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Ko A, Liao C. Paper-based colorimetric sensors for point-of-care testing. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:4377-4404. [PMID: 37641934 DOI: 10.1039/d3ay00943b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
By eliminating the need for sample transportation and centralized laboratory analysis, point-of-care testing (POCT) enables on-the-spot testing, with results available within minutes, leading to improved patient management and overall healthcare efficiency. Motivated by the rapid development of POCT, paper-based colorimetric sensing, a powerful analytical technique that exploits the changes in color or absorbance of a chemical species to detect and quantify analytes of interest, has garnered increasing attention. In this review, we strive to provide a bird's eye view of the development landscape of paper-based colorimetric sensors that harness the unique properties of paper to create low-cost, easy-to-use, and disposable analytical devices, thematically covering both fundamental aspects and categorized applications. In the end, we authors summarized the review with the remaining challenges and emerging opportunities. Hopefully, this review will ignite new research endeavors in the realm of paper-based colorimetric sensors.
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Affiliation(s)
- Anthony Ko
- Renaissance Bio, New Territories, Hong Kong SAR, China.
- Medical School, Sun Yat-Sen University, Guangzhou, China
| | - Caizhi Liao
- Renaissance Bio, New Territories, Hong Kong SAR, China.
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Tsegaye Amlak B, Tesfa S, Tesfamichael B, Abebe H, Zewudie BT, Mewahegn AA, Chekole Temere B, Terefe TF, GebreEyesus FA, Tsehay T, Solomon M. Needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia. SAGE Open Med 2023; 11:20503121221149536. [PMID: 36741932 PMCID: PMC9893066 DOI: 10.1177/20503121221149536] [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] [Received: 06/15/2022] [Accepted: 12/19/2022] [Indexed: 01/25/2023] Open
Abstract
Background Needlesticks and sharp injuries are occupational hazards for healthcare workers that result from the accidental piercing of the skin. Needlestick injuries expose healthcare workers to blood and body fluids that may be infected and can be transmitted to them. Healthcare workers have been exposed to blood-borne pathogens through contaminated needles and other sharp materials every day. Around 20 blood-borne diseases can be transmitted through casual needlesticks and sharp injuries. Objective To assess needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia, 2021. Methods The hospital-based cross-sectional study design was conducted among 341 healthcare workers in Worabe Comprehensive Specialized Hospital from June 10 to July 6, 2021. A stratified sampling technique was used and data were collected using standardized structural questionnaires by BSc nursing professionals. The collected data were checked for completeness and consistency by the investigator. The completed questionnaire was given an identification number and entered into EpiData version 3.5.1. The data were coded and analyzed using SPSS version 26 using a binary logistic regression model and presented with texts, tables, and graphs. Results The finding revealed that 30.6% of healthcare workers had experienced needlestick and sharp injuries within their working area. Healthcare workers not trained on safety measures of needlestick and sharp injury (adjusted odds ratio: 7.179 (3.494-14.749)), working in the delivery unit (adjusted odds ratio: 6.528 (3.171-11.834)), being older age (adjusted odds ratio: 3.394 (1.775-7.126)), working in inpatient unit (3.278 (1.804-5.231)), working in an emergency unit (adjusted odds ratio: 5.718 (4.326-6.398)), working in an operation room theater (adjusted odds ratio: 2.359 (1.781-4.430)), working as a medical laboratory technician (adjusted odds ratio: 1.070 (1.432-3.304)), working in pediatrics unit (adjusted odds ratio: 1.063 (1.431-2.843)), working as cleaners (adjusted odds ratio: 0.018 (0.002-0.195)), working <40 h per week (adjusted odds ratio: 0.036 (0.004-0.345)), and seldom needle recapping (adjusted odds ratio: 0.043 (0.015-0.125)) were statistically associated with needlestick and sharp injury. Conclusions In this study, there is a high magnitude of needlestick or sharp injuries among healthcare workers. Lack of training on work-related safety measures; working in delivery; being older age; working in the inpatient unit, emergency, operation room, and pediatrics units; being laboratory technicians, and cleaners; working hours per week; and seldom needle recapping were significant predictors of needlestick and sharp injury.
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Affiliation(s)
- Baye Tsegaye Amlak
- Department of Nursing, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Shegaw Tesfa
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia,Shegaw Tesfa, Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
| | - Betelhem Tesfamichael
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Haimanot Abebe
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Bitew Tefera Zewudie
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Agerie Aynalem Mewahegn
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Bogale Chekole Temere
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tamene Fetene Terefe
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Fisha Alebel GebreEyesus
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tadesse Tsehay
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Mamo Solomon
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
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Prevyzi E, Patrinos S, Intas G, Elefsiniotis I, Velonakis E, Grapsa E. Perceptions of Teamwork and Knowledge Attitudes of Hemodialysis Unit Nurses on Infection Prevention. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:555-565. [PMID: 37581829 DOI: 10.1007/978-3-031-31986-0_54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
INTRODUCTION The Nurses of Hemodialysis Units: it is necessary to face HAIs (hospital-acquired infections) as a "well-tuned" teamwork. The aim of this study was to investigate the perceptions of the teamwork as well as the knowledge attitudes of the nurses of hemodialysis units on infection prevention in Greece. METHODOLOGY A cross-sectional survey was conducted with a sample of 1018 HCWs (health care workers) of hemodialysis units in Greece. The questionnaires used were: Teamwork Perceptions Questionnaire (T-TPQ) TeamSTEPPS®-Instructor Manual, and questionnaire APPENDIX A. RESULTS The majority of them were nurses (69.45%) and nurse assistants (23.87%). About teamwork perceptions per factor, we observed uniformity in their responses with very high rates of agreement. The attitudes of nurses of hemodialysis units on the prevention of infections were distinguished in particularly high rates of compliance with a high perception of the risk of transmission of infections with better compliance being that of women. Also, women seem to be more knowledgeable about diseases that mostly affect the pediatric population. It seemed that level of knowledge between the two sexes did not differ regarding HBV (63.16% vs. 66.71%, p = 0.430), HCV (63.91% vs. 66.71%, p = 0.553), HIV infection (78.95% vs. 81.76%, p = 0.471), and influenza (55.64% vs. 59.61%, p = 0.394). CONCLUSIONS This study highlighted for the first time the high level of perceptions of teamwork of the HCWs of the hemodialysis units in Greece. It is recommended to investigate the correct application of prevention measures and to detect the causes of deviation from good practices with subsequent investigations on hemodialysis units of Greece.
