1
|
Keicher F, Zirkel J, Leutritz T, König S. Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue? BMC MEDICAL EDUCATION 2024; 24:312. [PMID: 38509544 PMCID: PMC10953246 DOI: 10.1186/s12909-024-05309-1] [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: 08/31/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Needle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study. METHODS An online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany. RESULTS The response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs. CONCLUSION We assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.
Collapse
Affiliation(s)
- Franca Keicher
- Department of Paediatrics, University Hospital Würzburg, Würzburg, Bavaria, Germany.
| | - Janina Zirkel
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - Tobias Leutritz
- University Hospital Würzburg, Institute of Medical Teaching and Medical Education Research, Würzburg, Bavaria, Germany
| | - Sarah König
- University Hospital Würzburg, Institute of Medical Teaching and Medical Education Research, Würzburg, Bavaria, Germany
| |
Collapse
|
2
|
Smith JL, Banerjee R, Linkin DR, Schwab EP, Saberi P, Lanzi M. 'Stat' workflow modifications to expedite care after needlestick injuries. Occup Med (Lond) 2021; 71:20-24. [PMID: 33399827 DOI: 10.1093/occmed/kqaa209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is recommended to start within hours of needlestick injuries (NSIs) among healthcare workers (HCWs). Delays associated with awaiting the results of testing from the source patient (whose blood was involved in the NSI) can lead to psychological consequences for the exposed HCW as well as symptomatic toxicities from empiric PEP. AIMS After developing a 'stat' (immediate) workflow that prioritized phlebotomy and resulting of source patient bloodwork for immediate handling and processing, we retrospectively investigated whether our new workflow had (i) decreased HIV order-result interval times for source patient HIV bloodwork and (ii) decreased the frequency of HIV PEP prescriptions being dispensed to exposed HCWs. METHODS We retrospectively analysed NSI records to identify source patient HIV order-result intervals and PEP dispensing frequencies across a 6-year period (encompassing a 54-month pre-intervention period and 16-month post-intervention period). RESULTS We identified 251 NSIs, which occurred at similar frequencies before versus after our intervention (means 3.54 NSIs and 3.75 NSIs per month, respectively). Median HIV order-result intervals decreased significantly (P < 0.05) from 195 to 156 min after our intervention, while the proportion of HCWs who received one or more doses of PEP decreased significantly (P < 0.001) from 50% (96/191) to 23% (14/60). CONCLUSION Using a 'stat' workflow to prioritize source patient testing after NSIs, we achieved a modest decrease in order-result intervals and a dramatic decrease in HIV PEP dispensing rates. This simple intervention may improve HCWs' physical and psychological health during a traumatic time.
Collapse
Affiliation(s)
- J L Smith
- The University of Texas Health Science Center at Houston, McGovern Medical School, UT Health, Houston, TX, USA
| | - R Banerjee
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - D R Linkin
- Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - E P Schwab
- Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.,Division of Geriatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P Saberi
- Division of Employee Occupational Health, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - M Lanzi
- Division of Employee Occupational Health, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| |
Collapse
|
3
|
Saul J, Bachman G, Allen S, Toiv NF, Cooney C, Beamon T. The DREAMS core package of interventions: A comprehensive approach to preventing HIV among adolescent girls and young women. PLoS One 2018; 13:e0208167. [PMID: 30532210 PMCID: PMC6285267 DOI: 10.1371/journal.pone.0208167] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In sub-Saharan Africa, adolescent girls and young women (AGYW) are 5 to 14 times more likely to be infected with HIV than their male peers. Every day, more than 750 AGYW are infected with HIV. Many factors make girls and young women particularly vulnerable to HIV, including gender-based violence, exclusion from economic opportunities, and a lack of access to secondary school. The President's Emergency Plan for AIDS Relief (PEPFAR) is dedicating significant resources through the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) partnership to impact the lives of women and girls based on PEPFAR's mission to help countries achieve epidemic control of HIV/AIDS. The data show that new HIV infections must be reduced in AGYW, or the global community risks losing the extensive progress made towards reaching epidemic control. With support from PEPFAR and private sector partners-the Bill & Melinda Gates Foundation, Gilead Sciences, Girl Effect, Johnson & Johnson and ViiV Healthcare, DREAMS works together with partner governments to deliver a core package of interventions that combines evidence-based approaches that go beyond the health sector, addressing the structural drivers that directly and indirectly increase girls' HIV risk. Not only is DREAMS an effort to reduce new HIV infections, but it aims to reduce other critical vulnerabilities such as gender-based violence. When girls and young women thrive, the effects are felt throughout their families, communities and countries.
