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Mohamed M, Tandon N, Kim Y, Kopp I, Tanaka N, Mikamo H, Friedman K, Bajpai S. Needlestick Injuries With Insulin Injections: Risk Factors, Concerns, and Implications of the Use of Safety Pen Needles in the Asia-Pacific Region. J Diabetes Sci Technol 2023:19322968231186402. [PMID: 37475682 DOI: 10.1177/19322968231186402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Globally, health care workers (HCWs) are at a high risk of occupational exposure to needlestick injuries (NSIs). Needlestick injuries not only are associated with an increased risk of infections caused by bloodborne pathogens but are also a primary source of emotional distress and job burnout for HCWs and patients. Insulin injection-related NSIs are common among HCWs working in hospitals in the Asia-Pacific (APAC) region and impose a significant burden. Insulin pen needles have a high risk of transmitting infections (at both the patient-end and cartridge end of the sharp) after use. Recapping a needle after administering an insulin injection poses a major risk to HCWs. Currently, several safety-engineered needle devices (SENDs) are available with active or passive safety mechanisms. Passive insulin safety pen needles with dual-ended protection and automatic recapping capabilities have resulted in a significant drop in accidental punctures to HCWs while administering insulin to patients with diabetes. In this article, we have reviewed the burden and common causes of NSIs with insulin injections among HCWs in the APAC region. We have discussed current approaches to address the issues associated with NSIs and the benefits of introducing SENDs in health care settings, including long-term care facilities, nursing homes, and home care settings where patients may require assisted insulin injections. This review also summarizes key strategies/recommendations to prevent NSIs in HCWs and patients with diabetes in the APAC region.
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Affiliation(s)
- Mafauzy Mohamed
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Youngsoon Kim
- Kangwon National University Hospital, Gangwon-do, South Korea
| | - Irene Kopp
- Nepean Diabetes Service, Nepean Hospital, Kingswood, NSW, Australia
| | - Nagaaki Tanaka
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Kevin Friedman
- embecta (formerly BD Diabetes Care), Parsippany, NJ, USA
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Mathew R, Mohindra R, Sahu A, Bhat R, Ramaswami A, Aggarwal P. Occupational Sharp Injury and Splash Exposure among Healthcare Workers in a Tertiary Hospital. J Lab Physicians 2022; 13:323-327. [PMID: 34975250 PMCID: PMC8714307 DOI: 10.1055/s-0041-1731135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background
Occupational hazards like sharp injury and splash exposure (SISE) are frequently encountered in health-care settings. The adoption of standard precautions by healthcare workers (HCWs) has led to significant reduction in the incidence of such injuries, still SISE continues to pose a serious threat to certain groups of HCWs.
Materials and Methods
This was a retrospective study which examined the available records of all patients from January 2015 to August 2019 who self-reported to our emergency department with history of sharp injury and/or splash exposure. Details of the patients, mechanism of injury, the circumstances leading to the injury, status of the source (hepatitis B surface antigen, human immunodeficiency virus, and hepatitis C virus antibody status), and the postexposure prophylaxis given were recorded and analyzed. Data were represented in frequency and percentages.
Results
During the defined period, a total of 834 HCWs reported with SISE, out of which 44.6% were doctors. Majority of the patients have SISE while performing medical procedures on patients (49.5%), while 19.2% were exposed during segregation of waste. The frequency of needle stick injury during cannulation, sampling, and recapping of needle were higher in emergency department than in wards. More than 80% of HCWs received hepatitis B vaccine and immunoglobulin postexposure.
Conclusion
There is need for periodical briefings on practices of sharp handling as well as re-emphasizing the use of personal protective equipment while performing procedures.
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Affiliation(s)
- Roshan Mathew
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ritin Mohindra
- Department of Internal Medicine, Postgraduate Institute of Medical Research, Chandigarh, India
| | - Ankit Sahu
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rachana Bhat
- Department of Emergency Medicine, Kasturba Medical College, Manipal, India
| | - Akshaya Ramaswami
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Aggarwal
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
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Cordeiro TMSC, Ferreira Filho RP, D'Oliveira Júnior A. Factors associated with occupational and non-occupational viral hepatitis infections in Brazil between 2007-2014. Ann Hepatol 2020; 18:751-756. [PMID: 31153910 DOI: 10.1016/j.aohep.2019.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/17/2019] [Accepted: 02/17/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Viral hepatitis is an endemic and epidemic disease of relevance in public health. This study estimated the frequency of viral hepatitis by occupational and non-occupational infections and analyzed the factors associated with case notifications in Brazil from 2007 to 2014. MATERIAL AND METHODS This was an exploratory epidemiological study using the Notifiable Diseases Information System database. Descriptive and multivariate analyses were performed. RESULTS The frequency of viral hepatitis by occupational infections was 0.7%, of which 1.3% were due to hepatitis A virus (HAV), 45.1% hepatitis B virus (HBV), and 45.3% hepatitis C virus (HCV). There was a significant association of the disease with female sex [AOR=1.31; P=0.048], schooling [AOR=1.71; P<0.001], occupation [AOR=2.74; P<0.001], previous contact with an HBV or HCV-infected patient [AOR=5.77; P<0.001], exposure to accidents with biological materials [AOR=99.82; P<0.001], and hepatitis B vaccination [AOR=0.73; P=0.033]. CONCLUSION While there was a low frequency of viral hepatitis by occupational infections in Brazil from 2007 to 2014, these findings might be underreported and have been associated with individual and occupational characteristics. This reinforces the need for the adoption of prevention strategies in the workplace and for completeness of case notifications.