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Affiliation(s)
- Evangelia Prevyzi
- Public Institute of Vocational Training «Τzaneio», General Hospital of Piraeus «Tzaneio», Piraeus, Greece
| | | | - Georgios Intas
- Department General Hospital of Nikaia "Agios Panteleimonas", Professor member of SEP, DMY 50, Hellenic Open University, Patra, Greece
- Metropolitan College, Athens, Greece
| | - Ioannis Elefsiniotis
- Nursing School of Athens, National and Kapodistrian University of Athens, Athens, Greece
- University Clinic - Hepato-Gastroenterology Laboratory, General Oncology Hospital "Agioi Anargyri", Kifissia, Greece
| | - Emmanouil Velonakis
- Nursing School of Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Grapsa
- Medical School of Athens, National Kapodistrian University of Athens, Athens, Greece
- Hemodialysis Unit, "Aretaeio" Regional General Hospital of Athens, Athens, Greece
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Wang Z, Yuan T, Fan S, Qian HZ, Li P, Zhan Y, Li H, Zou H. HIV Nonoccupational Postexposure Prophylaxis Among Men Who Have Sex with Men: A Systematic Review and Meta-Analysis of Global Data. AIDS Patient Care STDS 2020; 34:193-204. [PMID: 32396477 DOI: 10.1089/apc.2019.0313] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
HIV nonoccupational postexposure prophylaxis (nPEP) has been prescribed to men who have sex with men (MSM) for decades, but the global situation of nPEP implementation among this population remains unclear. To understand nPEP awareness, uptake, and factors associated with uptake among MSM, we searched PubMed, Scopus, Embase, the Cochrane Library, and Web of Science for studies reporting nPEP implementation among MSM published before May 19, 2019. We estimated pooled rates and their 95% confidence intervals (CIs) of awareness, uptake using a random-effects model. We identified 74 studies: 3 studies (4.1%) from upper-middle-income regions and 71 (95.9%) from high-income regions. The pooled rate of nPEP awareness and uptake was 51.6% (95% CI 40.6-62.5%) and 6.0% (5.0-7.1%), respectively. Pooled uptake rate was higher in upper-middle-income regions [8.9% (7.8-10.0%)] than in high-income regions [5.8% (4.8-6.9%)]. Unprotected anal sex was the most common exposure (range: 55.0-98.6%, median: 62.9%). Pooled completion of nPEP was 86.9% (79.5-92.8%). Of 19,546 MSM prescribed nPEP, 500 HIV seroconversions (2.6%) were observed. Having risky sexual behaviors and history of sexually transmitted infections were associated with higher nPEP uptake, whereas insufficient knowledge, underestimated risk of exposure to HIV, lack of accessibility, and social stigma might hinder nPEP uptake. Awareness and uptake of nPEP among MSM worldwide are low. Further efforts are needed to combat barriers to access nPEP, including improving accessibility and reducing stigma. Seroconversions post-nPEP uptake suggest that joint prevention precautions aside from nPEP are needed for high-risk MSM. More evidence from low-income and middle-income regions is needed.
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Affiliation(s)
- Zhenyu Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Tanwei Yuan
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Song Fan
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Han-zhu Qian
- School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Peiyang Li
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yuewei Zhan
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Hui Li
- Shizhong District Center for Disease Control and Prevention, Jinan, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
- Kirby Institute, University of New South Wales, Sydney, Australia
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Assen S, Wubshet M, Kifle M, Wubayehu T, Aregawi BG. Magnitude and associated factors of needle stick and sharps injuries among health care workers in Dessie City Hospitals, north east Ethiopia. BMC Nurs 2020; 19:31. [PMID: 32336947 PMCID: PMC7171769 DOI: 10.1186/s12912-020-00422-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/02/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Work-related exposures to needle stick and sharps accidents are essential reason of infections with blood borne pathogens amongst health care employees and can cause extensive fitness consequences and psychological stress. The aim of this study was to determine the magnitude of needle stick and sharps injuries and associated factors among health care workers in Dessie town hospitals. METHOD This institution-based cross-sectional study was conducted from March 21-April 21/2015, amongst health care people in Dessie city hospitals.Data have been collected by a structured and pre-tested questionnaire. The study included 438 health care employees who had been selected through the use of a simple random sampling technique. The gathered data have been checked, coded and entered to EPI-info version 3.5.1 and exported to SPSS model 20 for analysis. Bivariate and multivariate logistic regression analyses have been executed to identify elements related with the structured variable. RESULTS From 457 selected study participants, 438 (95.8%) responded to the questionnaire. The magnitude of needle stick and sharps injuries in the last 12 months was 124(28.3%), of which 92(74.2%) was reported by males and the rest 32(25.8%) by females. Being male [AOR: 4.25, 95%CI:(2.43,7.41)],had no safety instructions in the work area [AOR:2.27,95%CI: (1.29,3.97)],had no training on safety and health [AOR:4.92,95%CI:(2.75,8.79)],had ≤5 years work experience [AOR:9.0,95%CI:(4.88,16.60)],recapping of used needle [AOR: 2.63, 95%CI: (1.39, 4.99)] were the variables that significantly associated with needle stick and sharps injuries. CONCLUSION This study showed still a high magnitude of needle stick or sharps among healthcare workers. Therefore, training on work related safety and wellbeing, making safety instructions accessible and avoiding a recap of the needle after use are important to reduce the chance of such injuries among healthcare workers.
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Affiliation(s)
- Solomon Assen
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamo Wubshet
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Manay Kifle
- Departments of Public Health, College of Health Sciences, Aksum University, P. O. Box: 298, Aksum, Ethiopia
| | - Tewelde Wubayehu
- School of Medicine, Department of Pediatrics, Aksum University, Aksum, Ethiopia
| | - Berihu Gidey Aregawi
- Departments of Public Health, College of Health Sciences, Aksum University, P. O. Box: 298, Aksum, Ethiopia
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Riesgo biológico en Cardiología intervencionista. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Onadeko MO, Balogun MO, Onigbogi OO, Omokhodion FO. Occupational exposure, attitude to HIV-positive patients and uptake of HIV counselling and testing among health care workers in a tertiary hospital in Nigeria. SAHARA J 2018; 14:193-201. [PMID: 29132270 PMCID: PMC5700496 DOI: 10.1080/17290376.2017.1398104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Health care workers (HCWs) are at risk of occupational exposure to HIV. Their attitude to HIV-positive patients influences patients' willingness and ability to access quality care. HIV counselling and testing (HCT) services are available to inform HCWs and patients about their status. There is little information about HCT uptake and attitude to HIV-positive patients among HCWs in tertiary health facilities in Nigeria. The aim of this study was to determine occupational exposure and attitude to HIV-positive patients and level of uptake of HCT services among HCWs in a tertiary hospital in Nigeria. A cross-sectional design was utilized. A total of 977 HCWs were surveyed using semi-structured, self-administered questionnaires. Nurses and doctors comprised 78.2% of the respondents. Their mean age was 35 ± 8.4 years. Almost half, 47.0%, reported accidental exposure to blood and body fluids (BBFs) in the preceding year. The main predictor of accidental exposure to BBFs in the last year was working in a surgical department, OR = 1.7, 95% CI (1.1-2.6). HCWs aged <40 years, OR = 5.5, 95% CI (1.9-15.9), who had worked for >5 years, OR = 3.6, 95% CI (1.4-9.3) and who work in nursing department, OR = 6.8, 95% CI (1.7-27.1) were more likely to be exposed to BBFs. Almost half, 52.9%, had accessed HCT services. Predictors for HCT uptake were age <40 years OR = 1.6, 95% CI (1.1-2.4), having worked for >5 years OR = 1.5, 95% CI (1.03-2.2) and working in medical department OR = 1.7, 95% CI (1.1-2.8). Respondents in nursing departments were more likely to require routine HIV test for all patients, OR = 3.9, 95% CI (2.4-6.2). HCWs in the laboratory departments were more likely to believe that HIV patients should be on separate wards, OR = 3.6, 95% CI (1.9-7.0). HCWs should be protected and encouraged to access HCT services in order to be effective role models in the prevention of HIV/AIDS.