Collapse
Affiliation(s)
- Janet Saul
- Office of the U.S. Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington, DC, United States of America
| | - Gretchen Bachman
- Office of the U.S. Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington, DC, United States of America
| | - Shannon Allen
- Office of the U.S. Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington, DC, United States of America
| | - Nora F. Toiv
- Office of the U.S. Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington, DC, United States of America
| | - Caroline Cooney
- Office of the U.S. Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington, DC, United States of America
| | - Ta’Adhmeeka Beamon
- Office of the U.S. Global AIDS Coordinator and Health Diplomacy, U.S. Department of State, Washington, DC, United States of America
| |
Collapse
|
4
|
Bayar F, Ozkan RE, Tas D. Occupational Exposures to Blood and Body Fluids among Healthcare Personnel. JOURNAL OF MEDICAL SCIENCES AND HEALTH 2016. [DOI: 10.46347/jmsh.2016.v02i02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
5
|
Makhado L, Davhana-Maselesele M. Knowledge and uptake of occupational post-exposure prophylaxis amongst nurses caring for people living with HIV. Curationis 2016; 39:1593. [PMID: 27246789 PMCID: PMC6091603 DOI: 10.4102/curationis.v39i1.1593] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/30/2015] [Accepted: 12/05/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Nurses caring for people living with HIV (PLWH) are at higher risk of exposure to the human immunodeficiency virus (HIV) by needle sticks, cuts, getting body fluids in their eyes or mouth and skin when bruised or affected by dermatitis. OBJECTIVES To determine knowledge, insight and uptake of occupational post-exposure prophylaxis (OPEP) amongst nurses caring for PLWH. METHOD A cross-sectional descriptive design was used in this study. Stratified random sampling was used to sample 240 nurses. The study was conducted in a regional hospital in Limpopo province. Both parametric and non-parametric statistics were employed to analyse data. RESULTS A total of 233 nurses participated in the study. Sixty per cent (n = 138) of all nurses had a situation at work when they thought that they were infected by HIV and 100 (43%) nurses had experienced the situation once or more in the past 12 month. Approximately 40% did not know what PEP (post-exposure prophylaxis) is, and 22% did not know or were not sure if it was available in the hospital. Only few participants (n = 68, 29%) had sought PEP and most (n = 37, 54%) of them did not receive PEP when they needed it. There was a significant association between the knowledge and availability of PEP (r = 0.622). CONCLUSION The study recommend an urgent need for policy makers in the health sector to put in place policies, guidelines and programmes that will rapidly scale up PEP services in health care settings, so that preventable occupationally acquired HIV infection can be minimised amongst nurses.
Collapse
Affiliation(s)
- Lufuno Makhado
- Department of Nursing Sciences, North-West University, Mmabatho.
| | | |
Collapse
|
6
|
Pérez-Diaz C, Calixto OJ, Faccini-Martínez ÁA, Bravo-Ojeda JS, Botero-García CA, Uribe-Pardo E, Mantilla-Florez YF, Benitez F, Duran A, Osorio J. Occupational exposure to blood borne pathogens among healthcare workers: a cross-sectional study of a registry in Colombia. J Occup Med Toxicol 2015; 10:45. [PMID: 26677395 PMCID: PMC4681124 DOI: 10.1186/s12995-015-0088-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 12/11/2015] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Occupational exposure to blood borne pathogens caused by percutaneous injuries or mucosal contamination is frequent among Healthcare Workers (HCW). METHODS A cross-sectional analysis of HCW with an occupational exposure to blood reported to professional risk insurance agencies between 2009 and 2014 was performed. Comparisons between groups according to exposure level (mild, moderate, and severe) were evaluated. RESULTS Two thousand, four hundred three reports were classified according exposure as mild 2.7 %, moderate 74.8 %, severe 21.9 %. Factors related: health sciences student with mild exposure events [adjusted odds ratio (AOR) 11.91, 95 % CI 5.13-27.61, p < 0.00001], and physician with moderate exposure events (AOR 1.90, 95 % CI 1.17-3.07, p = 0.009). Factors inversely related: physician with severe exposure events (AOR 0.54, 95 % CI 0.32-0.91, p = 0.02) and health sciences student with moderate exposure events (AOR 0.08, 95 % CI 0.04-0.15, p < 0.00001). It was found an important relationship between severe events with infectious diseases specialist assessment, and follow-up adherence. Additionally, a case of Human Immunodeficiency Virus seroconversion was presented (0.0004 %), no other seroconversions were observed. CONCLUSIONS Occupational exposure events must be managed according to established protocols, but adherence failure was evident with the exception of severe exposure cases. Thus, interventions to enhance occupational safety are required. Occupation must be considered as a risk factor during initial assessment of events.
