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Kiddeer M, Basit A, Ahmad T, Masood I. Needle stick injuries and post-exposure prophylaxis practices among healthcare personnel working at tertiary care hospitals in Punjab, Pakistan. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2024:JRS240010. [PMID: 39240591 DOI: 10.3233/jrs-240010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
BACKGROUND Healthcare workers face a high risk of blood-borne infections due to needlestick injuries, especially in developing countries like Pakistan. OBJECTIVE This study aims to evaluate the prevalence of needlestick injuries, reporting practices, and post-exposure prophylaxis measures among healthcare personnel in tertiary care hospitals in Punjab. METHODS A cross-sectional study was conducted from May to July 2019. Data were collected from healthcare personnel working in teaching hospitals across six randomly selected cities of Punjab. Data were collected from 600 healthcare personnel using a pretested, self-administered questionnaire, employing stratified random sampling to ensure representative sampling. Descriptive statistics were applied, and differences in needlestick injuries across demographic segments were assessed using the Mann-Whitney U and Kruskal-Wallis H tests. RESULTS Among the 600 respondents, 533 returned the complete questionnaire, yielding a response rate of 88.8%. The majority of respondents were female (n = 341, 64.2%). The mean years of service was 5.58 (±5.78), with most participants falling in the 0.5-5 years category (n = 338, 66.4%). The prevalence of self-reported needlestick injuries in the last six months was 35.25%. Most injuries occurred during sampling (n = 95, 35.85%), followed by recapping (n = 63, 23.77%). Reporting of needlestick injuries to the respective department was poor, with only 82 (21.87%) injuries reported. The frequency of needlestick injuries differed significantly across profession, working department, and education categories (p < 0.05). Sanitary staff were more likely to sustain needlestick injuries during garbage collection and waste handling. Post-exposure screening for blood-borne infections was received by 79 (42.93%) individuals, and post-exposure prophylaxis (PEP) was administered to 67 (36.41%). CONCLUSION The high prevalence of needlestick injuries among healthcare personnel occurred primarily during sampling and recapping. Reporting of NSIs was inadequate, and post-exposure testing and prophylaxis practices were substandard. Enhanced policies and protocols are necessary for effective NSI surveillance and the administration of pre- and post-exposure prophylaxis.
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Affiliation(s)
- Muhammad Kiddeer
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
- Tehsil Headquarter Hospital, Haroonabad, Pakistan
| | - Abdul Basit
- Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Thailand
| | - Tawseef Ahmad
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Thailand
| | - Imran Masood
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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Kenne L, Hinman A, Holley S, Healy S, Sebolt T, Edmond M, Nelson DL, Valley K, Mueller RN, Schuessler B, Hanna B, Kobayashi T, Hartley P. Implementation of a hotline ("S-T-I-C-K") to expedite management of occupational bloodborne pathogen exposures at an academic medical center: A Process Improvement Initiative. Am J Infect Control 2024; 52:618-620. [PMID: 38211666 DOI: 10.1016/j.ajic.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
Previously, blood and body fluid exposures were managed by a visit to the University Employee Health Clinic during normal business hours and the Emergency Department after hours. We implemented the "S-T-I-C-K" program where health care personnel were evaluated immediately after exposure by a nurse-driven 24/7 hotline. Increasing accessibility to care and a simplified process for exposure management led to a significant decrease in Emergency Department utilization and time between the exposure and receipt of post-exposure prophylaxis.
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Affiliation(s)
- Lynnette Kenne
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA.
| | - Ashley Hinman
- University Employee Health Clinic, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Stephanie Holley
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Sarah Healy
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Tamara Sebolt
- University Employee Health Clinic, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Michael Edmond
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - David L Nelson
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Kenneth Valley
- University Employee Health Clinic, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Rashmi N Mueller
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Barbara Schuessler
- University Employee Health Clinic, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Beth Hanna
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Takaaki Kobayashi
- Quality Improvement Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Patrick Hartley
- University Employee Health Clinic, University of Iowa Hospitals and Clinics, Iowa City, IA
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Abdelmalik MA, Alhowaymel FM, Fadlalmola H, Mohammaed MO, Abbakr I, Alenezi A, Mohammed AM, Abaoud AF. Global prevalence of needle stick injuries among nurses: A comprehensive systematic review and meta-analysis. J Clin Nurs 2023; 32:5619-5631. [PMID: 36841963 DOI: 10.1111/jocn.16661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/08/2023] [Accepted: 02/06/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Nurses usually provide direct patient care. However, they account for the majority of healthcare workers (HCWs) injured by needles or other sharp objects. OBJECTIVES To assess the prevalence of needle stick injuries (NSI) among nurses worldwide; according to WHO regions, the socioeconomic development index (SDI) of countries, and the developmental status of individual countries, and in the Middle East. DESIGN Systematic review and meta-analysis. METHODS We searched PubMed, Scopus, and Web of Science databases. We calculated the pooled NSI prevalence estimates using a random-effect meta-analysis with the Comprehensive Meta-Analysis software. The report of the study was in accordance with the PRISMA 2020 statement. RESULTS The overall worldwide NSI prevalence pooled from our analysis was 40.97% (95% confidence interval [CI]: 31.29-50.63%, p = .00001). A subgroup analysis of NSI prevalence according to WHO regions revealed the highest prevalence in Southeast Asia (49.9%, 95% CI: [23.4-76.3%]) and the lowest in the United States of America (25.1%, 95% CI: [18.1-32.1%]), respectively. The pooled prevalence in developed and developing countries was 30.5% (95% CI: 27.3-33.8%) and 46.6% (95% CI: 33.7-59.5%), respectively. According to the SDI, NSI prevalence was highest in low-middle SDI countries (48.9% [95% CI: 30.7-67.2%]). CONCLUSION Our results showed a high NSI prevalence among nurses worldwide. Developing countries had a significantly higher NSI prevalence than developed countries, especially low-middle SDI countries. RELEVANCE TO CLINICAL PRACTICE This study highlighted the prevalence of NSI risk among nurses practising in clinical settings worldwide. The study findings suggest that continuous training programs should be implemented for nurses to enhance their knowledge, performance and attitude toward NSI prevention in clinical settings. NO PATIENT OR PUBLIC CONTRIBUTION Contributions from patients or the public are irrelevant because the purpose of this study was to examine the global prevalence of NSIs in nurses.