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Affiliation(s)
- Modupe O Onadeko
- a FWACP, MPH, MD, Professor of Community Medicine, Department of Community Medicine , University College Hospital Ibadan , Ibadan , Oyo State , Nigeria
| | - Mary O Balogun
- b MBBS, MPH, FWACP, DOccMed, Lecturer and Consultant Community Physician, Department of Community Medicine , University College Hospital Ibadan , Ibadan , Oyo State , Nigeria
| | - Olanrewaju O Onigbogi
- c MBBS, MPH, FMCPH, Lecturer and Consultant Community Physician, Department of Community Health and Primary Care, College of Medicine , University of Lagos , Lagos State , Nigeria
| | - Folashade O Omokhodion
- d MBBS, MSc, PhD, FWACP, FFOM, FFPH, Professor and Consultant Community Physician, Department of Community Medicine , University College Hospital Ibadan , Ibadan , Oyo State , Nigeria
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Lee JM, Botteman MF, Xanthakos N, Nicklasson L. Needlestick Injuries in the United States: Epidemiologic, Economic, and Quality of Life Issues. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/216507990505300311] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Lars Nicklasson
- Health Economics and Pricing, Novo Nordisk Inc., Princeton, New Jersey
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Seroconversion rate among health care workers exposed to HIV-contaminated body fluids: The University of Pittsburgh 13-year experience. Am J Infect Control 2017; 45:896-900. [PMID: 28449921 DOI: 10.1016/j.ajic.2017.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/16/2017] [Accepted: 03/16/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND The studies enumerating the risk of HIV transmission to health care workers (HCWs) as 0.3% after percutaneous exposure to HIV-positive blood, and 0.09% after a mucous membrane exposure, are weakened by dated literature. Our study aims to demonstrate the seroconversion rate after exposure to HIV-contaminated body fluids in a major academic center in the United States. METHODS A prospectively maintained database of reported occupational injuries occurring between 2002 and 2015 at an academic medical center was analyzed. Data collected included the type of injury, injured body part, type of fluid, contamination of sharps, involvement of resident physicians, use of postexposure prophylaxis, and patients' HIV, hepatitis B virus, and hepatitis C virus status. RESULTS A total of 266 cases were included in the study. Most exposures were caused by percutaneous injuries (52.6%), followed by 43.2% mucocutaneous injuries. Of the injuries, 52.6% were to the hand and 33.5% to the face and neck. Blood exposure accounted for 64.3% of all cases. Of the patients, 21.1% received postexposure prophylaxis. None of the HCWs exposed to HIV-contaminated body fluids seroconverted (seroconversion rate, 0%). CONCLUSIONS HIV does not seem to be as easily transmitted by needlestick, laceration, or splash injuries as previously surmised. Further large-scale and multicenter studies are needed for a more accurate estimation of the risk of transmission of HIV in U.S. health care workers.
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Abstract
HIV transmission in the health-care setting is of concern. To assess the current position in dentistry, we have reviewed the evidence to November 1, 2005. Transmission is evidently rare in the industrialized nations and can be significantly reduced or prevented by the use of standard infection control measures, appropriate clinical and instrument-handling procedures, and the use of safety equipment and safety needles. We hope that breaches in standard infection control will become vanishingly small. When occupational exposure to HIV is suspected, the application of post-exposure protocols for investigating the incident and protecting those involved from possible HIV infection further reduces the likelihood of HIV disease, and also stress and anxiety.
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Affiliation(s)
- C Scully
- Eastman Dental Institute, University College London, 256 Grays Inn Road, London WC1X 8LD, UK.
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Fukuda H, Yamanaka N. Reducing needlestick injuries through safety-engineered devices: results of a Japanese multi-centre study. J Hosp Infect 2015; 92:147-53. [PMID: 26601603 DOI: 10.1016/j.jhin.2015.09.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/28/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Quantitative information on the effectiveness of safety-engineered devices (SEDs) is needed to support decisions regarding their implementation. AIM To elucidate the effects of SED use in winged steel needles, intravenous (IV) catheter stylets and suture needles on needlestick injury (NSI) incidence rates in Japan. METHODS Japan EPINet survey data and device utilization data for conventional devices and SEDs were collected from 26 participating hospitals between 1 April 2009 and 31 March 2014. The NSI incidence rate for every 100,000 devices was calculated according to hospital, year and SED use for winged steel needles, IV catheter stylets and suture needles. Weighted means and 95% confidence intervals (CI) were used to calculate overall NSI incidence rates. FINDINGS In total, there were 236 NSIs for winged steel needles, 152 NSIs for IV catheter stylets and 180 NSIs for suture needles. The weighted NSI incidence rates per 100,000 devices for SEDs and non-SEDs were as follows: winged steel needles, 2.10 (95% CI 1.66-2.54) and 14.95 (95% CI 2.46-27.43), respectively; IV catheter stylets, 0.95 (95% CI 0.60-1.29) and 6.39 (95% CI 3.56-9.23), respectively; and suture needles, 1.47 (95% CI -1.14-4.09) and 16.50 (95% CI 4.15-28.86), respectively. All devices showed a significant reduction in the NSI incidence rate with SED use (P < 0.001 for winged steel needles, P = 0.035 for IV catheter stylets and P = 0.044 for suture needles). CONCLUSION SED use substantially reduces the incidence of NSIs, and is therefore recommended as a means to prevent occupational infections in healthcare workers and improve healthcare safety.