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Affiliation(s)
- Técia Maria S C Cordeiro
- School of Medicine in Bahia, Post-Graduate Program in Health Sciences, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.
| | - Raymundo P Ferreira Filho
- School of Medicine in Bahia, Post-Graduate Program in Health Sciences, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Argemiro D'Oliveira Júnior
- School of Medicine in Bahia, Post-Graduate Program in Health Sciences, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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Auta A, Adewuyi EO, Tor-Anyiin A, Edor JP, Kureh GT, Khanal V, Oga E, Adeloye D. Global prevalence of percutaneous injuries among healthcare workers: a systematic review and meta-analysis. Int J Epidemiol 2018; 47:1972-1980. [DOI: 10.1093/ije/dyy208] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | - Emmanuel O Adewuyi
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Amom Tor-Anyiin
- Royal Alexandra Hospital Pharmacy, Alberta Health Services, Edmonton, AB, Canada
| | - Joseph P Edor
- Johns Hopkins Center for Communication Programs, Abuja, Nigeria
| | - Gbednet T Kureh
- Department of Pharmacology, Faculty of Medicine, St Francis University College of Health and Allied Sciences, Ifakara, Tanzania
| | - Vishnu Khanal
- Nepal Development Society, Bharatpur, Chitwan, Nepal
| | - Enoche Oga
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | - Davies Adeloye
- Centre for Global Health Research and the World Health Organization Collaborating Centre for Population Health Research and Training, Usher Institute, University of Edinburgh, Edinburgh, UK
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Cooke CE, Stephens JM. Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2017; 10:225-235. [PMID: 29033615 PMCID: PMC5628664 DOI: 10.2147/mder.s140846] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Introduction Needlestick injuries (NSIs) from a contaminated needle put healthcare workers (HCWs) at risk of becoming infected with a blood-borne virus and suffering serious short- and long-term medical consequences. Hypodermic injections using disposable syringes and needles are the most frequent cause of NSIs. Objective To perform a systematic literature review on NSI and active safety-engineered devices for hypodermic injection. Methods MEDLINE, EMBASE, and COCHRANE databases were searched for studies that evaluated the clinical, economic, or humanistic outcomes of NSI or active safety-engineered devices. Results NSIs have been reported by 14.9%–69.4% of HCWs with the wide range due to differences in countries, settings, and methodologies used to determine rates. Exposure to contaminated sharps is responsible for 37%–39% of the worldwide cases of hepatitis B and C infections in HCWs. HCWs may experience serious emotional effects and mental health disorders after a NSI, resulting in work loss and post-traumatic stress disorder. In 2015 International US$ (IntUS$), the average cost of a NSI was IntUS$747 (range IntUS$199–1,691). Hypodermic injections, the most frequent cause of NSI, are responsible for 32%–36% of NSIs. The use of safety devices that cover the needle-tip after hypodermic injection lowers the risk of NSI per HCW by 43.4%–100% compared to conventional devices. The economic value of converting to safety injective devices shows net savings, favorable budget impact, and overall cost-effectiveness. Conclusion The clinical, economic, and humanistic burden is substantial for HCWs who experience a NSI. Safety-engineered devices for hypodermic injection demonstrate value by reducing NSI risk, and the associated direct and indirect costs, psychological stress on HCWs, and occupational blood-borne viral infection risk.