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Affiliation(s)
- Mohammed A Abdelmalik
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
- Faculty of Nursing, University of El Imam El Mahdi Faculty of Medicine and Health Sciences, Nursing, Kosti, Sudan
| | - Fahad M Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Hammad Fadlalmola
- Community Health Nursing Department, Nursing College, Taibah University, Almadinah, Saudi Arabia
| | - Mohammaed O Mohammaed
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Ibrahim Abbakr
- Department of Nursing Practice, College of Nursing, Umm Alqura University, Mecca, Saudi Arabia
| | - Atallah Alenezi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Almoez M Mohammed
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
- College of Medicine and Health Sciences, University of Sinnar, Sinnar City, Sudan
| | - Abdulaziz F Abaoud
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
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Chang YT, Chen NC, Huang SH, Lai CS, Chen CS, Chang TW, Chang PC. Matching intraoperative teaching and learning for medical undergraduates via modified briefing-intraoperative teaching-debriefing (BID) model. Sci Rep 2023; 13:13732. [PMID: 37612418 PMCID: PMC10447542 DOI: 10.1038/s41598-023-40755-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
Intraoperative teaching is a challenging task. The briefing-intraoperative teaching-debriefing (BID) model, which is based on guided discovery learning at limited time intervals, has rarely been investigated. This study validated the benefits of the modified BID model on medical clerks. This study involved 37 first-year medical clerks enrolled from September 2019 to May 2020. Every learner scrubbed in one the totally implantable venous access device placement surgery and completed a pre-/posttest survey on surgical procedures and associated anatomy conducted through an intraoperative teaching questionnaire. Of these participants, 15 merely observed throughout the entire procedure (observation group), whereas the remaining 22 performed simple suturing under supervision (suturing group). All participants underwent an objective structured assessment of simple interrupted suturing skills at the end of the observership. Correlations were tested using a two-tailed paired t-test, with a p-value < 0.05 indicating statistical significance. The response rate was 100% and participants could reconfirm the precise venous access, catheter tip location, and suture materials for portal fixation after totally implantable venous access device placement (p < 0.05). Although a relatively higher satisfaction of the intraoperative teaching environment and educator attitude was reported in the suturing group than in the observation group, the difference in scores on the objective structured assessment was not statistically significant (8.7 ± 1.8 vs. 7.2 ± 3.7; p = 0.104). Our findings indicate that the modified BID model with hands-on experience is a practicable module for matching intraoperative teaching and learning via learning perception enhancement for medical undergraduates during totally implantable venous access device placement.
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Affiliation(s)
- Yu-Tang Chang
- Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Nan-Chieh Chen
- Department of Medical Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Shu-Hung Huang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Siaogang Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chung-Sheng Lai
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Cheng-Sheng Chen
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ting-Wei Chang
- Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80756, Taiwan
| | - Po-Chih Chang
- Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80756, Taiwan.
- Weight Management Center, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan.
- College of Medicine, Ph. D. Program in Biomedical Engineering, Kaohsiung Medical University, Kaohsiung City, Taiwan.
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
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Bevan V, Blake P, Radwan RN, Azzopardi E. Sharps and needlestick injuries within the operating room: Risk prone procedures and prevalence meta-analysis. J Perioper Pract 2023; 33:200-210. [PMID: 36597950 DOI: 10.1177/17504589221103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Sharps and needlestick injuries pose a serious risk to operating theatre personnel with considerable morbidity, mortality and healthcare implications. The cost of prophylaxis and post-exposure treatment is a significant institutional economic burden. AIM The aim of the review was to identify the prevalence of sharps and needlestick injury within the operating theatre and to establish the most common critical steps. METHOD A systematic literature search was conducted. Abstracts of all studies published in English from 2015 onwards exploring sharps and needlestick injury within the operating theatre were reviewed. Primary outcome measure was sharps and needlestick injury prevalence. Secondary outcome measures included operational steps resulting in sharps and needlestick injury and costs of sharps and needlestick injury management. RESULTS Sixteen studies were identified and included in analysis. Cross-sectional studies reported a pooled prevalence of 41.5% (n = 537; 95% confidence interval = 15.961 to 70.220). Retrospective data analysis reported an annualised prevalence of 5.027% (95% confidence interval = 0.676 to 13.073) on a total pooled sample population of 12,929. Further analysis of operational steps identified a 22% prevalence (n= 3460; 95% confidence interval = 14.2 to 31.3) of sharps and needlestick injury occurring during a procedure involving handing or receiving an instrument. CONCLUSION Sharps and needlestick injuries are a significant but preventable risk in the operating theatre. Further research into the development of safety devices to reduce injury during instrument transfer is paramount.
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Affiliation(s)
| | - Paul Blake
- Swansea Bay University Health Board, Swansea, UK
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Kasteler SD, Reid M, Lee PC, Sparer-Fine E, Laramie AK. Sharps Injuries Among Medical Trainees and Attending Physicians. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:805-812. [PMID: 36812071 DOI: 10.1097/acm.0000000000005187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Sharps injuries are a particularly concerning occupational hazard faced by physicians and are largely preventable. This study compared the proportion and rate of sharps injuries among medical trainees with those among attending physicians by sharps injury characteristics. METHOD The authors used data reported to the Massachusetts Sharps Injury Surveillance System from 2002-2018. Sharps injury characteristics examined were department where injury occurred, device, purpose or procedure for which device was used or intended, presence of sharps injury prevention feature, who was holding the device, and how and when the injury occurred. Global chi-square was used to assess differences in the percent distribution of sharps injury characteristics between physician groups. Joinpoint regression was used to evaluate trends in injury rates among trainees and attendings. RESULTS From 2002-2018, 17,565 sharps injuries among physicians were reported to the surveillance system, 10,525 of which occurred among trainees. For attendings and trainees combined, sharps injuries occurred most in operating and procedure rooms and most often involved suture needles. Significant differences in sharps injuries were found between trainees and attendings with respect to department, device, and intended purpose or procedure. Sharps without engineered sharps injury protections accounted for approximately 4.4 times as many injuries (13,355, 76.0%) as those with protections (3,008, 17.1%). Among trainees, sharps injuries were highest in the first quarter of the academic year and decreased over time, while sharps injuries among attendings had a very slight, significant increase. CONCLUSIONS Sharps injuries are an ongoing occupational hazard faced by physicians, particularly during clinical training. Further research is needed to elucidate the etiology of the observed injury patterns during the academic year. Medical training programs need to implement a multipronged approach to prevent sharps injuries, including increased use of devices with sharps injury prevention features and robust training on safe handling of sharps.
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Affiliation(s)
- Stephen D Kasteler
- S.D. Kasteler is currently an occupational medicine physician and a Major, U.S. Air Force, JBSA-Lackland, Texas. At the time of writing, he was chief resident, Occupational and Environmental Medicine Residency Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio; ORCID: https://orcid.org/0000-0001-7928-4779
| | - Michelle Reid
- M. Reid is an epidemiologist, Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, Massachusetts; ORCID: https://orcid.org/0000-0001-7272-6394
| | - Peter C Lee
- P.C. Lee is global medical director, Amazon, Seattle, Washington, assistant clinical professor, Yale School of Medicine, New Haven, Connecticut, and occupational medicine physician, Boston Medical Center, Boston, Massachusetts
| | - Emily Sparer-Fine
- E. Sparer-Fine is director, Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-9896-7345
| | - Angela K Laramie
- A.K. Laramie is an epidemiologist, Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, Massachusetts, and instructor, Occupational and Environmental Medicine Residency Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; ORCID: https://orcid.org/0000-0001-7243-1772
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Behzadmehr R, Balouchi A, Hesaraki M, Alazmani Noodeh F, Rafiemanesh H, J Nashwan A, Behmaneshpour F, Rahdar M, Dastres M, Atharyan S, Jahantigh M, Malekshahi F. Prevalence and causes of unreported needle stick injuries among health care workers: a systematic review and meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:111-123. [PMID: 34913621 DOI: 10.1515/reveh-2021-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs. CONTENT In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs. SUMMARY AND OUTLOOK Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers.