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Affiliation(s)
- H Fukuda
- Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-Ku, Fukuoka, Japan.
| | - N Yamanaka
- Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-Ku, Fukuoka, Japan; Kitakyushu General Hospital, Kitakyushu, Fukuoka, Japan
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The role of the dental profession in addressing the human immunodeficiency virus epidemic. J Am Dent Assoc 2015; 144:1104-8. [PMID: 24080926 DOI: 10.14219/jada.archive.2013.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Smartphone applications with sensors used in a tertiary hospital-current status and future challenges. SENSORS 2015; 15:9854-69. [PMID: 25923933 PMCID: PMC4481990 DOI: 10.3390/s150509854] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/13/2015] [Accepted: 04/22/2015] [Indexed: 11/16/2022]
Abstract
Smartphones have been widely used recently to monitor heart rate and activity, since they have the necessary processing power, non-invasive and cost-effective sensors, and wireless communication capabilities. Consequently, healthcare applications (apps) using smartphone-based sensors have been highlighted for non-invasive physiological monitoring. In addition, several healthcare apps have received FDA clearance. However, in spite of their potential, healthcare apps with smartphone-based sensors are mostly used outside of hospitals and have not been widely adopted for patient care in hospitals until recently. In this paper, we describe the experience of using smartphone apps with sensors in a large medical center in Korea. Among >20 apps developed in our medical center, four were extensively analyzed ("My Cancer Diary", "Point-of-Care HIV Check", "Blood Culture" and "mAMIS"), since they use smartphone-based sensors such as the camera and barcode reader to enter data into the electronic health record system. By analyzing the usage patterns of these apps for data entry with sensors, the current limitations of smartphone-based sensors in a clinical setting, hurdles against adoption in the medical center, benefits of smartphone-based sensors and potential future research directions could be evaluated.
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Thomas AN, Horner D, Taylor RJ. An analysis of patient safety incident reports describing injuries to staff working in critical care in the North West of England between 2009 and 2013. J Intensive Care Soc 2015; 16:208-214. [PMID: 28979412 DOI: 10.1177/1751143715574510] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Critical care environments are potentially high-risk areas for staff harm due to procedural demand and increased incidence of delirium/dependence. The principal types of harm and temporal trends have not yet been quantified. METHODS Retrospective analysis of a multicentre dataset prospectively collected over a five-year period. All patient safety incidents reported to a regional network project were analysed; those recorded as staff harm were extracted, quantified and assessed by thematic analysis to identify key areas of harm, temporal trends and incident rates. RESULTS Staff harm accounted for 7% of all reported patient safety incidents over the study period. Incident rates remained static, ranging annually from 2.6 to 3.7 episodes/1000 patient days. Assaults on staff accounted for the highest proportional contribution on thematic analysis, which was a consistent annual finding. Sharps injuries and manual handling incidents were also notable contributions. Temporal trends for each theme remained static over the study period implying limited reduction in staff harm despite implementation of national guidance and local initiatives. CONCLUSION Staff harm is a consistent issue for those working in critical care. Assaults on staff appear to be the highest contributor on thematic analysis. These data imply significant reduction in harm can still be achieved and can be used to design and implement interventional measures.
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Affiliation(s)
- Antony N Thomas
- Critical Care Department, Salford Royal Hospitals NHS Foundation Trust, Salford, UK
| | - Daniel Horner
- Critical Care Department, Salford Royal Hospitals NHS Foundation Trust, Salford, UK.,North West Deanery, UK
| | - Robert J Taylor
- Department of Medical Physics, Salford Royal Hospitals NHS Foundation Trust, Salford, UK
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Notes From the Field: Occupationally Acquired HIV Infection Among Health Care Workers-United States, 1985-2013. Am J Transplant 2015. [DOI: 10.1111/ajt.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gańczak M, Barss P. Fear of HIV Infection and Impact of Training on the Attitudes of Surgical and Emergency Nurses Toward Inpatient HIV Testing. Infect Control Hosp Epidemiol 2015; 28:230-3. [PMID: 17265411 DOI: 10.1086/510804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2006] [Accepted: 05/08/2006] [Indexed: 11/04/2022]
Abstract
This study evaluates the association between the degree of fear of human immunodeficiency virus (HIV) infection and support for different HIV testing policies. A strong fear of acquiring HIV infection at work was widespread among a sample of 601 Polish surgical and emergency nurses. Most favored inappropriate HIV testing of all surgical patients and inpatients. Previous training about HIV and acquired immunodeficiency syndrome (AIDS) and experience caring for HIV-positive patients had a significant impact on reducing support for testing of all inpatients but not for testing of surgical patients.
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Affiliation(s)
- Maria Gańczak
- Department of Hygiene, Epidemiology and Public Health, Faculty of Health Sciences, Pomeranian Medical University, Szczecin, Poland
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Henderson DK. How're We Doin'? Preventing Occupational Infections With Blood-Borne Pathogens in Healthcare. Infect Control Hosp Epidemiol 2015; 25:532-5. [PMID: 15301023 DOI: 10.1086/502435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Panlilio AL, Orelien JG, Srivastava PU, Jagger J, Cohn RD, Cardo DM. Estimate of the Annual Number of Percutaneous Injuries Among Hospital-Based Healthcare Workers in the United States, 1997–1998. Infect Control Hosp Epidemiol 2015; 25:556-62. [PMID: 15301027 DOI: 10.1086/502439] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractObjective:To construct a single estimate of the number of percutaneous injuries sustained annually by healthcare workers (HCWs) in the United States.Design:Statistical analysis.Methods:We combined data collected in 1997 and 1998 at 15 National Surveillance System for Health Care Workers (NaSH) hospitals and 45 Exposure Prevention Information Network (EPINet) hospitals. The combined data, taken as a sample of all U.S. hospitals, were adjusted for underreporting. The estimate of the number of percutaneous injuries nationwide was obtained by weighting the number of percutaneous injuries at each hospital by the number of admissions in all U.S. hospitals relative to the number of admissions at that hospital.Results:The estimated number of percutaneous injuries sustained annually by hospital-based HCWs was 384,325 (95% confidence interval, 311,091 to 463,922). The number of percutaneous injuries sustained by HCWs outside of the hospital setting was not estimated.Conclusions:Although our estimate is smaller than some previously published estimates of percutaneous injuries among HCWs, its magnitude remains a concern and emphasizes the urgent need to implement prevention strategies. In addition, improved surveillance could be used to monitor injury trends in all healthcare settings and evaluate the impact of prevention interventions.
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Affiliation(s)
- Adelisa L Panlilio
- Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Utkarsha Lokesh, Srinidhi D, Sudhakara Reddy K. Post exposure prophylaxis to occupational injuries for general dentist. J Indian Prosthodont Soc 2014; 14:1-3. [PMID: 26199484 PMCID: PMC4501978 DOI: 10.1007/s13191-012-0176-z] [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: 07/25/2012] [Accepted: 09/21/2012] [Indexed: 11/30/2022] Open
Abstract
Occupational injuries which expose health-care professionals to blood-borne pathogens continue to be an important public health concern. Especially, dentists are at increased risk of exposure to Hepatitis B, Hepatitis C, and HIV. Dentists should remember and apply many precautions to prevent the broad spectrum of sharps and splash injuries that could occur during the delivery of dental care. This article updates and consolidates recommendations for the management of dental health-care personnel who have occupational exposure to blood and other body fluids.