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Affiliation(s)
- Catherine E Cooke
- Department of Pharmacy Practice & Science, University of Maryland School of Pharmacy, Baltimore, MD
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Motaarefi H, Mahmoudi H, Mohammadi E, Hasanpour-Dehkordi A. Factors Associated with Needlestick Injuries in Health Care Occupations: A Systematic Review. J Clin Diagn Res 2016; 10:IE01-IE04. [PMID: 27656466 PMCID: PMC5028444 DOI: 10.7860/jcdr/2016/17973.8221] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/15/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Needlestick and sharps injuries (NSIs), are among the main job-related injuries that health care workers experience. In fact, contraction of hepatitis B or hepatitis C from work-related NSIs is one of the most common occupational hazards among health care workers. AIM The aim of this study was to determine the factors associated with NSIs in health care occupation. MATERIALS AND METHODS In this study, a systematic and purposive review with emphasis on the research question was run to retrieve, evaluate and consolidate the required information. The following four key words were used to search for the relevant articles published from January 1998 to May 2015: NSI health care workers, risk factor and factors associated, in Science direct, EBSCO Host, PubMed, ProQuest, SID and Cochrane Library. Several steps of evaluation were taken to select and analyse the full texts of relevant articles. According to the inclusion criteria, we finally selected 11 articles from the 18642 retrieved articles. RESULTS The data of the analysed articles indicated that the highest incidence of NSIs was seen in nurses and that the associated factors were age, level of education, number of shifts per month and history of related training. The highest rate of NSIs was related to instrument preparation followed by injection and recapping of used needles. Findings show that health care workers suffer a high rate of needlestick injuries. CONCLUSION It was seen that device, location, or action cannot be separately considered as responsible for all types of the NSIs. Rather, each of them has a contribution to the NSIs. Nevertheless, factors with higher frequency should be given a higher priority.
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Affiliation(s)
- Hossein Motaarefi
- PhD Nursing Student, Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran & Lecturer, Faculty of Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Hosein Mahmoudi
- Associate Professor, Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Eesa Mohammadi
- Professor, Department of Nursing, College of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Hasanpour-Dehkordi
- Assistant Professor, Department of Medical- surgical Nursing and Nursing and Midwifery Holistic Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
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Abstract
Reporting of percutaneous injuries (PIs) to the Chinese Exposure Prevention Information Network (EPINet) became mandatory for all public and tertiary referral hospitals in Taiwan in 2011. We have estimated the number of microbially contaminated PIs and the national PI incidence using a retrospective secondary data analysis approach to analyse 2011 data from the Chinese EPINet to determine the types of PI, mechanisms of occurrence and associated risks. The results revealed a national estimate of PIs between 6710 and 8319 in 2011. The most common incidents for physicians were disposable syringes, suture needles, and disposable scalpels; while for nurses they were disposable syringes, intravenous catheters, and lancets. About 13·0% of the source patients were seropositive for hepatitis B virus (HBV) surface antigen, 13·8% were seropositive for hepatitis C virus (HCV), and 1·1% seropositive for human immunodeficiency virus (HIV). From these results we estimate that annually 970 full-time healthcare workers (HCWs) would be exposed to HBV, 1094 to HCV, and 99 to HIV. This study improves our understanding of the mechanisms and risks of PIs and informs the development of more efficient preventive measures to protect HCWs from such injuries.
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Yoshikawa T, Wada K, Lee JJ, Mitsuda T, Kidouchi K, Kurosu H, Morisawa Y, Aminaka M, Okubo T, Kimura S, Moriya K. Incidence rate of needlestick and sharps injuries in 67 Japanese hospitals: a national surveillance study. PLoS One 2013; 8:e77524. [PMID: 24204856 PMCID: PMC3813677 DOI: 10.1371/journal.pone.0077524] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 09/04/2013] [Indexed: 12/17/2022] Open
Abstract
Background Determining incidence rates of needlestick and sharps injuries (NSIs) using data from multiple hospitals may help hospitals to compare their in-house data with national averages and thereby institute relevant measures to minimize NSIs. We aimed to determine the incidence rate of NSIs using the nationwide EPINet surveillance system. Methodology/Principal Findings Data were analyzed from 5,463 cases collected between April 2009 and March 2011 from 67 Japanese HIV/AIDS referral hospitals that participated in EPINet-Japan. The NSI incidence rate was calculated as the annual number of cases with NSIs per 100 occupied beds, according to the demographic characteristics of the injured person, place, timing, device, and the patients’ infectious status. The NSI incidence rates according to hospital size were analyzed by a non-parametric test of trend. The mean number of cases with NSIs per 100 occupied beds per year was 4.8 (95% confidence interval, 4.1–5.6) for 25 hospitals with 399 or fewer beds, 6.7 (5.9–7.4) for 24 hospitals with 400–799 beds, and 7.6 (6.7–8.5) for 18 hospitals with 800 or more beds (p-trend<0.01). NSIs frequently occurred in health care workers in their 20 s; the NSI incidence rate for this age group was 2.1 (1.6–2.5) for hospitals having 399 or fewer beds, 3.5 (3.0–4.1) for hospitals with 400–799 beds, and 4.5 (3.9–5.0) for hospitals with 800 or more beds (p-trend<0.01). Conclusions/Significance The incidence rate of NSIs tended to be higher for larger hospitals and in workers aged less than 40 years; injury occurrence was more likely to occur in places such as patient rooms and operating rooms. Application of the NSI incidence rates by hospital size, as a benchmark, could allow individual hospitals to compare their NSI incidence rates with those of other institutions, which could facilitate the development of adequate control strategies.