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Affiliation(s)
- Razieh Behzadmehr
- Department of Radiology, Zabol University of Medical Sciences, Zabol, Iran
| | - Abbas Balouchi
- Department of Nursing, Iran University of Medical Sciences, Tehran, Iran
| | - Mehran Hesaraki
- Pediatric Department, Zabol University of Medical Sciences, Zabol, Iran
| | - Farshid Alazmani Noodeh
- Department of Critical Care Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Hosein Rafiemanesh
- Non-communicable Diseases Research Center, Department of Epidemiology and Biostatistics, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Abdulqadir J Nashwan
- Nursing for Education and Practice Development, Hamad Medical Corporation, Doha, Qatar
| | | | - Maliheh Rahdar
- Department of Nursing, School of Nursing and Midwifery, Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Majid Dastres
- Department of Nursing, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shahaboddin Atharyan
- Department of Nursing, School of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Maryam Jahantigh
- Department of Nursing, School of Chabahar Nursing, Iranshahr University of Medical Sciences, Chabahar, Iran
| | - Frood Malekshahi
- Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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van der Staay LU, Koestner C, Dietz P. Differences in Work and Commuting Accidents between Employees and Students at Higher Education Institutions in Rhineland-Palatinate, Germany, from December 2014 to December 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2462. [PMID: 36767828 PMCID: PMC9915262 DOI: 10.3390/ijerph20032462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Accidents are one of the most important public health concerns because of their high prevalence and considerable health outcomes. Although higher education institutions (HEIs) play an important role in health promotion and disease prevention, accidents are rarely investigated in this setting. Therefore, the aim of the present study was to address this gap by analyzing the frequency and characteristics of employee and student accidents at HEIs in Rhineland-Palatinate, Germany. A dataset of all accidents that happened to employees and students at HEIs in Rhineland-Palatinate from December 2014 to December 2019 and the characteristics of these accidents was provided by the responsible statutory accident insurance (Accident Insurance Fund of Rhineland-Palatinate). Modified thousand-men quotas (the rate of injuries per 1000 people) were calculated to investigate the differences in frequencies and characteristics of accidents between employees and students, as well as between institutions. A total of 3810 accidents (n = 1326; 34.8% work and n = 2484; 65.2% commuting) were reported, of which 426 involved employees and 3384 involved students. The frequency and characteristics of the accidents varied between employees and students, as well as between institutions. Sports programs at HEIs for example imply high risks for unintentional injuries especially for students (as they make up the majority of participants). Other main findings are that medical students, as well as students of subjects including laboratory work, are at a higher risk to experience study-related accidents whereas employees seem to be at a higher risk when working in a technical field. The results call for the development of accident prevention concepts at HEIs and the implementation of interventions in respective institutions and target groups.
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Affiliation(s)
| | | | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
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Joshi A, Aissa Y, Le S, Cho SC, Lee L, Lopez JR. Sharps Injuries Related to Subdermal Needles in the Orbicularis Oris During Intraoperative Neurophysiologic Monitoring. J Clin Neurophysiol 2022; 39:643-646. [PMID: 33675313 DOI: 10.1097/wnp.0000000000000835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Little is known about the incidence and nature of sharps injuries caused by subdermal intraoperative neurophysiologic monitoring (IONM) needle electrodes. In their institution, the authors observed a series of sharps injuries attributed to placement of needles in the orbicularis oris (OO). METHODS One large academic institution's sharps injury monitoring database was queried for all reported events over 3 years. The de-identified list was filtered for sharps events occurring in the operating room, and the descriptions of the sharps injuries were individually evaluated. Interventions were performed to attempt to decrease the number of sharps injuries from IONM needles, particularly those placed in OO. Similar data were then collected for 3 months post-intervention. RESULTS Pre-intervention, 327 sharps injuries were reported over the span of 3 years, of which 13 (4.0%) were attributed to IONM needles not in OO and 5 (1.5%) were attributed to IONM needles in OO. Post-intervention, 41 sharps injuries were reported in 3 months, of which 5 (12.2%) were attributed to IONM needles not in OO and 1 (2.4%) was attributed to needles in OO. CONCLUSIONS The placement of subdermal needles in the OO presents a disproportionately high risk of sharps injury. Interventions were performed to attempt to decrease the rate of sharps injuries from needles in OO; the post-intervention increase in events was likely skewed by small sample sizes. The implementation of these changes and the ongoing surveillance of injury cases may be important data to help decrease the number of sharps injuries attributed to IONM needles.
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Affiliation(s)
- Aditya Joshi
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, U.S.A.; and
| | - Youbirt Aissa
- Stanford Healthcare, Stanford, California, U.S.A. Dr. Joshi is now with the Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Scheherazade Le
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, U.S.A.; and
| | - S Charles Cho
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, U.S.A.; and
| | - Leslie Lee
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, U.S.A.; and
| | - Jaime R Lopez
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, U.S.A.; and
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Battail T, Fort E, Denis MA, Fassier JB, Bonneterre V, Dutheil F, Fontana L, Paul A, Botokeky E, Massardier-Pilonchéry A. Underreporting of occupational blood and body fluid exposure in French university hospitals in 2017. Work 2022; 73:1393-1403. [DOI: 10.3233/wor-210007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Occupational blood and body fluid exposures (OBBFEs) are one of the biological risks run by health professionals, especially in hospitals. OBJECTIVE: The objectives of this study were to assess the occurrence and reporting of occupational blood and body fluid exposures (OBBFEs) in university hospital medical staff and to investigate factors associated to declared OBBFE and factors associated to reported OBBFE. METHODS: A self-administered questionnaire has been e-mailed to all junior and senior medical staff in four university hospital centers in one administrative region of France in 2017. RESULTS: 292 of the 1,228 respondents declared at least one OBBFE. More than two-thirds (70.2%) were under-reporters and more than half (53.8%) non-reporters. Younger subjects, surgical specialties and other associated work accidents were risk factors for OBBFE. Considering the reporting procedure too complex was a risk factor for underreporting. CONCLUSIONS: Underreporting by hospital medical staff was a persistent phenomenon, with a high rate. The OBBFE reporting procedure needs rethinking.