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Affiliation(s)
- Utkarsha Lokesh
- />Department of Oral Maxillofacial Surgery, Sri Rajivgandhi College of Dental Sciences, Cholanagar, Hebbal post, Bangalore, India
| | - D. Srinidhi
- />Department of Oral Maxillofacial Surgery, Rajarajeshwari Dental College, Bangalore, India
| | - K. Sudhakara Reddy
- />Department of Oral Maxillofacial Surgery, Sri Rajivgandhi College of Dental Sciences, Bangalore, India
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Beekmann SE, Henderson DK. Prevention of human immunodeficiency virus and AIDS: postexposure prophylaxis (including health care workers). Infect Dis Clin North Am 2014; 28:601-13. [PMID: 25287589 DOI: 10.1016/j.idc.2014.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Postexposure prophylaxis (PEP), which is designed to prevent human immunodeficiency virus (HIV) infection after an exposure, is one of several strategies for HIV prevention. PEP was first used after occupational HIV exposures in the late 1980s, with the Centers for Disease Control and Prevention issuing the first set of guidelines that included considerations regarding the use of antiretroviral agents for PEP after occupational HIV exposures in 1990. Use of PEP has been extended to nonoccupational exposures, including after sexual contact or injection-drug use. This article provides a rationale for PEP, assessment of the need for PEP, and details of its implementation.
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Affiliation(s)
- Susan E Beekmann
- Department of Internal Medicine, The University of Iowa College of Medicine, Infectious Diseases SW34-J GH, Iowa City, IA 52242, USA
| | - David K Henderson
- Clinical Center, National Institutes of Health, Bethesda, Building 10-CRC, Rm 6-2551, MD 20892, USA.
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Percutaneous Injuries and Transmission of HIV Among Cases Referred for Post Exposure Prophylaxis to Razi Hospital in Ahvaz, a City in the Southwest Iran. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.8266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Donnelly AF, Chang YHH, Nemeth-Ochoa SA. Sharps Injuries and Reporting Practices of U.S. Dermatologists. Dermatol Surg 2013; 39:1813-21. [DOI: 10.1111/dsu.12352] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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The role of the dental profession in addressing the human immunodeficiency virus epidemic. 1986. J Am Dent Assoc 2013; 144 Spec No:52S-56S. [PMID: 24141821 DOI: 10.14219/jada.archive.2013.0250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Pimenta FR, Ferreira MD, Gir E, Hayashida M, Canini SRMDS. [Care and specialized clinical follow-up of nursing professionals who have been victims of accidents with biological material]. Rev Esc Enferm USP 2013; 47:198-204. [PMID: 23515821 DOI: 10.1590/s0080-62342013000100025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 07/25/2012] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional study aimed to evaluate the conduct of nursing professionals who had been victims of accidents with biological material in a teaching hospital in the interior of the state of São Paulo, Brazil, regarding their care and specialized clinical follow-up. The study population consisted of 1,215 nursing professionals, who were interviewed individually between 2010 and 2011. Of the 1,215 nursing professionals interviewed, 636 (52.3%) reported having experienced accidents with biological material; of this population, 182 (28.6%) didn't sought specialized care. The most frequent reason reported for not seeking care was believing that it was a low-risk accident. The reasons professionals do not seek care and do not complete treatment and the clinical follow-up can contribute to strategies to increase professionals' adherence to prophylaxis measures after occupational exposure to biological material.
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Smilowitz NR, Balter S, Weisz G. Occupational hazards of interventional cardiology. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2013; 14:223-8. [DOI: 10.1016/j.carrev.2013.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 05/01/2013] [Accepted: 05/03/2013] [Indexed: 10/26/2022]
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Krueger A, Frink M, Kiessling A, Ruchholtz S, Kühne C. [Emergency room management : in the era of the White Paper, S3 guidelines, Advanced Trauma Life Support® and TraumaNetwork DGU® of the German Society of Trauma Surgery]. Chirurg 2013; 84:437-50. [PMID: 23553150 PMCID: PMC7096044 DOI: 10.1007/s00104-012-2384-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The treatment of the severely injured is, just as the injury severity and combinations, often highly complex and leaves little leeway for delay, dissent or even error. In order to reduce this to a minimum, trained emergency room teams in addition to optimal technical and structural prerequisites are necessary. This must function in an interdisciplinary fashion according to fixed consensus algorithms which are known to all team members and have been agreed by all participants. The White Paper on treatment of the severely injured of the German Society of Trauma Surgery (DGU) and the recently published S3 guidelines offer evidence-based recommendations on the structural, technical, organizational and personnel prerequisites.
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Affiliation(s)
- A. Krueger
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinika Gießen und Marburg GmbH, Standort Marburg, 35043 Marburg, Deutschland
| | - M. Frink
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinika Gießen und Marburg GmbH, Standort Marburg, 35043 Marburg, Deutschland
| | - A. Kiessling
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinika Gießen und Marburg GmbH, Standort Marburg, 35043 Marburg, Deutschland
| | - S. Ruchholtz
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinika Gießen und Marburg GmbH, Standort Marburg, 35043 Marburg, Deutschland
| | - C.A. Kühne
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinika Gießen und Marburg GmbH, Standort Marburg, 35043 Marburg, Deutschland
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Jason J. Community-acquired, non-occupational needlestick injuries treated in US Emergency Departments. J Public Health (Oxf) 2013; 35:422-30. [PMID: 23554512 DOI: 10.1093/pubmed/fdt033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The escalating number of persons self-injecting medications, predominantly insulin, has generated concerns that the public is at risk of acquiring blood-borne infections from discarded needles/syringes. Communities have developed disposal guidelines but a debate continues over the need for further legislation and/or at-home safety devices. This study examines the number, characteristics, treatment and costs of community-acquired needlestick injuries (CANSIs). METHODS US-representative CANSI rates and characteristics were derived from 2001-08 National Electronic Injury Surveillance System All Injury Program data on product-related injuries treated at US emergency departments (EDs). CANSI-related medical care was examined using 2003-09 National Hospital Ambulatory Medical Care Surveys, representing all US ED visits. Cost analyses used 2010 Current Procedural Terminology Coding and Medicare rates. RESULTS In 2001-08, an estimated 16 677 CANSIs were treated in US EDs, with an associated annual rate of 0.7 per 100 000 US citizens (95% CI 0.6-0.8) and no observable temporal trend. The estimated maximum annual medical cost of ED-treated CANSIs was $9.8 million, or $0.03 per citizen, $1.66 per insulin-injecting person and $0.0018 per insulin injection. CONCLUSIONS US ED-treated CANSI rates are extremely low. Stricter disposal programs and the at-home use of safety devices do not appear to be needed at this time.
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Affiliation(s)
- J Jason
- Jason and Jarvis Associates, LLC, Hilton Head Island, SC 29928, USA.
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Development of a postexposure biologic treatment algorithm on a medical center campus. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 19:366-70. [PMID: 23446879 DOI: 10.1097/phh.0b013e3182703e06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the development of an easily accessible online biologic exposure algorithm to guide postexposure medical evaluation and treatment of medical research personnel and health care workers in a Midwest medical center campus. METHODS We describe the steps involved in the creation of a biologic exposure algorithm from design through implementation. RESULTS One point of contact allows phone evaluation and immediate triage, providing effective and timely medical care for exposed employees as well as important guidance for clinicians. The algorithm and exposure response system achieved the goal of integrating clinical and research laboratory exposure response. CONCLUSIONS Development of an integrated clinical and research exposure protocol may be an efficient way to maximize biosafety for workers.