Collapse
Affiliation(s)
- Carlos Pérez-Diaz
- Infectious Diseases Department, Clinica Marly, Bogotá, Colombia ; Infectious Diseases Department, Hospital de la Samaritana, Bogotá, Colombia ; Servicios y asesorías en infectología (SAI), Calle 50 # 13-62, 110231420, Bogotá, Colombia
| | - Omar-Javier Calixto
- Servicios y asesorías en infectología (SAI), Calle 50 # 13-62, 110231420, Bogotá, Colombia
| | - Álvaro A Faccini-Martínez
- Servicios y asesorías en infectología (SAI), Calle 50 # 13-62, 110231420, Bogotá, Colombia ; School of Medicine, Universidad de la Sabana, Chia, Colombia
| | - Juan S Bravo-Ojeda
- Servicios y asesorías en infectología (SAI), Calle 50 # 13-62, 110231420, Bogotá, Colombia
| | | | - Erika Uribe-Pardo
- Servicios y asesorías en infectología (SAI), Calle 50 # 13-62, 110231420, Bogotá, Colombia
| | | | - Fabian Benitez
- Servicios y asesorías en infectología (SAI), Calle 50 # 13-62, 110231420, Bogotá, Colombia
| | - Ada Duran
- Servicios y asesorías en infectología (SAI), Calle 50 # 13-62, 110231420, Bogotá, Colombia
| | - Johana Osorio
- School of Medicine, Fundación Universitaria Navarra, Neiva, Colombia
| |
Collapse
|
7
|
Lunding S, Katzenstein TL, Kronborg G, Storgaard M, Pedersen C, Mørn B, Lindberg JÅ, Kronborg TM, Jensen J. The Danish PEP Registry: Experience with the use of post-exposure prophylaxis following blood exposure to HIV from 1999-2012. Infect Dis (Lond) 2015; 48:195-200. [PMID: 26529586 DOI: 10.3109/23744235.2015.1103896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The risk of occupational exposures to blood cannot be eliminated completely and access to post-exposure prophylaxis (PEP) to prevent HIV transmission is important. However, PEP administration has been associated with frequent adverse effects, low compliance and difficulties to ensure a proper risk assessment. This nationwide study describes 14 years of experience with the use of PEP following blood exposure in Denmark. METHODS A descriptive study of all PEP cases following non-sexual exposure to HIV in Denmark from 1999-2012. RESULTS A total of 411 cases of PEP were described. There was a mean of 29.4 cases/year, increasing from 23 cases in 1999 to 49 cases in 2005 and then decreasing to 16 cases in 2012. Overall 67.2% of source patients were known to be HIV-positive at the time of PEP initiation, with no significant change over time. The median time to initiation of PEP was 2.5 h (0.15-28.5) following occupational exposure. Adverse effects were reported by 50.9% with no significant difference according to PEP regimen. In 85.1% of cases with available data, either a full course of PEP was completed or PEP was stopped because the source was tested HIV-negative. Only 6.6% stopped PEP early due to adverse effects. CONCLUSIONS PEP in Denmark is generally prescribed according to the guidelines and the annual number of cases has declined since 2005. Adverse effects were common regardless of PEP regimens used and new drug regimens should be considered.