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Affiliation(s)
- Thibault Battail
- Faculty of Health Charles Mérieux Lyon Sud, University of Lyon, Claude Bernard Lyon 1 University, Oullins, France
| | - Emmanuel Fort
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
| | - Marie-Agnès Denis
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Jean-Baptiste Fassier
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Vincent Bonneterre
- “Environment and Health Prediction in Populations” Team, University of Grenoble, Grenoble Alpes University, TIMC-IMAG, UMR, La Tronche, France
- Department of Preventive and Occupational Medicine, University Hospital of Grenoble Alpes (CHU), Grenoble, France
| | - Frédéric Dutheil
- “Physiological and Psychosocial Stress” Team, University of Clermont-Ferrand, Clermont Auvergne University, LAPSCO, UMR, Clermont-Ferrand, France
- Occupational Diseases Center, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - Luc Fontana
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, Université Jean Monnet, UMRESTTE, UMR T, St Etienne, France
- Department of Preventive and Occupational Medicine, University Hospital of St Etienne (CHU), St Etienne, France
| | - Adèle Paul
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Elsa Botokeky
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Amélie Massardier-Pilonchéry
- University of Lyon, Claude Bernard Lyon 1 University, Gustave Eiffel University, UMRESTTE, UMR T, Lyon, France
- Hospices Civils de Lyon, Department of Occupational Medicine and Occupational Diseases, Centre Hospitalier Lyon Sud, Pierre Bénite, France
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Needlestick injuries among anesthesia providers from a large US academic center: A 10-year retrospective analysis. J Clin Anesth 2022; 80:110885. [PMID: 35644082 DOI: 10.1016/j.jclinane.2022.110885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE Anesthesiologists are at high risk for needlestick injury. Such injuries pose a serious health threat from exposure to bloodborne pathogens. This retrospective analysis aimed to examine needlestick injury rate among anesthesia providers between 2010 and 2020 at the University of California Los Angeles, Department of Anesthesiology and Perioperative Medicine to determine specialty-specific factors associated with these injuries. DESIGN Retrospective analysis. SETTING Academic Anesthesiology Department. PATIENTS AND INTERVENTIONS None. MEASUREMENTS All reported incidents of needlestick injuries to employees are sent to the Injury and Illness Prevention Committee. We included all anesthesia residents, fellows, nurse anesthetists, solo anesthesiologists, and supervising anesthesiologists. MAIN RESULTS The overall rate of reported needlestick injuries was 5.3%. The rates for anesthesia residents were 2.1%, 13.5%, 7.9%, and 6.7% for post graduate year 1-4 (PGY 1-4) residents. The rates were 14.3%, 4.7%, 2.1%, and 6.9% for fellows, nurse anesthetists, supervising anesthesiologists, and solo anesthesiologists, respectively. We found that PGY2 residents had a higher injury rate than PGY1 residents (p-value<0.001). When grouping PGY2, PGY3, and PGY4 residents together, they had a collective rate of 9.4%. Furthermore, residents had a higher needlestick injury rate than supervising anesthesiologists (p-value <0.001). CONCLUSIONS PGY2 residents and fellows had the highest rate of needlestick injury. Our study highlights the trend of increasing sharps injuries after PGY1 while supervising anesthesiologists had the lowest rate. Proposed mechanisms for the increased sharps injuries include residents' transition from medicine-based internship to the operating room environment with increased exposure to potentially injurious equipment, overnight call, and increased work-related and cognitive stress. Improving understanding of institution-specific prevention programs, raising awareness during their initial high-intensity training period with one-to-one supervision when habits are formed, and reducing exposure to sharps using a needleless system are some steps toward reducing the incidence of sharps injuries in a field where the risk remains high.
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Workplace Hazards in Orthopaedic Surgery Training: A Nationwide Resident Survey Involving Sharps-related Injuries. J Am Acad Orthop Surg 2022; 30:428-436. [PMID: 35171846 DOI: 10.5435/jaaos-d-21-00941] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Surgical specialties are at an increased risk for occupational hazards, including sharps-related injuries. The objective of this study was to report the frequency of sharps injuries and evaluate which characteristics influence the number of injuries and reporting behaviors. METHODS A web-based, anonymous survey was available for 10 weeks to 46 US orthopaedic surgery residency programs (1,207 potential residents) participating in an education research collaborative. The survey was divided into the following areas: demographics, training and attitudes concerning occupational hazards, and sharps injuries and reporting. Logistic regression was used to evaluate the association between the above variables on experiencing sharps injuries with significance threshold set at P < 0.05. RESULTS In this study, 518 surveys were included yielding a response rate of 42.9% (518/1,207). Nearly 80% of the residents recalled some form of safety training during intern orientation and 62% of the respondents felt that they received adequate occupation safety training specifically related to orthopaedic surgery. Four hundred seventeen residents (80.5%) experienced a sharps injury (mean 2.8). Nearly 20% of the respondents experienced ≥5 sharps injuries. Needle sticks (38.8%) were responsible for the greatest percentage of injuries, followed by Kirschner wires (33.6%), scalpel (22.5%), and bone (17.3%). Only 42% of the residents consistently reported all injuries. Reasons included feelings of no risk (63.1%), too much hassle (58.9%), embarrassment (14.5%), other (8.7%), forgot (5.8%), and unclear what to do (3.3%). Inadequate safety training specific to orthopaedic surgery (odds ratio, 2.32 [95% confidence interval, 1.20 to 4.46]; P = 0.012) and greater training seniority (odds ratio, 2.04 [95% confidence interval, 1.64 to 2.52]; P < 0.0001) were associated with acquiring five or more sharps injuries. DISCUSSION Sharps injuries are a prevalent and concerning reality for orthopaedic surgical trainees. Despite this common occurrence, only 42% of the residents always reported their injuries. Inadequate training specific to orthopaedic surgery and each subsequent year of postgraduate training are associated with increased sharps injuries. STUDY TYPE Level III, retrospective observational survey.
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Nicholas J, Grimmond T, Bradywood A, Church E, Moran J, Ogg M. Addressing Underreporting of Blood and Other Body Fluid Exposures Among Perioperative Personnel. AORN J 2021; 114:368-375. [PMID: 34586671 DOI: 10.1002/aorn.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/22/2021] [Accepted: 02/24/2021] [Indexed: 11/10/2022]
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Zhang W, Yan Z, Zhang X, Pi H, Sai X. Occupational injuries and psychological support in Chinese nurses: a cross-sectional study. Rev Esc Enferm USP 2021; 55:e20200422. [PMID: 34516601 DOI: 10.1590/1980-220x-reeusp-2020-0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/16/2021] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To assess the occupational injuries and psychological support received by nurses and to investigate the relationship between the two. METHOD This was a nation-wide cross-sectional study of nurses working across 1858 hospitals in China. Data were collected using an online structured, self-administered questionnaire between 2016 and 2017. RESULTS Nearly half of respondents had experienced aggressive behavior from patients or their attendants; 13.4% respondents had experienced aggressive behavior on more than three occasions. 78.96% respondents had experienced needle-stick injuries and 51.22% had experienced psychological trauma. 20.5% respondents believed that hospitals do not pay any attention to occupational safety. 86.1% respondents expressed the need for little or moderate psychological support. Nurses who had experienced aggressive behavior expressed a greater need for psychological support. Nurses working at hospitals that adequately addressed the occupational safety issues expressed the lowest need for psychological support. CONCLUSION We found a high prevalence of psychological stress and occupational injuries among nurses. Nursing managers need to address this issue and implement interventions to prevent and reduce injuries.