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Affiliation(s)
- Toru Yoshikawa
- Department of Research, The Institute for Science of Labour, Kawasaki, Japan
| | - Koji Wada
- Bureau of International Medical Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail:
| | - Jong Ja Lee
- Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan
| | - Toshihiro Mitsuda
- Department of Infection Prevention and Control, Yokohama City University Hospital, Yokohama, Japan
| | | | - Hitomi Kurosu
- Department of Nursing, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital, Tokyo, Japan
| | - Yuji Morisawa
- Department of Infection Prevention and Control, Jichi Medical University Hospital, Tochigi, Japan
| | | | - Takashi Okubo
- Department of Infection Prevention and Control, Tokyo Healthcare University Postgraduate School, Tokyo, Japan
| | | | - Kyoji Moriya
- Department of Infection control and prevention, The University of Tokyo, Tokyo, Japan
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The health promoting hospital movement in Taiwan: recent development and gaps in workplace. Int J Public Health 2012; 58:313-7. [DOI: 10.1007/s00038-012-0391-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 06/14/2012] [Accepted: 07/02/2012] [Indexed: 11/26/2022] Open
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Wu FFS, Wu MW, Chou YH, Ting MH, Siebers R. Incidence of percutaneous injuries and non-reporting rates among first-aid responders in Taiwan. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2012; 9:535-537. [PMID: 22803689 DOI: 10.1080/15459624.2012.697349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We determined the incidence of percutaneous (needlestick and sharps) injuries among emergency medical technicians (EMTs) in one county in Taiwan, compared this with the official reporting rate, and sought reasons for non-reporting. An anonymous questionnaire was distributed to all EMTs in that county, eliciting percutaneous injuries occurrences, reasons why, and reporting data. Data were analyzed by logistic regression. A total of 329 out of 353 EMTs completed the questionnaire, giving a response rate of 93.2%. Thirty-nine EMTs (11.9%) experienced at least one percutaneous injury in the preceding 12 months. Older, less experienced EMTs were at greater risk of percutaneous injuries. None of the EMTs officially reported their percutaneous injuries primarily because they thought reporting was not mandatory and that the reporting process was too complicated. About one in eight EMTs had experienced at least one percutaneous injury in the preceding year. None of these injuries was officially reported to their organization. Ways to make reporting more user friendly are required, along with resources to minimize percutaneous injuries among EMTs in Taiwan.
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Ko NY, Yeh SH, Tsay SL, Ma HJ, Chen CH, Pan SM, Feng MC, Chiang MC, Lee YW, Chang LH, Jang JF. Intention to comply with post-exposure management among nurses exposed to blood and body fluids in Taiwan: application of the theory of planned behaviour. J Hosp Infect 2011; 77:321-6. [DOI: 10.1016/j.jhin.2010.09.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 09/17/2010] [Indexed: 11/30/2022]
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Irmak Z, Baybuga MS. Needlestick and sharps injuries among Turkish nursing students: A cross-sectional study. Int J Nurs Pract 2011. [DOI: 10.1111/j.1440-172x.2011.01920.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Assaults against nurses of general and psychiatric hospitals in Taiwan. Int Arch Occup Environ Health 2009; 83:823-32. [DOI: 10.1007/s00420-009-0501-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2009] [Accepted: 12/08/2009] [Indexed: 10/20/2022]
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Shiao JS, McLaws M, Lin M, Jagger J, Chen C. Chinese EPINet and Recall Rates for Percutaneous Injuries: An Epidemic Proportion of Underreporting in the Taiwan Healthcare System. J Occup Health 2009; 51:132-6. [DOI: 10.1539/joh.l8111] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Judith Shu‐Chu Shiao
- Department of NursingNational Taiwan University, College of Medicine and NTU HospitalTaiwan
| | - Mary‐Louise McLaws
- NSW Hospital Infection, Epidemiology & Surveillance Unit, School of Health Services Management, The University of New South WalesAustralia
| | - Ming‐Hsiu Lin
- Institute of Occupational Safety and Health, Council of Labor Affairs, Executive YuanTaiwan
| | - Janine Jagger
- Department of Internal MedicineUniversity of Virginia Health SystemUSA
| | - Chiou‐Jong Chen
- Institute of Occupational Safety and Health, Council of Labor Affairs, Executive YuanTaiwan
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