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Health care worker follow-up compliance after occupational bloodborne pathogens exposure: A brief report. Am J Infect Control 2016; 44:1738-1740. [PMID: 27451313 DOI: 10.1016/j.ajic.2016.04.243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 04/26/2016] [Accepted: 04/26/2016] [Indexed: 11/21/2022]
Abstract
A retrospective cohort study was conducted examining health care worker (HCW) compliance with Centers for Disease Control and Prevention recommendations following occupational bloodborne pathogen (BBP) exposure. HCWs with a BBP exposure from a known HIV- or hepatitis C virus-seropositive individual were less likely to complete recommended follow-up compared with HCWs with seronegative source patient exposures (adjusted odds ratio, 0.02 and 0.09, respectively). Continued targeted education and extra vigilance in performing postexposure surveillance are warranted in this higher-risk population.
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Chang HH, Lee WK, Moon C, Choi WS, Yoon HJ, Kim J, Ryu SY, Kim HA, Jo YM, Kwon KT, Kim HI, Sohn JW, Yoon YK, Jung SI, Park KH, Kwon HH, Lee MS, Kim YK, Kim YS, Hur J, Kim SW. The acceptable duration between occupational exposure to hepatitis B virus and hepatitis B immunoglobulin injection: Results from a Korean nationwide, multicenter study. Am J Infect Control 2016; 44:189-93. [PMID: 26518500 DOI: 10.1016/j.ajic.2015.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/22/2015] [Accepted: 08/27/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Postexposure prophylaxis for occupational exposure to hepatitis B virus (HBV) plays an important role in the prevention of HBV infections in health care workers (HCWs). We examined data concerning the acceptable duration between occupational exposure and administration of a hepatitis B immunoglobulin (HBIG) injection in an occupational clinical setting. METHODS A retrospective analysis was conducted with data from 143 cases of HCWs exposed to HBV in 15 secondary and tertiary teaching hospitals between January 2005 and June 2013. Data were taken from the infection control records of each hospital. RESULTS Active vaccination after HBV exposure was started in 119 cases (83.2%) and postvaccination testing for hepatitis B antibody showed positive seroconversion in 93% of cases. In 98 cases (68.5%), HBIG was administered within 24 hours after HBV exposure; however, 45 HCWs (31.5%) received an HBIG injection more than 24 hours postexposure and 2 among the 45 received an injection after 7 days. Although 31.5% received an HBIG injection more than 24 hours postexposure, no cases of seroconversion to hepatitis b antibody positivity occurred. CONCLUSIONS For susceptible HCWs, HBIG administered between 24 hours and 7 days postexposure may be as effective as administration within 24 hours in preventing occupational HBV infection.
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Escudero DVS, Furtado GHC, Medeiros EA. Healthcare worker adherence to follow-up after occupational exposure to blood and body fluids at a teaching hospital in Brazil. ACTA ACUST UNITED AC 2015; 59:566-71. [PMID: 25636318 DOI: 10.1093/annhyg/meu117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 12/16/2014] [Indexed: 11/14/2022]
Abstract
Healthcare workers (HCWs) are at a high risk for exposure to pathogens in the workplace. The objective of this study was to evaluate HCW adherence to follow-up after occupational exposure to blood and body fluids at a tertiary care university hospital in the city of São Paulo, Brazil. Data were collected from 2102 occupational exposures to blood and body fluids reports, obtained from the Infection Control Division of the Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo, in São Paulo, Brazil, occurring between January of 2005 and December of 2011. To evaluate adherence to post-exposure follow-up among the affected HCWs, we took into consideration follow-up visits for serological testing. For HCWs exposed to materials from source patients infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV), as well as from source patients of unknown serological status, follow-up serological testing was scheduled for 3 and 6 months after the accident. For those exposed to materials from source patients co-infected with HIV and HCV, follow-up evaluations were scheduled for 3, 6, and 12 months after the accident. During the study period, there were 2056 accidental exposures for which data regarding the serology of the source patient were available. Follow-up evaluation of the affected HCW was recommended in 612 (29.8%) of those incidents. After the implementation of a post-exposure protocol involving telephone calls and official letters mailed to the affected HCW, adherence to follow-up increased significantly, from 30.5 to 54.0% (P = 0.028). Adherence was correlated positively with being female (P = 0.009), with the source of the exposure being known (P = 0.026), with the source patient being HIV positive (P = 0.029), and with the HCW having no history of such accidents (P = 0.047). Adherence to the recommended serological testing was better at the evaluation scheduled for 3 months after the exposure (the initial evaluation) than at those scheduled for 6 and 12 months after the exposure (P = 0.004). During the study period, there was one confirmed case of HCW seroconversion to HCV positivity. The establishment of a protocol that involves the immediate supervisor of the affected HCWs, in the formal summoning of those HCWs is necessary in order to increase the rate of adherence to post-exposure follow-up.