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Affiliation(s)
- Wenyu Zhang
- Capital Medical University School of Nursing, Beijing, China.,Ministry of Civil Affairs Training Center, Beijing College of Social Administration, Department of Senior Citizens Welfare, Beijing, China.,Medical School of Chinese PLA, Beijing, China
| | - Zixuan Yan
- Ministry of Civil Affairs Training Center, Beijing College of Social Administration, Department of Senior Citizens Welfare, Beijing, China
| | - Xueli Zhang
- Department of Nursing Network, Beijing, China
| | - Hongying Pi
- Chinese PLA General Hospital, Beijing, China
| | - Xiaoyong Sai
- Chinese PLA General Hospital, Departament of Epidemiology and Statistics, Graduate School, Beijing, China
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Cohen TN, Boquet AJ. The Effects of Flow Disruptions on RN Circulators. AORN J 2021; 113:351-358. [PMID: 33788236 DOI: 10.1002/aorn.13344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 11/09/2022]
Abstract
The RN circulator role includes maintaining situational awareness and mitigating risks to patient safety in the OR. Flow disruptions-deviations that threaten the safe and efficient flow of surgery-may contribute to the occurrence of errors and negatively affect safety for patients and health care providers. We used an existing data set to explore the effects of flow disruptions on the RN circulator. To create the data set, doctoral-level human factors students observed 24 cardiac surgery procedures and recorded the types and durations of disruptions. We used a human factors taxonomy to classify the flow disruptions. Of the 1,470 events observed, interruptions were most prevalent (66.67%), followed by coordination issues (15.37%) and communication breakdowns (8.37%). Layout (7.21%), equipment (1.77%), and usability (0.61%) issues accounted for the remainder of the disruptions. Perioperative leaders should work with staff members to minimize workflow disruptions and provide support for identifying and documenting flow disruptions.
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Landford WN, Ngaage LM, Lee E, Rasko Y, Yang R, Slezak S, Redett R. Occupational exposures in the operating room: Are surgeons well-equipped? PLoS One 2021; 16:e0253785. [PMID: 34214125 PMCID: PMC8253435 DOI: 10.1371/journal.pone.0253785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/14/2021] [Indexed: 12/05/2022] Open
Abstract
Background Occupational health hazards are ubiquitously found in the operating room, guaranteeing an inevitable risk of exposure to the surgeon. Although provisions on occupational health and safety in healthcare exist, they do not address non-traditional hazards found in the operating room. In order to determine whether surgeons or trainees receive any form of occupational health training, we examine the associations between occupational health training and exposure rate. Study design A cross-sectional survey was distributed. Respondent characteristics included academic level, race/ethnicity, and gender. The survey evaluated seven surgical disciplines and 13 occupational hazards. Multivariable logistic regression was used to examine the association between academic level, surgical specialty, and exposure rate. Results Our cohort of 183 respondents (33.1% response rate) consisted of attendings (n = 72, 39.3%) and trainees (n = 111, 60.7%). Surgical trainees were less likely to have been trained in cytotoxic drugs (OR 0.22, p<0.001), methylmethacrylate (OR 0.15, p<0.001), patient lifting (OR 0.43, p = 0.009), radiation (OR 0.40, p = 0.007), and surgical smoke (OR 0.41, p = 0.041) than attending surgeons. Additionally, trainees were more likely to experience frequent exposure to bloodborne pathogens (OR 5.26, p<0.001), methylmethacrylate (OR 2.86, p<0.001), cytotoxic drugs (OR 3.03, p<0.001), and formaldehyde (2.08, p = 0.011), to name a few. Conclusion Although surgeon safety is not a domain in residency training, standardized efforts to educate and change the culture of safety in residency programs is warranted. Our study demonstrates a disparity between trainees and attendings with a recommendation to provide formal training to trainees independent of their anticipated risk of exposure.
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Affiliation(s)
- Wilmina N. Landford
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
| | - Ledibabari M. Ngaage
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Erica Lee
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Yvonne Rasko
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
| | - Robin Yang
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Sheri Slezak
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, United States of America
| | - Richard Redett
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Occupational exposures in US obstetrics and gynecology resident physicians. Infect Control Hosp Epidemiol 2021; 42:485-486. [PMID: 33568252 DOI: 10.1017/ice.2021.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Bagnasco A, Zanini M, Catania G, Watson R, Hayter M, Dasso N, Dini G, Agodi A, Pasquarella C, Zotti CM, Durando P, Sasso L. Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale. Nurs Open 2020; 7:1578-1587. [PMID: 32802379 PMCID: PMC7424443 DOI: 10.1002/nop2.540] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/21/2020] [Indexed: 12/19/2022] Open
Abstract
Aim To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design Instrument development and cross-sectional study for psychometric testing. Methods A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018-January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50-1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of "personal exposure" (4.06, SD 3.78) were reported by third-year students. Higher scores for "perceived benefits" of preventive behaviours (13.6, SD 1.46) were reported by second-year students.
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Affiliation(s)
| | - Milko Zanini
- Department of Health SciencesUniversity of GenoaGenoaItaly
| | | | - Roger Watson
- Faculty of Health and Social CareUniversity of HullHullUK
| | - Mark Hayter
- Faculty of Health and Social CareUniversity of HullHullUK
| | | | - Guglielmo Dini
- Occupational Medicine UnitDepartment of Health SciencesPoliclinico San Martino HospitalUniversity of GenoaGenoaItaly
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia"University of CataniaCataniaItaly
| | | | - Carla Maria Zotti
- Department of Public Health and PediatricsUniversity of TurinTurinItaly
| | - Paolo Durando
- Occupational Medicine UnitDepartment of Health SciencesPoliclinico San Martino HospitalUniversity of GenoaGenoaItaly
| | - Loredana Sasso
- Department of Health SciencesUniversity of GenoaGenoaItaly
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Weaver MD, Landrigan CP, Sullivan JP, O'Brien CS, Qadri S, Viyaran N, Wang W, Vetter C, Czeisler CA, Barger LK. The Association Between Resident Physician Work-Hour Regulations and Physician Safety and Health. Am J Med 2020; 133:e343-e354. [PMID: 32061733 PMCID: PMC7469904 DOI: 10.1016/j.amjmed.2019.12.053] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/24/2019] [Accepted: 12/28/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND In 2011, the Accreditation Council for Graduate Medical Education (ACGME) instituted a 16-h limit on consecutive hours for first-year resident physicians. We sought to examine the effect of these work-hour regulations on physician safety. METHODS All medical students matched to a US residency program from 2002 to 2007 and 2014 to 2017 were invited to participate in prospective cohort studies. Each month participants reported hours of work, extended duration shifts, and adverse safety outcomes, including motor vehicle crashes, percutaneous injuries, and attentional failures. The incidence of each outcome was compared before and after the 2011 ACGME work-hour limit. Hypotheses were tested using generalized linear models adjusted for potential confounders. RESULTS Of all first-year resident physicians nationwide, 13% participated in the study, with 80,266 monthly reports completed by 15,276 first-year resident physicians. Following implementation of the 16-h 2011 ACGME work-hour limit, the mean number of extended duration (≥24-h) shifts per month decreased from 3.9 to 0.2. The risk of motor vehicle crash decreased 24% (relative risk [RR] 0.76; 0.67-0.85), percutaneous injury risk decreased more than 40% (relative risk 0.54; 0.48-0.61), and the rate of attentional failures was reduced 18% (incidence rate ratio [IRR] 0.82; 0.78-0.86). Extended duration shifts and prolonged weekly work hours were associated with an increased risk of adverse safety outcomes independent of cohort. CONCLUSIONS The 2011 ACGME work-hour limit was associated with meaningful improvements in physician safety and health. Surveillance is needed to monitor the ongoing impact of work hours on physician safety, health, and well-being.