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Cheng HC, Su CY, Huang CF, Chuang CY. Changes in Compliance with Recommended Infection Control Practices and Affecting Factors Among Dentists in Taiwan. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2012.76.12.tb05432.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Hsin-Chung Cheng
- School of Dentistry, College of Oral Medicine; Taipei Medical University; Department of Dentistry; Taipei Medical University Hospital; Taipei Taiwan
| | - Chen-Yi Su
- Graduate Institute of Life Sciences; National Defense Medical Center; Taipei Taiwan
| | - Chiung-Fang Huang
- Department of Dentistry; Taipei Medical University Hospital, and School of Dental Technology; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Chi-Yu Chuang
- Department of Bio-Industrial Mechatronics Engineering; National Taiwan University; Taipei Taiwan
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Zarra T, Lambrianidis T. Percutaneous injuries amongst Greek endodontists: a national questionnaire survey. Int Endod J 2012; 46:264-74. [DOI: 10.1111/j.1365-2591.2012.02126.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 08/03/2012] [Indexed: 11/28/2022]
Affiliation(s)
- T. Zarra
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - T. Lambrianidis
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki; Greece
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Gaballah K, Warbuton D, Sihmbly K, Renton T. Needle stick injuries among dental students: risk factors and recommendations for prevention. Libyan J Med 2012; 7:LJM-7-17507. [PMID: 22741025 PMCID: PMC3384083 DOI: 10.3402/ljm.v7i0.17507] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 05/05/2012] [Indexed: 11/28/2022] Open
Abstract
Aim To evaluate the risk factors of needle stick injuries (NSIs) sustained by undergraduate dental students and nurse students at the King's College London (KCL) Dental Institute. Materials and methods A retrospective study evaluated the incident reports relating to NSIs reported over a period of 2 years. Factors including the dental department, study year, and when the injury took place during administration of local anaesthesia (LA) and recapping conventional syringe or clearing work surface or during disposal. Results This report showed that students are at the highest risk of NSIs at the fourth year of their 5-year BDS course. About one-third of injuries were reported among this group of students followed by year 5 students (25%). Oral surgery clinics were the major source of incident reporting when compared with other specialised dental clinics within the institute. The left hands of the students were the most frequently affected by such injuries and then the right hands of student dental nurses. The attempt of needle recapping of conventional syringes was the least reported mechanism of injuries and constituted only 15% of the total injuries and mainly occurred in third year students. The most frequent injuries among student nurses were during disposal of the needle. Conclusion Less NSIs occur when using safety syringes. A non-recapping policy with immediate disposal of either the conventional or safety syringe systems after injection would prevent all clearance-related NSIs sustained by nurses. To avoid NSIs, education plays a vital role particularly with effective implementation of the change to safety syringes with appropriate training.
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Affiliation(s)
- Kamis Gaballah
- Department of Oral Surgery, King's College London Dental Institute, London, UK
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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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Korniewicz D, El-Masri M. Exploring the Benefits of Double Gloving During Surgery. AORN J 2012; 95:328-36. [DOI: 10.1016/j.aorn.2011.04.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 03/19/2011] [Accepted: 04/15/2011] [Indexed: 11/16/2022]
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Sharps exposures among otolaryngology-head and neck surgery residents. Laryngoscope 2012; 122:578-82. [DOI: 10.1002/lary.22469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 10/26/2011] [Accepted: 10/27/2011] [Indexed: 02/04/2023]
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HIV and hepatitis in an urban penetrating trauma population: unrecognized and untreated. ACTA ACUST UNITED AC 2011; 71:306-10; discussion 311. [PMID: 21825931 DOI: 10.1097/ta.0b013e31822178bd] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite limited prospective data, it is commonly believed that human immunodeficiency virus (HIV) and hepatitis infections are widespread in the penetrating trauma population, placing healthcare workers at risk for occupational exposure. Our primary study objective was to measure the prevalence of HIV (anti-HIV), hepatitis B (HB surface antigen [HBsAg]), and hepatitis C virus (anti-HCV) in our penetrating trauma population. METHODS We prospectively analyzed penetrating trauma patients admitted to Temple University Hospital between August 2008 and February 2010. Patients (n = 341) were tested with an oral swab for anti-HIV and serum evaluated for HBsAg and anti-HCV. Positives were confirmed with western blot, neutralization immunoassay, and reverse transcription polymerase chain reaction, respectively. Demographics, risk factors, and clinical characteristics were analyzed. RESULTS Of 341 patients, 4 patients (1.2%) tested positive for anti-HIV and 2 had a positive HBsAg (0.6%). Hepatitis C was the most prevalent measured infection as anti-HCV was detected in 26 (7.6%) patients. Overall, 32 (9.4%) patients were tested positive for anti-HIV, HBsAg, or anti-HCV. Twenty-eight (75%) of these patients who tested positive were undiagnosed before study enrollment. When potential risk factors were analyzed, age (odds ratio, 1.07, p = 0.031) and intravenous drug use (odds ratio 14.4, p < 0.001) independently increased the likelihood of anti-HIV, HBsAg, or anti-HCV-positive markers. CONCLUSIONS Greater than 9% of our penetrating trauma study population tested positive for anti-HIV, HBsAg, or anti-HCV although patients were infrequently aware of their seropositive status. As penetrating trauma victims frequently require expedient, invasive procedures, universal precautions are essential. The prevalence of undiagnosed HIV and hepatitis in penetrating trauma victims provides an important opportunity for education, screening, and earlier treatment of this high-risk population.
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Blundell L, Cains T, Ressler KA, Ferson MJ. Compliance with sharps waste standards by a sample of Sydney acupuncture premises. NEW SOUTH WALES PUBLIC HEALTH BULLETIN 2011; 22:149-153. [PMID: 21982259 DOI: 10.1071/nb10073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To examine current practices with regard to the safe collection, storage and disposal of sharps waste in acupuncture premises and to determine compliance with the NSW Public Health (Skin Penetration) Regulation 2000 and the NSW Health Skin Penetration Code of Best Practice. METHODS A random sample of acupuncturists in the City of Sydney local government area was selected and surveyed using a structured questionnaire. RESULTS All 26 acupuncturists surveyed had sharps disposal bins and complied with the Regulation, but the following elements of the Code were not uniformly followed: regular disposal of sharps (77%), disposal through a waste contractor (23%) and placement of bins out of reach of visitors (8%). CONCLUSION Regular disposal of sharps containers in acupuncture premises could be improved.