Collapse
Affiliation(s)
- Suzanne Lunding
- a Department of Pulmonary and Infectious Diseases , Nordsjælland Hospital , Hillerød , Denmark
| | | | - Gitte Kronborg
- c Department of Infectious Diseases , Hvidovre Hospital , Hvidovre , Denmark
| | - Merete Storgaard
- d Department of Infectious Diseases , Skejby Hospital , Århus , Denmark
| | - Court Pedersen
- e Department of Infectious Diseases , Odense Hospital , Odense , Denmark
| | - Birgitte Mørn
- f Department of Infectious Diseases , Ålborg Hospital , Ålborg , Denmark
| | - Jens Å Lindberg
- g Department of Medicine , Herning Hospital , Herning , Denmark
| | - Thit M Kronborg
- h Medical Faculty, Copenhagen University , Copenhagen , Denmark
| | - Janne Jensen
- i Department of Medicine , Kolding Hospital , Kolding , Denmark
| |
Collapse
|
8
|
Ramjee G, Naidoo S. The road ahead: working towards effective clinical translation of biomedical HIV prevention strategies. Future Virol 2015. [DOI: 10.2217/fvl.14.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
ABSTRACT Emerging evidence from several randomized controlled trials show that antiretroviral-based biomedical HIV prevention interventions are efficacious in preventing HIV if they are taken as directed, and could potentially reduce the number of new HIV infections globally. Strategies such as treatment as prevention and use of oral pre-exposure prophylaxis for HIV prevention have shown great promise, yet have raised important implementation concerns around awareness and acceptance, delivery, adherence, side effects, risk compensation, cost–effectiveness and drug resistance. In order to address these issues, a number of treatment as prevention and pre-exposure prophylaxis demonstration projects have been initiated to assess the feasibility of introducing these interventions in ‘real-world’ settings. These projects will be instrumental in determining best practices for optimal delivery and sustainability of these HIV prevention interventions. The road to effective translation to clinical setting is promising, but comes with challenges which are not insurmountable.
Collapse
Affiliation(s)
- Gita Ramjee
- HIV Prevention Research Unit, South African Medical Research Council, Durban, KwaZulu-Natal, South Africa
- Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarita Naidoo
- HIV Prevention Research Unit, South African Medical Research Council, Durban, KwaZulu-Natal, South Africa
| |
Collapse
|
9
|
Flynn MH, Reid A. Management of occupational blood exposures: looking at progress. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2015; 24:8-11. [PMID: 25541870 DOI: 10.12968/bjon.2015.24.1.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Occupational blood exposure (OBE) is a well-recognised hazard in the healthcare setting. A 4-year review of OBE in a large Irish teaching hospital over 2008-2011 found encouraging results, but identified deficits in documentation, communication and follow-up. The process was repeated 1 year later to determine if improvements were achieved and recommendations implemented. In 2012, 110 OBEs were reported, of which 81% were reported within 72 hours of the injury. The administration of first aid was adequately documented in 85% of cases and confirmation of the provision of appropriate information and/or counselling in 72% of the cases. Attendance for follow-up was broadly in line with the previous review. The findings and recommendations contributed to improvements in practice. However, to ensure these are ongoing, the reinforcement of an educational strategy in a systematic way is fundamental.
Collapse
|
10
|
Ansari A, Ramaiah P, Collazo L, Salihu HM, Haiduven D. Comparison of Visual versus Microscopic Methods to Detect Blood Splatter from an Intravascular Catheter with Engineered Sharps Injury Protection. Infect Control Hosp Epidemiol 2015; 34:1174-80. [DOI: 10.1086/673462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.To determine whether retractable intravenous devices produced blood splatter and whether blood splatter frequency differed between visual and microscopy detection methods.Methods.In this laboratory-based experiment, 105 venipunctures were performed in a simulated brachial vein containing mock venous blood. The retraction mechanism was activated in a testing chamber with precut fabric filters, placed at 3 different locations, to capture blood splatter. Differences in filter mass, visual inspection, and microscopic analysis for presence of blood on filters were the units of analysis. Descriptive statistics, paired Student t tests, and k statistics were used for data analysis.Results.Blood splatter was detected visually and microscopically as follows: filter A, 70% and 71%, respectively; filter B, 12% and 9%, respectively; and filter C, 13% and 10%, respectively. A statistically significant difference was observed in the mean mass of filter A between before and after activation when confirmed by the naked eye (P = .014) and microscopically (P = .0092). Substantial agreement between methods was observed for filter A (k = 0.78 [95% confidence interval, 0.64-0.92]), filter B (k = 0.73 [95% confidence interval, 0.51-0.95]), and filter C (k = 0.75 [95% confidence interval, 0.55-0.96]). However, blood was detected by microscopy and not by the naked eye in 7 instances (7%).Conclusions.Our findings demonstrate that splatter, which can potentially expose healthcare workers (HCWs) to bloodborne pathogens, is associated with the activation of intravascular catheters with retraction mechanisms. HCWs may not detect this splatter when it occurs and may not report a splash to mucous membranes or nonintact skin. The need to wear personal protective equipment when using such devices is reinforced.