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Affiliation(s)
- Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine, Harvard Medical School, Boston, Mass.
| | - Christopher P Landrigan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine, Harvard Medical School, Boston, Mass; Department of Medicine, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Mass
| | - Jason P Sullivan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Conor S O'Brien
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Salim Qadri
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Natalie Viyaran
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Wei Wang
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine, Harvard Medical School, Boston, Mass
| | - Céline Vetter
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass; Department of Integrative Physiology, University of Colorado, Boulder
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine, Harvard Medical School, Boston, Mass
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Mass; Division of Sleep Medicine, Harvard Medical School, Boston, Mass
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Treviño H, Romero Arenas MA. Systematic Review of Blood-Borne Pathogen Exposure Rates Among Medical Students. J Surg Res 2020; 255:66-70. [PMID: 32543380 DOI: 10.1016/j.jss.2020.05.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/16/2020] [Accepted: 05/05/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Blood-borne pathogen exposures (BBPEs) pose a risk to health care workers (HCWs). Needlestick injuries (NSIs) have declined overall, but not for surgical HCWs. There are limited data regarding BBPEs among medical students (MSs) in their clinical years. We aimed to quantify this risk for third- and fourth-year MSs. METHODS A literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The PUBMED database was searched to identify studies of third- and fourth-year MSs using the terms BBPE, NSI, and MS. Studies of other HCWs were excluded if MS data were not extractable. Additional studies were identified from references. Descriptive analysis was performed. RESULTS Seven of 171 articles published from 2002 to 2018 met study criteria. All used self-reported data from surveys/questionnaires. One-third of MSs reported BBPEs (n = 194/600, 32.3%) with a mean of 1 in 3.09 and a median of 1 in 3.53 (range: 1 in 1.9-8.3 students). Most events were NSIs (144/194, 74%) with a mean of 1 NSI per 4.05 MSs and median of 1 in 4.625 (range: 1 in 2.47-10.71). The remaining BBPEs reported included blood and bodily fluid splashes (n = 37, 19%), other mucocutaneous exposures (n = 7, 3.6%), and uncategorized injuries (n = 2, 1%). CONCLUSIONS One-third of senior MSs reported BBPEs during clinical rotations. Most BBPEs were NSIs. Quantifying this risk allows for anticipatory education and protocol development to protect students and other new HCWs. Educational efforts focused on NSI prevention before and during clinical rotations may help reduce BBPEs.
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Affiliation(s)
- Haldo Treviño
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; University of Texas Rio Grande Valley School of Medicine, Department of Surgery, Edinburg, Texas
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21
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Study-Related Work and Commuting Accidents among Students at the University of Mainz from 12/2012 to 12/2018: Identification of Potential Risk Groups and Implications for Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103676. [PMID: 32456141 PMCID: PMC7277531 DOI: 10.3390/ijerph17103676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 12/04/2022]
Abstract
Background: Universities represent an important setting of everyday life for health promotion. The aim of the present study was to assess whether university students of specific disciplines might have an increased risk for having a study-related work accident and to analyze what types of study-related work accidents occur most frequently. Furthermore, knowledge regarding study-related commuting accidents will be provided by identifying places where study-related commuting accidents might occur most frequently and on potential types of commuting (walking vs. biking) which might be associated with an increased risk for having a study-related commuting accident. Methods: Retrospective analyses of a dataset provided by the Accident Insurance Fund of Rhineland-Palatinate, Germany, including all accidents that happened at the University of Mainz (JGU) between December 2012 and December 2018 were performed. Binominal tests were computed to reveal whether the frequency of study-related work accidents in students affiliated with a specific faculty or institution differs significantly from the expected frequency of all reported study-related work accidents. Results: Overall, 1285 study-related accidents were analyzed—of which, 71.8% were work and 28.2% commuting accidents. Students of ‘Faculty—Medicine’ (80.5%; p = 0.003), ‘Faculty—Chemistry, Pharmaceutical Sciences, Geography and Geosciences’ (90.7%; p < 0.001), and students that participated in study-related sports activities (97.4%; p ≤ 0.001) had a significantly increased risk for the occurrence of a study-related work accident. Needlestick and sharps injuries (NSIs) as well as lab accidents play a pivotal role. Furthermore, above 40% of the study-related commuting accidents were cycling accidents. Conclusions: There is a call for prevention in order to decrease the number of NSIs among medical students, lab accidents as well as sport-related accidents. Concrete implications for prevention are discussed in the present paper. In addition, given that students are among the most likely to bicycle, and given that most bicycle-related accidents involve fatal injuries, cycling safety campaigns need to be initiated on campus.
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Ishak AS, Haque MS, Sadhra SS. Needlestick injuries among Malaysian healthcare workers. Occup Med (Lond) 2020; 69:99-105. [PMID: 30295884 DOI: 10.1093/occmed/kqy129] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Needlestick injury (NSI) is a significant occupational health issue among healthcare workers (HCWs). AIMS To determine the national self-reported incidence and risk factors for NSI among Malaysian Ministry of Health (MOH) HCWs. METHODS Using data from the MOH national sharps injury surveillance programme, information on reported NSIs over a 1-year period (2016) for different HCW subgroups were extracted and analysed. RESULTS A total of 1234 NSI cases were reported in 2016, giving an overall incidence of 6 injuries per 1000 HCWs. Medical doctors recorded the highest incidence (21.1 per 1000 HCWs) followed by dental staff (7.5), pharmacy staff (4.2), nurses (3.7), medical assistants (3.4) and allied and auxiliary staff (1.0). Doctors had significantly increased risk of NSI compared with allied and auxiliary staff (relative risk [RR] = 20.7, 95% confidence interval [CI] 15.5-27.5), medical assistants (RR = 6.1, 95% CI 4.5-8.2), nurses (RR = 5.7, 95% CI 5.0-6.6), pharmacy staff (RR = 5.0, 95% CI 3.7-6.6) and dental staff (RR = 2.8, 95% CI 2.2-3.5). Significant differences were found in age and sharps- handling experience between occupational subgroups (P < 0.001 for both variables). Male employees had higher risk than females (RR = 1.33, 95% CI 1.18-1.50), with a significant difference seen in their sharps-handling experience (P < 0.01). Important risk factors included unsafe practices such as recapping of needles and their improper disposal. CONCLUSIONS The national incidence of NSI amongst Malaysian HCWs was lower compared with other countries, but unsafe practices remain an important concern. There is a need to formulate, implement and monitor safe and consistent practices for the different healthcare professionals.