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Affiliation(s)
- Louise Blundell
- Aboriginal Environmental Health Officer Training Program, NSW Department of Health
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Flint SR, Croser D, Reznik D, Glick M, Naidoo S, Coogan M. HIV transmission in the dental setting and the HIV-infected oral health care professional: workshop 1C. Adv Dent Res 2011; 23:106-11. [PMID: 21441490 DOI: 10.1177/0022034511400075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This workshop addressed two important issues: first, the global evidence of HIV transmission from health care provider to patient and from patient to health care provider in the general health care environment and the dental practice setting; second, in the era of highly active antiretroviral therapy, whether oral health care professionals living with HIV pose a risk of transmission to their patients and whether standard infection control is adequate to protect both the patient and the oral health care professional in dental practice. The workshop culminated in a general discussion and the formulation of a consensus statement from the participating delegates, representing more than 30 countries, on the criteria under which an HIV-infected oral health care professional might practice dentistry without putting patients at risk. This consensus statement, the Beijing Declaration, was agreed nem con.
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Affiliation(s)
- S R Flint
- Dublin Dental School and Hospital and Trinity College, Dublin, Ireland.
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Sydnor ERM, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clin Microbiol Rev 2011; 24:141-73. [PMID: 21233510 PMCID: PMC3021207 DOI: 10.1128/cmr.00027-10] [Citation(s) in RCA: 340] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program.
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Affiliation(s)
- Emily R. M. Sydnor
- Department of Medicine, Division of Infectious Diseases, Department of Hospital Epidemiology and Infection Control, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Trish M. Perl
- Department of Medicine, Division of Infectious Diseases, Department of Hospital Epidemiology and Infection Control, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Leiss JK. Provision and use of safety-engineered medical devices among home care and hospice nurses in North Carolina. Am J Infect Control 2010; 38:636-9. [PMID: 20416972 DOI: 10.1016/j.ajic.2010.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 01/25/2010] [Accepted: 01/26/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nurses who provide care in the home are at risk of blood exposure from needlesticks. Using safety-engineered medical devices reduces the risk of needlestick. The objectives of this study were to assess provision of safety devices by home care and hospice agencies as well as the use of these devices by home care and hospice nurses in North Carolina, and to examine the association between provision and use. METHODS A mail survey was conducted among North Carolina home care and hospice nurses in 2006. RESULTS The adjusted response rate was 69% (n = 833). The percentage of nurses who were always provided with safety devices ranged from 51% (blood tube holders) to 83% (winged steel needles). Ninety-five percent of nurses who were always provided with safety devices, but only 15%-50% of nurses who were not always provided with safety devices, used a safety device the last time they used that general type of device. Among nurses who did not use a safety device on that occasion, 60%-80% did not use it because it was not provided by the agency. CONCLUSION This study suggests that limited access is the primary reason for home care/hospice nurses' failure to use safety devices. The policy goal of providing safety devices to health care workers in all situations in which such devices could reduce their risk of needlestick is not being achieved for home care nurses in North Carolina.
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Affiliation(s)
- Jack K Leiss
- Epidemiology Research Program, Cedar Grove Institute for Sustainable Communities, Mebane, NC 27302, USA.
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Knowledge, attitudes and behaviour of students from a medicine faculty, dentistry faculty, and medical technology Vocational Training School toward HIV/AIDS. Int J Occup Med Environ Health 2010; 23:153-60. [PMID: 20630832 DOI: 10.2478/v10001-010-0008-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES With increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients should have sufficient knowledge of the disease, and their attitude and behaviour should be proper. In our study, we aimed to examine the level of knowledge about HIV/AIDS among students from a medicine faculty, dentistry faculty, and medical technology vocational training school, to investigate attitudes and behaviour, and differences between first- and last-year students (if any) and to determine students' perception of the importance of this disease for our country and our world. MATERIAL AND METHODS This descriptive study comprised first-year and last-year students of Akdeniz University Faculty of Medicine, Akdeniz University Medical Technology Vocational Training School (MTVTS), and Süleyman Demirel University Faculty of Dentistry. A questionnaire was administered to a total of 357 students. RESULTS Lack of the relevant education is obvious among all three occupational groups in our study. CONCLUSIONS The importance of HIV/AIDS as a public health problem all over the world should be emphasized more, and awareness of all humanity should be augmented.
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Mohebati A, Davis JM, Fry DE. Current risks of occupational blood-borne viral infection. Surg Infect (Larchmt) 2010; 11:325-31. [PMID: 20528133 DOI: 10.1089/sur.2010.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and other viruses remain occupational risks for both surgeons and patients in the operating room environment. In the past, this concern attracted great attention, but recently, this subject has been given much less attention. METHODS Review of the literature over the past 50 years on occupational risks of viral infection in the operating room. RESULTS Transmission of HIV still looms as a potential pathogen in the operating room, but no case has been documented in the United States. Infection with HBV can be prevented by a safe and effective vaccine. Chronic HCV infection is present in more than three million U.S. residents and remains a risk that can be managed only by adhering to strict infection control practices and avoiding blood exposure. CONCLUSIONS The risks of viral infection in the operating room remain the same as a decade ago even though attention to this issue has waned. The avoidance of blood exposure to prevent transmission of both known and unknown blood-borne pathogens continues to be a goal for all surgeons.
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Affiliation(s)
- Arash Mohebati
- Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
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Abstract
OBJECTIVE To summarize current concepts on preventing occupationally acquired infections in healthcare workers. DESIGN Review of the pertinent medical literature. SETTINGS Focus on healthcare workers practicing in acute care hospitals, especially intensive care units. SUBJECTS Healthcare workers. MEASUREMENTS AND MAIN RESULTS Key components of an effective infection control program include the following: 1) pre-exposure immunization with vaccines to prevent mumps, measles, rubella, varicella, pertussis, hepatitis B, and viral influenza; 2) adherence to standard precautions when providing patient care, especially the performance of hand hygiene before and after patient care; 3) rapid evaluation and initiation of appropriate isolation precautions for patients with potentially communicable diseases; 4) proper use of personal protective equipment such as masks, N95 respirators, eye protection, and gowns when caring for patients with potentially communicable diseases; and 5) evaluation of personnel with exposure to communicable diseases for receipt of postexposure prophylaxis. CONCLUSIONS Risks of acquisition of infectious diseases by healthcare workers can be minimized by adherence to current infection control guidelines.