Collapse
|
11
|
Knowledge and Practices of Jordanian Nurses on Needlestick Injuries. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2015. [DOI: 10.1097/ipc.0000000000000159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
12
|
Assessment of Prevalence and Determinants of Occupational Exposure to HIV Infection among Healthcare Workers in Selected Health Institutions in Debre Berhan Town, North Shoa Zone, Amhara Region, Ethiopia, 2014. AIDS Res Treat 2014; 2014:731848. [PMID: 25478213 PMCID: PMC4247935 DOI: 10.1155/2014/731848] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/26/2014] [Accepted: 10/14/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction. Health care workers are exposed to different kinds of occupational hazards due to their day to day activities. The most common occupational exposure like body fluids is a potential risk of transmission of blood-borne infection like human immunodeficiency virus. Objective. To assess the prevalence and determinants of occupational exposure to human immunodeficiency virus infection. Methods and Materials. A descriptive cross-sectional institution based study was conducted in selected four health institutions in Debre Berhan town. Quantitative and qualitative data were collected using semistructured interviewer administered questionnaire. The frequency distribution of dependent and independent variables was worked out and presented using frequency table, graph, and chart. Result. The overall prevalence of occupational exposure of the health care workers was found to be 88.6% (n = 187) in the past 12 months. Contact to potentially infectious body fluids accounts for the largest proportion (56.7%) followed by needle stick injury (31.5%) and glove breakage (28.8%). Conclusion. In this study majority (88.6%) of the health care workers had a risky occupational hazard that exposed them to human immunodeficiency virus infection during the past 12 months. The statistically significant determinant factors were professional status, working room, and time of personal protective equipment usage.
Collapse
|
13
|
Post-exposure prophylaxis among Ugandan nurses: “Accidents do happen”. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2014. [DOI: 10.1016/j.ijans.2014.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
14
|
Jones AB, Hughes A, Barton S. Guidance on Occupational-Related HIV Post-Exposure Prophylaxis (PEP) in the Intensive Care Setting. J Intensive Care Soc 2012. [DOI: 10.1177/175114371201300413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ann-Britt Jones
- Specialist Registrar in Genito-urinary Medicine, Chelsea and Westminster Hospital NHS Foundation Trust
| | - Amelia Hughes
- Specialist Registrar in Genito-urinary Medicine, Chelsea and Westminster Hospital NHS Foundation Trust
| | - Simon Barton
- Clinical Director HIV, GUM and Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust
| |
Collapse
|
15
|
|
16
|
Needlestick Injuries, Short Peripheral Catheters, and Health Care Worker Risks. JOURNAL OF INFUSION NURSING 2012; 35:164-78. [DOI: 10.1097/nan.0b013e31824d276d] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
17
|
Underhill K. Paying for prevention: challenges to health insurance coverage for biomedical HIV prevention in the United States. AMERICAN JOURNAL OF LAW & MEDICINE 2012; 38:607-66. [PMID: 23356098 PMCID: PMC4041033 DOI: 10.1177/009885881203800402] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Reducing the incidence of HIV infection continues to be a crucial public health priority in the United States, especially among populations at elevated risk such as men who have sex with men, transgender women, people who inject drugs, and racial and ethnic minority communities. Although most HIV prevention efforts to date have focused on changing risky behaviors, the past decade yielded efficacious new biomedical technologies designed to prevent infection, such as the prophylactic use of antiretroviral drugs and the first indications of an efficacious vaccine. Access to prevention technologies will be a significant part of the next decade's response to HIV and advocates are mobilizing to achieve more widespread use of these interventions. These breakthroughs, however, arrive at a time of escalating healthcare costs; health insurance coverage therefore raises pressing new questions about priority-setting and the allocation of responsibility for public health. The goals of this Article are to identify legal challenges and potential solutions for expanding access to biomedical HIV prevention through health insurance coverage. This Article discusses the public policy implications of HIVprevention coverage decisions, assesses possible legal grounds on which insurers may initially deny coverage for these technologies, and evaluates the extent to which these denials may survive external and judicial review. Because several of these legal grounds may be persuasive, particularly denials on the basis of medical necessity, this Article also explores alternative strategies for financing biomedical HIV prevention efforts.