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Affiliation(s)
- A S Ishak
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - M S Haque
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - S S Sadhra
- Occupational and Environmental Medicine, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Foytl J, Chisholm F, Varsou O. Sharps Injuries during Dissection: A Five-Year Retrospective Study in the Context of Safety. ANATOMICAL SCIENCES EDUCATION 2020; 13:158-167. [PMID: 31091009 DOI: 10.1002/ase.1894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/12/2019] [Accepted: 05/13/2019] [Indexed: 06/09/2023]
Abstract
The supplementation of lecture-based anatomy teaching with laboratory sessions, involving dissection or anatomical specimens, is commonly used. Hands-on dissection allows students to handle instruments correctly while actively exploring three-dimensional anatomy. However, dissection carries a potential risk of sharps and splash injuries. The aim of this study was to quantify the frequency rate of such cases per 1,000 student-hours of dissection and identify potential factors than might influence safety in anatomy laboratories. Data were retrospectively collected from September 2013 to June 2018 at the University of St Andrews, Scotland, UK. Overall, 35 sharps injuries were recorded in undergraduate medical students, with a frequency rate of 0.384 and no splash cases. A statistically significant, moderate negative association between year of study and frequency rate (rho(25) = -0.663; P < 0.001) was noted. A statistically significant difference in the frequency rate between different semester modules (χ2 (4) = 13.577, P = 0.009) was observed with the difference being between Year 1 Semester 2 and Year 3 Semester 1 (P = 0.004). The decreasing trend with advancing year of study might be linked to increasing dissecting experience or the surface area of the region dissected. The following factors might have contributed to increased safety influencing frequency rates: single-handed blade removal systems; mandatory personal protective equipment; and having only one student dissecting at a given time. The authors propose that safety familiarization alongside standardized training and safety measures, as part of an evidence-based culture shift, will instill safety conscious behaviors and reduce injuries in anatomy laboratories.
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Affiliation(s)
- Jakub Foytl
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Fraser Chisholm
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Ourania Varsou
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
- Anatomy Facility, School of Life Sciences, University of Glasgow, Glasgow, United Kingdom
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La-Rotta EIG, Garcia CS, Pertuz CM, Miquilin IDOC, Camisão AR, Trevisan DD, Aoki FH, Correa-Filho HR. Conhecimento e adesão como fatores associados a acidentes com agulhas contaminadas com material biológico: Brasil e Colômbia. CIENCIA & SAUDE COLETIVA 2020; 25:715-727. [DOI: 10.1590/1413-81232020252.04812018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/03/2018] [Indexed: 11/21/2022] Open
Abstract
Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.
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Ogg MJ. Clinical Issues—January 2020. AORN J 2019; 111:123-130. [DOI: 10.1002/aorn.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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26
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Swendiman RA, Edmondson AC, Mahmoud NN. Burnout in Surgery Viewed Through the Lens of Psychological Safety. Ann Surg 2019; 269:234-235. [PMID: 30169397 DOI: 10.1097/sla.0000000000003019] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Robert A Swendiman
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | | | - Najjia N Mahmoud
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
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27
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Lee JT, Gaertner WB. Workplace Exposures. Clin Colon Rectal Surg 2019; 32:435-441. [PMID: 31686995 DOI: 10.1055/s-0039-1693010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Workplace exposure in colorectal surgery is unique compared with other surgical specialties and generally underreported. Although the most common device-associated exposure in surgery is suture needle injury, colorectal surgeons are increasingly exposed to gastrointestinal-related infectious agents, radiation, and other hazards in multiple different clinical settings. Highlighting the unique workplace exposures in colorectal surgery may help increase awareness, improve education, and identify possible targets for early intervention in order to minimize these risks.
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Affiliation(s)
- Janet T Lee
- Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Wolfgang B Gaertner
- Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
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28
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Papadopoli R, Bianco A, Pepe D, Pileggi C, Pavia M. Sharps and needle-stick injuries among medical residents and healthcare professional students: pattern and reporting in Italy-a cross-sectional analytical study. Occup Environ Med 2019; 76:739-745. [PMID: 31439689 DOI: 10.1136/oemed-2019-105873] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Healthcare workers, in the course of their professional activity, are potentially exposed to chemical, physical and above all biological risks. The aims of our study were to investigate the extent and distribution of needle-stick and sharp injuries (NSIs) in healthcare students, the behaviours and circumstances most frequently associated with NSIs, the frequency of NSI reporting and the adherence to the post-exposure protocols. METHODS This study involved, through an interviewer-administered structured questionnaire, undergraduate and postgraduate students attending postgraduate medical schools and healthcare professional schools who underwent occupational health visits between January 2015 and July 2018. RESULTS Of the 642 students that participated in the study, 95 (14.8%) sustained an NSI during the traineeship and, of these, 59 (62.1%) reported the NSI to the occupational health service. NSIs were significantly more frequent in older subjects (χ²=9.853, p=0.020) and, among medical residents, in surgical residents (χ²=31.260, p<0.0001); moreover, occurrence of NSIs increased with increasing duration of traineeship (t=-2.051, p=0.041). Reporting of NSIs significantly increased with increasing age (χ²=12.543, p=0.006), with medical residents significantly under-reporting NSIs compared with undergraduate healthcare professional students (χ²=10.718, p=0.001) and among medical residents, those attending critical care units had the highest under-reporting (χ²=7.323, p=0.026). CONCLUSIONS The study showed remarkable under-reporting, as well as a lack of preparedness of students for NSI preventive and post-exposure effective measures. Our findings underline that healthcare student education should be reinforced to ensure that safe practices are carried out when needles and sharps are involved, as well as stressing the importance of NSI reporting and adherence to post-exposure prophylaxis protocols.
