:探讨六西格玛理念下分级管理模式对降低实习护生针刺伤发生率的效果。方法:选取2021年8月—2023年6月在我院实习的60名实习护生随机分为对照组和研究组,各30人。对照组实行常规管理,研究组实行六西格玛理念下的分级管理,比较两组各环节针刺伤发生率、针刺伤基本知识知晓情况、实习效果及实习满意度。结果:与对照组比较,研究组各环节针刺伤发生率更低(P<0.05),针刺伤基本知识知晓情况、实习效果及实习满意度更高(P<0.05)。结论:将六西格玛理念下分级管理模式应用于实习护生中,可降低针刺伤发生率,提升针刺伤基本知识知晓率、实习效果和实习满意度。

天津市某三甲医院2013-2015年医护人员HIV职业暴露风险分析

目的了解医务人员免疫缺陷病毒(HIV)职业暴露风险,做好医务人员血源性病原体职业暴露预防,保护医务人员执业安全。方法对2013-2015年某医院46例确证实验HIV阳性患者各项信息进行统计分析。同时对该医院感染控制科登记随访的45例医务人员职业暴露相关信息进行回顾性分析。结果 2013-2015年间共登记存档医务人员血源性病原体职业暴露45例,以女性护士和实习护士居多,血源性病原体职业暴露主要以针刺伤为主(97.8%),其中主要病原体为乙肝病毒(44.4%);接诊HIV阳性患者逐年增加,医务人员HIV职业暴露风险不断加大。结论随着接诊HIV阳性患者增多,医务人员HIV职业暴露风险随之升高,应了解患者血源性病原体感染情况,缩短HIV暴露风险窗口期,同时医务人员应加强岗位培训,做好标准预防措施,降低HIV暴露风险。

护理人员针刺伤防护的影响因素

目的:分析护理人员针刺伤防护的影响因素。方法:选取2023年7—9月该院216名护理人员进行横断面研究,收集其临床资料,评估并比较不同护理人员针刺伤防护评分。采用多元线性回归分析护理人员针刺伤防护的影响因素。结果:护理人员针刺伤防护评分为(66.23±6.15)分;不同性别、年龄、职称、婚姻状况、文化程度、月平均收入、受聘方式的护理人员针刺伤防护评分比较,差异均无统计学意义(P>0.05);工作年限<5年、职业防护培训<2次/年、夜班数>5次/月、自我效能评分≤9分、护士职业生活质量量表(QNWLS)评分≤168分、汉密尔顿焦虑量表(HAMA)评分≥14分的护理人员针刺伤防护评分均低于其他类型护理人员,差异有统计学意义(P<0.05);多元线性回归分析结果显示,工作年限<5年、职业防护培训<2次/年、夜班数>5次/月、自我效能评分≤9分、QNWLS评分≤168分、HAMA评分≥14分均为护理人员针刺伤防护的危险因素(P<0.05)。结论:工作年限<5年、职业防护培训<2次/年、夜班数>5次/月、自我效能评分≤9分、QNWLS评分≤168分、HAMA评分≥14分均为护理人员针刺伤防护的危险因素。

Clinical efficacy of sticking-needle acupuncture plus tendon-regulating manipulation in the treatment of acute ankle sprain

Objective To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain,swelling and joint dysfunction due to acute ankle sprain.Methods A total of 80 patients with acute ankle sprain were recruited and divided into a control group and a treatment group according to the random number table method,with 40 patients in each group.Both groups received the same conventional interventions.The control group was treated with additional tendon-regulating manipulation,and the treatment group was treated with tendon-regulating manipulation plus sticking-needle acupuncture.The pain,swelling and joint dysfunction of the ankle were observed in both groups before and after 3 d,7 d and 14 d of treatment.Results Before treatment,there was no statistically significant difference in the visual analog scale(VAS)score of pain between the two groups(P>0.05).After treatment,the VAS scores of both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the VAS scores in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in the degree of swelling between the two groups(P>0.05).After treatment,the degrees of swelling in both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d and 7 d of treatment,the degrees of swelling in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistical difference in the degree of swelling between the two groups after 14 d of treatment(P>0.05).Before treatment,there was no statistically significant difference in the American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scale score between the two groups(P>0.05).After treatment,the AOFAS ankle-hindfoot scale scores of both groups showed an increasing trend over time,and all the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the AOFAS ankle-hindfoot scale scores in the treatment group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Based on the routine intervention,the addition of sticking-needle acupuncture and tendon-regulating manipulation was better in alleviating pain and swelling and improving joint function in patients with acute ankle sprain than the addition of tendon-regulating manipulation alone.