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Affiliation(s)
- Daniela Vieira Silva Escudero
- Infection Control Division, Department of Infectious Diseases, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Guilherme Henrique Campos Furtado
- Infection Control Division, Department of Infectious Diseases, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Eduardo Alexandrino Medeiros
- Infection Control Division, Department of Infectious Diseases, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Wu Q, Xue XF, Shah D, Zhao J, Hwang LY, Zhuang G. Knowledge, Attitude, and Practices Regarding Occupational HIV Exposure and Protection among Health Care Workers in China: Census Survey in a Rural Area. J Int Assoc Provid AIDS Care 2014; 15:363-9. [PMID: 25425637 DOI: 10.1177/2325957414558300] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health care workers (HCWs) seek, treat, and care for patients living with HIV/AIDS on a daily basis and thus face a significant risk to work-related infections. To assess the knowledge, attitude, and practices regarding occupational HIV exposure and protection among HCWs in low HIV prevalence areas of rural China. METHODS A cross-sectional questionnaire survey was carried out among all medical units in Pucheng County, Shaanxi, China. RESULTS Response rate of this study was 94%. The average overall knowledge score of HCWs was 10.9 of 21.0. Deficiencies in general, transmission, exposure, and protection knowledge were identified among HCWs at all levels. A high rate of occupational exposure (85%) and lack of universal precautions practice behavior were recorded. Significant predictors of universal precautions practice behavior were female sex, prior training, and greater knowledge about HIV/AIDS. CONCLUSION Health care workers at various levels have inadequate knowledge on HIV/AIDS and do not practice universal precautions. Nurses and medical technicians at the county level faced more occupation risk than other HCWs. The key of AIDS training for different levels of HCWs should be distinguished.
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Affiliation(s)
- Qian Wu
- Department of Epidemiology, Xi'an Jiaotong University School of Public Health, Shaanxi, People's Republic of China
| | - Xiao Fei Xue
- Pucheng County Hospital, Weinan, Shaanxi, People's Republic of China
| | - Dimpy Shah
- Division of Epidemiology, Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
| | - Jian Zhao
- Pucheng County Hospital, Weinan, Shaanxi, People's Republic of China
| | - Lu-Yu Hwang
- Division of Epidemiology, Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
| | - GuiHua Zhuang
- Department of Epidemiology, Xi'an Jiaotong University School of Public Health, Shaanxi, People's Republic of China
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Ribeiro LCM, Souza ACSE, Tipple AFV, Melo DS, Peixoto MKAV, Munari DB. [Intervening factors in attention flow of professionals injured by biological material]. Rev Esc Enferm USP 2014; 48:507-13. [PMID: 25076280 DOI: 10.1590/s0080-623420140000300017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 04/08/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the barriers and facilitator factors to follow the attention flow of professionals injured by biological material in the worker perspective. METHOD Qualitative descriptive study with data collected through individual interviews with 18 injured workers, assisted in reference public units in the city of Goiânia. The content analysis was carried out with assistance of the ATLAS.ti 6.2 software, under the work organization and subjective perspectives. RESULTS From the interviews regarding the barriers and facilitator factors emerged the categories: organizational structure, Support from close people, and Knowledge influence. CONCLUSION The organized services have enabled more qualified consultations and the workers follow-up, which caused a satisfaction feeling in relation to the working environment.
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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]
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Cheng HC, Su CY, Yen AMF, Huang CF. Factors affecting occupational exposure to needlestick and sharps injuries among dentists in Taiwan: a nationwide survey. PLoS One 2012; 7:e34911. [PMID: 22509367 PMCID: PMC3318009 DOI: 10.1371/journal.pone.0034911] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 03/10/2012] [Indexed: 01/05/2023] Open
Abstract
Background Although the risks of needlestick and sharps injuries (NSIs) for dentists are well recognized, most papers published only described the frequency of occupational exposure to NSIs. Less has been reported assessing factors contributing to exposure to NSIs. The purpose of this study was to update the epidemiology of NSIs among dentists in Taiwan and identify factors affecting NSIs in order to find preventive strategies. Methodology/Principal Findings A nationwide survey was conducted in dentists at 60 hospitals and 340 clinics in Taiwan. The survey included questions about factors supposedly affecting exposure to NSIs, such as dentist and facility characteristics, knowledge and attitudes about infectious diseases, and practices related to infection control. Univariate and multivariate logistic regression analyses were conducted to determine the association between risk factors and exposure to NSIs. In total, 434 (74.8%) of 580 dentists returned the survey questionnaires, and 100 (23.0%) reported that they had experienced more than one NSI per week. Our data showed that the risk of occupational NSIs is similarly heightened by an older age (odds ratio [OR], 3.18; 95% confidence interval [CI], 1.62–6.25), more years in practice (OR, 2.57; 95% CI, 1.41–4.69), working in clinics (OR, 1.73; 95% CI, 1.08–2.77), exhibiting less compliance with infection-control procedures (OR, 1.82; 95% CI, 1.04–3.18), having insufficient knowledge of blood-borne pathogens (OR, 1.67; 95% CI, 1.04–2.67), and being more worried about being infected by blood-borne pathogens (OR, 1.82; 95% CI, 1.05–3.13). Conclusions/Significance High rates of NSIs and low compliance with infection-control procedures highly contribute to the chance of acquiring a blood-borne pathogen infection and threaten occupational safety. This study reveals the possible affecting factors and helps in designing prevention strategies for occupational exposure to NSIs.
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Affiliation(s)
- Hsin-Chung Cheng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- * E-mail:
| | - Chen-Yi Su
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chiung-Fang Huang
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, 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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