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Affiliation(s)
- Rosa Papadopoli
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Aida Bianco
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Davide Pepe
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Claudia Pileggi
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Maria Pavia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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29
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Wang C, Huang L, Li J, Dai J. Relationship between psychosocial working conditions, stress perception, and needle-stick injury among healthcare workers in Shanghai. BMC Public Health 2019; 19:874. [PMID: 31272426 PMCID: PMC6610837 DOI: 10.1186/s12889-019-7181-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 06/17/2019] [Indexed: 12/18/2022] Open
Abstract
Background The present study aims to identify the association between psychosocial working conditions, global stress perception, and needle-stick injury among Chinese healthcare workers. It also endeavors to detect the mediating effects of global stress perception. Methods A total of 1956 valid samples were collected from eight teaching hospitals in Shanghai, China. A self-reported questionnaire was administered to participants after obtaining their written consent. Structural equation model was used to analyze the relationship between study variables. Results Most of the correlation coefficients between psychosocial conditions at work, stress perception, and needle-stick injury are of statistical significance ranging from 0.004 to 0.869. Results of the internal consistency test shows that Cronbach’s α is between 0.770 and 0.925. All three models for effect analysis demonstrated satisfactory global goodness and acceptable path loadings. Psychosocial working conditions and stress perception were directly associated with events of needle-stick injury, as 0.39 (95%CI: 0.32 to 0.48) and 0.32 (95%CI: 0.22 to 0.39), respectively. Furthermore, stress perception had been proved to have a mediating effect (0.25, 95%CI: 0.19 to 0.31) between psychosocial working condition and needle-stick injury, which occupied over one-third of the total effect. Conclusions Both stressful psychosocial working conditions and negative stress perception could increase the risk of needle-stick injury that occurs among healthcare workers. Management of stress perception could reduce health risk brought by stressful psychosocial working conditions. Electronic supplementary material The online version of this article (10.1186/s12889-019-7181-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chao Wang
- School of Public Health, Fudan University, Shanghai, China.,Department of Disease Surveillance, Beijing Prevention and Treatment Hospital of Occupational Disease for Chemical Industry, Beijing, China
| | - Li Huang
- School of Public Health, Fudan University, Shanghai, China
| | - Jue Li
- Department of Disease Surveillance, Beijing Prevention and Treatment Hospital of Occupational Disease for Chemical Industry, Beijing, China
| | - Junming Dai
- School of Public Health, Fudan University, Shanghai, China.
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Don't Get Stuck: A Quality Improvement Project to Reduce Perioperative Blood-Borne Pathogen Exposure. Jt Comm J Qual Patient Saf 2019; 45:329-336. [PMID: 30733139 DOI: 10.1016/j.jcjq.2018.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Blood-borne pathogen exposure (BBPE) represents a significant safety and resource burden, with more than 380,000 events reported annually across hospitals in the United States. The perioperative environment is a high-risk area for BBPE, and efforts to reduce exposures are not well defined. A multidisciplinary group of nurses, surgical technologists, surgeons, and employee health specialists created a BBPE prevention bundle to reduce Occupational Safety and Health Administration (OSHA) recordable cases. METHODS Mandatory double gloving, a safety zone, engineered-sharps injury prevention devices, and clear communication when passing sharps were implemented in an evidence-based fashion at one institution. Days between exposures and total number of exposures were monitored. Analysis by specialty, role, location, type of injury, and timing was performed. RESULTS During fiscal year (FY) 2015, 45 cases were reported. During the first year of implementation, cases decreased to 38 (a 15.6% decrease; p < 0.65). In the postimplementation period (FY 2017), only 21 cases were reported (an additional 44.7% decrease; p < 0.12), for a total decrease of 53.3% (p < 0.01). The mean number of days between injuries significantly increased (2.5 to 16.3) over the study period. For FY 2017, the main cause of BBPE was needlestick while suturing (47.6%); fellows and attendings combined had the most injuries (52.4%); among divisions, pediatric surgery (19.0%), operating room staff (19.0%), and orthopedics (19.0%) had the most events. CONCLUSION A comprehensive and multidisciplinary approach to employee safety, focused on reduction of BBPE resulted in a significant progressive annual decrease of injuries among perioperative staff.
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31
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Tlili MA, Belgacem A, Sridi H, Akouri M, Aouicha W, Soussi S, Dabbebi F, Ben Dhiab M. Evaluation of surgical glove integrity and factors associated with glove defect. Am J Infect Control 2018; 46:30-33. [PMID: 28893444 DOI: 10.1016/j.ajic.2017.07.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Surgical glove perforation may expose both patients and staff members to severe complications. This study aimed to determine surgical glove perforation rate and the factors associated with glove defect. MATERIAL AND METHODS This descriptive cross-sectional study was conducted between January and March 2017 at a Tunisian university hospital center in 3 different surgical departments: urology, maxillofacial, and general and digestive. The gloves were collected and tested to detect perforations using the water-leak test as described in European Norm NF EN 455-1. For percentage comparisons, the χ2 test was used with a significance threshold of 5%. RESULTS A total of 284 gloves were collected. Of these, 47 were found to be perforated, a rate of 16.5%. All perforations were unnoticed by the surgical team members. The majority of perforated gloves (61.7%) were collected after urology procedures (P = .00005), 77% of perforated gloves were detected when the duration of the procedure exceeded 90 minutes (P = .001), and 96% were from brand A, which were the thicker gloves (P = .015). CONCLUSIONS This study highlighted an important problem neglected by surgical teams. The findings reaffirm the importance of double-gloving and changing gloves in surgeries of more than 90 minutes' duration.
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Affiliation(s)
- Mohamed Ayoub Tlili
- Health Sciences Research, Higher School of Health Sciences and Techniques of Sousse, University of Sousse, Tunisia.
| | - Amina Belgacem
- Health Sciences Research, Higher School of Health Sciences and Techniques of Sousse, University of Sousse, Tunisia
| | - Haifa Sridi
- Higher School of Health Sciences and Techniques of Sousse, University of Sousse, Tunisia
| | - Maha Akouri
- Higher School of Health Sciences and Techniques of Sousse, University of Sousse, Tunisia
| | - Wiem Aouicha
- Health Sciences Research, Higher School of Health Sciences and Techniques of Sousse, University of Sousse, Tunisia
| | - Sonia Soussi
- Health Sciences Research, Higher School of Health Sciences and Techniques of Tunis, University of Tunis El Manar, Tunisia
| | - Faten Dabbebi
- Department of Occupational Medicine, University Hospital Center of Sahloul, Tunisia
| | - Mohamed Ben Dhiab
- Health Sciences Research, Higher School of Health Sciences and Techniques of Sousse, University of Sousse, Tunisia
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Alsiddiky AM, Alatassi R, Altamimi SM, Alqarni MM, Alfayez SM. Occupational injuries among pediatric orthopedic surgeons: How serious is the problem? Medicine (Baltimore) 2017; 96:e7194. [PMID: 28640103 PMCID: PMC5484211 DOI: 10.1097/md.0000000000007194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In this cross-sectional study, we surveyed all pediatric orthopedic surgeons in Saudi Arabia using an anonymous electronic questionnaire composed of 23 items to identify the rate of occupational injuries and obtain other relevant information. Thirty-nine participants completed the questionnaire (response rate: 83%). Participants who sustained occupational injuries throughout their careers represented 82.5%. The most injured areas were the hands, eyes, and back by 54.5%, 24.2%, and 15.2%, respectively. Approximately 11.1% were injured while operating on infected patients. Approximately 30.3% reported their injuries to their institution. We concluded that the rate of occupational injuries among pediatric orthopedic surgeons is very high and underreported.
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Affiliation(s)
- Abdulmonem M. Alsiddiky
- Department of Orthopaedics, College of Medicine, Department of Orthopedics, King Saud University
| | | | - Saad M. Altamimi
- Department of Orthopaedics, College of Medicine, Department of Orthopedics, King Saud University
| | - Mahdi M. Alqarni
- Department of Orthopaedics, College of Medicine, Department of Orthopedics, King Saud University
| | - Saud M. Alfayez
- Department of Orthopaedics, College of Medicine, Department of Orthopedics, King Saud University
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