Collapse
|
18
|
Salzer HJF, Hoenigl M, Kessler HH, Stigler FL, Raggam RB, Rippel KE, Langmann H, Sprenger M, Krause R. Lack of risk-awareness and reporting behavior towards HIV infection through needlestick injury among European medical students. Int J Hyg Environ Health 2011; 214:407-10. [PMID: 21665538 DOI: 10.1016/j.ijheh.2011.05.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 05/06/2011] [Accepted: 05/17/2011] [Indexed: 11/26/2022]
Abstract
Medical students are at risk for occupational needlestick injuries (NSIs) which can result in substantial health consequences and psychological stress. Therefore, an open online survey among final year medical students from Austria, Germany, and the United Kingdom (UK) was conducted. The aim of the study was to evaluate risk-awareness and reporting behavior regarding needlestick injury (NSI), post-exposure prophylaxis, and level of education regarding the transmission of HIV through NSIs. Of 674 medical students, 226 (34%) reported at least one NSI during medical school. Respondents from Austria and Germany experienced a significantly higher number of NSIs in comparison to respondents from the UK. Seventy-six respondents (34%) did not report their most recent injury to an employee health office. Almost one third were not familiar with reporting procedures in case of a NSI and 45% of the study population feared that reporting an injury might have an adverse effect on their study success. 176 respondents (78%) who had suffered a NSI were not aware of the patient's HIV status. Education regarding NSIs and HIV transmission reduced the actual risk of experiencing a NSI significantly. These data indicate that medical students are at high risk of suffering NSIs during medical school. The rate of nonreporting of such injuries to an employee health service is alarmingly high. Improved medical curricula including precise recommendations may contribute to a more efficient prevention of occupational HIV infection in medical students.
Collapse
Affiliation(s)
- Helmut J F Salzer
- Section of Infectious Diseases, Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Austria.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Kumakech E, Achora S, Berggren V, Bajunirwe F. Occupational exposure to HIV: a conflict situation for health workers. Int Nurs Rev 2011; 58:454-62. [DOI: 10.1111/j.1466-7657.2011.00887.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Olowookere SA, Fatiregun AA. Human immunodeficiency virus postexposure prophylaxis at IBadan, Nigeria. ACTA ACUST UNITED AC 2010; 9:187-90. [PMID: 20357035 DOI: 10.1177/1545109709359938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
HIV infection from occupational and nonoccupational exposures can be prevented through risk assessment and management with antiretroviral drug therapy (ART). This study sought to examine the pattern of presentation and outcome of clients who were given postexposure prophylaxis (PEP) at the University College Hospital, Ibadan, Nigeria. A retrospective review of case notes of clients presenting for HIV PEP from January 2005 to December 2006 was carried out. A total of 48 clients with a mean age of 27.9 +/- 12.3 years underwent PEP during the period under review. Rape constituted 50% of reasons for PEP, while needle pricks and blood splash into mucous membranes constituted 25% each. Among those who received therapy, 10 (23.8%) could not complete drug therapy because of side effects. Although no client was HIV positive after the recommended 6 months of follow-up, 8 (16.7%) clients did not complete attendance to the clinic during the period.
Collapse
|
21
|
An extracellular stochastic model of early HIV infection and the formulation of optimal treatment policy. Chem Eng Sci 2008. [DOI: 10.1016/j.ces.2008.05.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
22
|
Easterbrook P. Sexual health: overview. Occup Med (Lond) 2007; 57:311-2. [PMID: 17656495 DOI: 10.1093/occmed/kqm043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Philippa Easterbrook
- Department of HIV/GUM, Kings College London, 10 Cutcombe Road, London SE5 9RS, UK.
| |
Collapse
|