2011-2018年我院医务人员锐器伤调查分析

目的了解我院医务人员发生锐器伤的人群分布特征和风险环节,为制定有效防控措施提供依据。方法回顾性分析上海市杨浦区中心医院2011年1月至2018年12月发生锐器伤的333名医务人员及其所致职业暴露资料。结果在发生针刺伤的333名医务人员中,医生56名、护士235名、医技人员7名、工勤人员10名、其他人员25名,其中工作年限为1~5年占73.38%;受伤发生的环节排名前三的是连接静脉输液器、静脉注射(直接注射或加药)、肌肉/皮下注射;损伤主要发生在锐器使用后处理前和器械使用过程中;针刺伤主要发生在普通病房、手术室和重症监护病房;损伤部位排名前三的分别为手指、手腕和手心;24.62%的职业暴露与接触血源性病原体有关,其中乙型肝炎病毒和梅毒螺旋体是主要的病原体。结论锐器伤给医务人员带来较大的安全隐患,需要加强医务人员职业危害相关知识的培训及教育,规范医务工作人员的操作,提高职业伤害后紧急处理能力,对预防和减少护理人员锐器伤有重要的意义。

针头放置器在护士胰岛素笔注射规范处理针头中的应用

目的 设计胰岛素注射笔用针头放置器,并评价其在护士规范处理胰岛素注射笔用针头操作中的应用效果。方法 选择2017年4月—2021年5月参加本院糖尿病专科护理小组组织的胰岛素注射笔操作考核的456名护士作为研究对象,按参加考核时间分为对照组(2017年4月—2019年4月)和实验组(2019年5月—2021年5月)两组,每组各228名。两组均接受过胰岛素注射笔操作的培训,实验组所在科室配备胰岛素注射笔用针头放置器,并接受过针头放置器使用的培训。比较两组护士单手回套外针帽处理使用后的胰岛素注射笔用针头的达标率、处理使用后的胰岛素注射笔用针头的耗时,评价科室放置器规范管理达标率、护士使用放置器处理胰岛素注射笔用针头依从率及满意率。结果 实验组护士达标率高于对照组,差异具有统计学意义(P<0.05);实验组护士处理胰岛素注射针头耗时短于对照组,差异具有统计学意义(P<0.05);实验组护士科室放置器管理平均达标率为96.49%;护士使用放置器处理胰岛素注射笔用针头依从率为94.59%;护士使用放置器处理胰岛素注射针头总体平均满意率为97.14%。结论 胰岛素注射笔用针头放置器制作简单,应用该装置可提高护士处理胰岛素注射笔用针头依从率及满意率,促进护士规范处理使用后的胰岛素注射笔用针头,从而减少针刺伤的发生。

临床护士针刺伤风险评估指标体系的构建

目的:构建临床护士针刺伤风险评估指标体系,为我国临床护士针刺伤风险评估提供依据。方法:以人因分析与分类系统理论框架为指导,通过文献研究、德尔菲专家函询法及层次分析法,确定临床护士针刺伤风险评估指标体系及各级指标权重。结果:共进行了2轮专家函询,问卷有效回收率分别为100.0%和94.7%,专家权威系数分别为0.937和0.936,肯德尔协调系数分别为0.216和0.256。最终形成的临床护士针刺伤风险评估指标体系包含4个一级指标、12个二级指标和54个三级指标。结论:构建的临床护士针刺伤风险评估指标体系具有较好的科学性和可靠性,可用于临床护士针刺伤风险的评估,为医院职业防护管理实践的持续优化和改进提供理论和实践依据。

一次性静脉回缩式留置针的临床运用效果

目的探讨一次性静脉回缩式留置针的临床运用价值。方法选择2019年1月至2019年12月衡水市哈励逊国际和平医院化疗科200例患者,随机分为两组,各100例。对照组给予患者使用普通静脉留置针,观察组给予患者使用一次性静脉回缩式留置针。比较两组患者穿刺效果、并发症、护士的满意度、职业暴露情况。结果两组一次性穿刺成功率,输液通畅、静脉炎、回血、药液外渗、针眼局部并发症及疼痛感的差异显著,(P<0.05);观察组患者满意率、护士满意率均显著高于对照组,(P<0.05);两组针刺、污染护士及污染环境率差异显著,(P<0.05)。结论化疗患者采用一次性静脉回缩式留置针进行输液治疗,患者满意度更高,可有效防止针刺及伤职业暴露。