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Compliance with occupational post-exposure protocol for injuries among dental surgeons. Rev Saude Publica 2010; 44:528-40. [PMID: 20499014 DOI: 10.1590/s0034-89102010005000018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 12/13/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the compliance with occupational post-exposure protocol for accidents and factors associated with compliance among dental surgeons. METHODS A cross-sectional study was performed in the municipality of Montes Claros, Southeastern Brazil, from 2007 to 2008, with accident reports from needles and sharp instruments among practicing dental surgeons. Variables describing the dentists' characteristics, work conditions, clients, injuries from needles and sharp instruments and post-accident actions were evaluated by means of a previously tested, structured questionnaire. The data underwent descriptive analysis and chi-square testing (p<0.05). RESULTS A total of 241 dentists (89.2%) answered the questionnaire. Compliance with occupational post-exposure protocol was reported by 51.5%. The majority of the professionals reported seeing blood at the time of the accident. Burs were the instrument most often involved in accidents, and the finger was the most injured body part. Compliance with a post-exposure protocol was more prevalent among those with greater monthly income (OR=2.42; 95% CI=1.03;5.71), continuing education in the last two years (OR=2.16; 95% CI=1.09;4.27) and who took regular breaks every four hours (OR=1.23; 95% CI=1.23;4.92). Dental surgeons who attended to children (OR=0.50; 95%CI=0.27;0.93) and to individuals from the middle, middle-high and high socioeconomic classes (OR=0.54, 95% CI=0.31;0.95) showed less compliance with the occupational post-exposure protocol. The frequency of compliance to a post-exposure protocol was significantly greater among individuals who followed the actions described in post-exposure protocols. CONCLUSIONS There is low compliance with occupational post-exposure protocols among dentists, which is influenced by the knowledge and monthly income of professionals, by taking regular breaks, by age group and the socioeconomic class of the clientele.
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Henderson DK, Dembry L, Fishman NO, Grady C, Lundstrom T, Palmore TN, Sepkowitz KA, Weber DJ. SHEA guideline for management of healthcare workers who are infected with hepatitis B virus, hepatitis C virus, and/or human immunodeficiency virus. Infect Control Hosp Epidemiol 2010; 31:203-32. [PMID: 20088696 DOI: 10.1086/650298] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This guideline provides the updated recommendations of the Society for Healthcare Epidemiology of America (SHEA) regarding the management of healthcare providers who are infected with hepatitis B virus (HBV), hepatitis C virus (HCV), and/or the human immunodeficiency virus (HIV). For the reasons cited in the guideline, SHEA continues to recommend that, although some aspects of the approach to and administrative management of each of these infectious syndromes in healthcare providers are similar, separate management strategies for healthcare workers who are infected with these unrelated viruses remain appropriate. As we did in both prior iterations of this document, SHEA emphasizes the use of appropriate infection control procedures to minimize exposure of patients or providers to blood, emphasizes that transfers of blood from patients to providers and from providers to patients should be avoided, and recommends that infected healthcare providers should not be totally prohibited from participating in patient-care activities solely on the basis of a bloodborne pathogen infection. The types of procedures assessed by the panel as associated with an increased risk for provider-to-patient transmission of these pathogens are discussed in detail. For each pathogen, recommendations are graduated according to the relative viral load level of the infected provider (Tables 1 and 2). However, SHEA emphasizes that, because of the complexity of these cases, each such case will be slightly different from the next, and each should be independently considered in context.
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Affiliation(s)
- David K Henderson
- National Institutes of Health Clinical Center, Bethesda, Maryland 20892-1504, USA.
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Wald J. The psychological consequences of occupational blood and body fluid exposure injuries. Disabil Rehabil 2010; 31:1963-9. [PMID: 19479544 DOI: 10.1080/09638280902874147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This article describes the psychological impact of occupational blood and body fluid (BBF) exposure injuries and provides suggestions for improving clinical practice. METHOD A literature review was conducted to search for articles relating to the psychological consequences and management of these work injuries. RESULTS Acute psychological symptoms including posttraumatic stress, anxiety and depression are frequently experienced postexposure, which appear to be the major contributing factors of time loss from work. Furthermore, a subgroup is at risk for chronic symptoms and disability that persists beyond notification that no disease transmission occurred. Distressed workers often go unrecognised and untreated, and their assistance needs are largely unknown. Accordingly, this article draws upon the posttraumatic stress literature to offer suggestions for advancing the postexposure management of these injuries. CONCLUSIONS This clinical commentary underscores the serious yet understudied secondary psychological effects of occupational BBF exposure injuries. Postexposure management programmes need to place greater emphasis on psychosocial and educational initiatives to improve the identification and treatment of symptomatic workers.
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Affiliation(s)
- Jaye Wald
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, British Columbia, Canada.
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Safety Precautions. MANUAL OF SURGICAL PATHOLOGY 2010. [PMCID: PMC7151921 DOI: 10.1016/b978-0-323-06516-0.10008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Ferguson JK. Preventing healthcare-associated infection: risks, healthcare systems and behaviour. Intern Med J 2009; 39:574-81. [PMID: 19769680 PMCID: PMC7165553 DOI: 10.1111/j.1445-5994.2009.02004.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 05/19/2009] [Indexed: 12/11/2022]
Abstract
More than 177 000 potentially preventable healthcare-associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other healthcare staff are often poor. These lapses in practice create significant risk for patients and staff from HAI. Excessive patient exposure to antimicrobials is another key factor in the emergence of antibiotic-resistant bacteria and Clostridium difficile infection. Physicians must ensure that their interactions with patients are safe from the infection prevention standpoint. The critical preventative practice is hand hygiene in accord with the World Health Organization 5 moments model. Improving the use of antimicrobials, asepsis and immunization also has great importance. Hospitals should measure and feed back HAI rates to clinical teams. Physicians as leaders, role models and educators play an important part in promoting adherence to safe practices by other staff and students. They are also potentially effective system engineers who can embed safer practices in all elements of patient care and promote essential structural and organizational change. Patients and the public in general are becoming increasingly aware of the risk of infection when entering a hospital and expect their carers to adhere to safe practice. Poor infection control practice will be regarded in a negative light by patients and their families, regardless of any other manifest skills of the practitioner.
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Affiliation(s)
- J K Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
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Evaluation of institutional practices for prevention of phlebotomy-associated percutaneous injuries in hospital settings. Am J Infect Control 2009; 37:490-4. [PMID: 19188001 DOI: 10.1016/j.ajic.2008.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 06/23/2008] [Accepted: 06/27/2008] [Indexed: 11/23/2022]
Abstract
BACKGROUND To reduce the incidence of phlebotomy-related percutaneous injuries (PIs), factors that contribute to these injuries must be identified. This study examined institutional phlebotomy practices, policies, perceptions, and culture to identify facilitators and barriers that appear to have the greatest impact in preventing injuries. METHODS During site visits at study hospitals, observational data were collected during the performance of phlebotomy. In addition, interviews and focus groups were conducted with hospital personnel involved in phlebotomy procedures. RESULTS Nine hospitals participated in the study. A total of 126 phlebotomy procedures were observed. Health care personnel chose devices with safety features for the majority of observed procedures (n = 122, 97%). Recommended phlebotomy practices for handling needles after use were observed in 42% to 92% of procedures. Adherence varied by type of device, occupation, and facility PI rate. In the 23 interviews and 9 focus groups, participants identified factors that facilitated PI prevention such as the availability and use of devices with safety mechanisms, adherence to recommended safe needle-handling practices, and institutional phlebotomy training. CONCLUSION The quantitative and qualitative data indicate that a wide array of factors can affect phlebotomy-related practices and perceptions. Prevention of PIs may require comprehensive, multifaceted intervention efforts to improve the safety culture and reduce PIs and exposure to bloodborne pathogens in health care facilities.
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