护生进入临床实习前针刺伤相关知识和态度的现状调查

目的调查护生进入临床实习前针刺伤的相关知识和态度现状。方法于2015年6月20—23日调查某院2015年6月准备进入临床实习的护生,采用问卷调查法调查实习护生针刺伤知识和态度。结果共发放问卷350份,回收有效问卷324份,有效率92.57%。男生40名(12.35%),女生284名(87.65%);本科学历34名(10.49%);平均年龄(20.83±1.24)岁。实习护生针刺伤相关知识各条目中回套针帽、戴手套相关问题的回答正确率最低,均为60%左右;接种乙肝疫苗后发生针刺伤感染乙型肝炎病毒的问题及针刺伤后的用药问题回答正确率均在70%左右。实习护生针刺伤态度部分部分条目得分≤3分,主要为针刺伤所致血液、体液传播性疾病易感性以及回套针帽的问题。结论实习护生的针刺伤相关知识和态度存在薄弱的方面,如回套针帽、及时报告、传染病易感性等问题。学校和医院应加强对护生职业安全防护知识教育,提高职业防护的态度和能力。

实习护生发生针刺伤的现状调查

目的 :为了解实习护生发生针刺伤的刺伤率、刺伤原因及环节 ,探讨防范措施。方法 :对北京 9所护士学校的 434名实习护生在 6个月实习期间发生针刺伤的情况进行前瞻性调查。结果 :发生针刺伤 160人次 ,发生率为36.9% ,其中 61.9%被污染针头刺伤 ,仅有 2人在刺伤后进行了血液学检测 ;71.9%的刺伤发生在病房 ,85 .6%发生在白班。发生针刺伤不同环节的刺伤率分别是 :操作前占2 5 .6% ,操作中占2 0 .0 % ,操作后占5 4.4%。结论 :建立全面防护及岗前职业安全教育、增强防护意识、加强安全操作技能训练。

护理人员工作中被针刺伤调查及对策

目的 了解护理人员被针刺伤的情况 ,为采取职业防护措施提供科学依据。方法 采用问卷调查法调查护理人员被针头刺伤的有关情况。结果 不同职称护理人员被针刺伤的情况存在差异高度显著性 ,P<0 .0 1;不同科室护理人员被针刺伤的操作环节比较均存在差异高度显著性 ,P<0 .0 1;绝大多数护理人员对针刺伤后的处理不规范。结论 护理人员应主动增强职业防护意识 ;加强职业防护管理 ;改进废弃的一次性医疗用品管理方法和尽快采用防刺性护理用具。

379名护士针刺伤原因分析及对策

目的分析临床护士针刺伤的原因,探讨防护措施。方法对426名护士进行回顾性问卷调查。结果其中379名发生过针刺伤,发生率为88.97%;人均被刺伤4.75次/年、刺伤≥10次者占总人数的6.10%,刺伤最多1人1年被刺伤29次;针刺伤的主要原因有拔针、加药、回套针帽、分离针头等。结论护士针刺伤发生率很高,而防护意识淡漠,故应加强全面性防护概念的教育,预防针刺伤,减少经血液传播疾病的发生。

护理人员在静脉输液操作中针刺伤的调查研究

目的了解云南省护理人员在静脉输液操作中发生针刺伤的情况,并提出有效的防护对策。方法利用组织护理学术活动机会,对云南地区15所医院的323名护士随机发放问卷调查表,对调查资料采用回顾性分析方法。结果323名护士针刺伤发生率为92.26%;护龄短的护士针刺伤发生率明显高于护龄长的护士,两者比较有统计学意义(P<0.01);静脉输液操作中以针头用后重新套入针帽、吸取药液配液体时、安装或取下注射器/输液器针帽时较其他环节更容易发生针刺伤。针刺伤前接种乙肝疫苗的护士仅占55.36%;针刺伤后能够采取正确处理方法的护士仅占52.34%;对针刺伤防护知识基本了解的护士仅占26.85%;针刺伤好发部位以手掌居多,占78%。结论静脉输液操作中针刺伤已成为护士最常见的职业损伤,增强护士安全防护意识至关重要,应制定静脉输液中防止针刺伤的规范操作流程,建立静脉输液针刺伤报告及回访制度,提高静脉输液器材的安全性,最大限度地减少对护士造成的危害。

635名护理人员针刺伤的防护意识调查分析

目的 :了解医院护理人员针刺伤的防护意识 ,促进其树立职业防护观念 ,采取相应的职业防护措施保护健康。方法 :采用问卷调查法调查某医院 6 35名临床护理人员有关针刺伤的防护意识。结果 :92 3 %的护理人员有被针刺伤的经历 ;88 0 %的护理人员做注射操作未戴手套 ;对做注射操作要戴手套吗等防护知识和发生针刺伤后应采取预防血源性感染疾病措施的认知情况令人担忧 ,不同科室的护理人员对针刺伤防护知识要戴手套吗、为什么要戴和不能回套针帽的认识均分存在高度显著性差异 ,P <0 0 1。结论 :护理人员应深刻认识针刺伤的危害性及树立职业防护观念 ,医院管理者应加大职业防护管理力度实现安全注射。