Occupational exposure to blood and body fluids and associated factors among health care workers at the University of Gondar Hospital, Northwest Ethiopia

Association of hospital safety climate and compliance with occupational safety practices among nurse interns: A cross-sectional study using canonical correlation analysis

Background and Aims

Nurse interns may be at a similar or higher risk than registered nurses. The key elements and mechanisms involved in the effects of safety climate on safety performance are not well understood. This study explores the relationship between the perceived hospital safety climate and compliance with occupational safety practices among nurse interns.

Methods

A cross-sectional study was conducted among 178 nurse interns in three tertiary university hospitals in Chongqing city, China. The Chinese version of the Hospital Safety Climate Scale (HSCS) was used to measure the perceived hospital safety climate of nurse interns. Compliance behavior was measured using the Compliance with Occupational Safety Practice Scale (COSPS). Canonical correlation analysis and multiple linear regression modeling were used to examine their relationship.

Results

Total scores for the HSCS and COSPS were 92 (80,100) and 185 (175,185) [M (P25, P75)], respectively. Canonical correlation coefficients for canonical variates 1 and 2 were 0.636 (p < 0.001) and 0.414 (p < 0.001), respectively. Nurse interns' compliance with occupational safety practices was mainly influenced by management support, feedback/training, personal protective and engineering control equipment availability, and absence of job hindrance. Multiple linear regression showed that management support of HSCS accounted for 37.1% of the variance in compliance (β = 0.283, p = 0.039).

Conclusion

Nurse interns reported high levels of perceived hospital safety climate and compliance with occupational safety practices. Younger nurse interns reported a lower level of perceived hospital safety climate. Nurse educators can improve interns' compliance by promoting better management support, feedback/training, personal protective and engineering control equipment availability, and fewer job hindrance.

Comparison of lecture-based learning with presentation-assimilation-discussion method in occupational bloodborne exposure education of nursing students, a randomised trial

BACKGROUND

Occupational Bloodborne Exposures (OBEs) are incidents where healthcare workers come into contact with blood or other potentially infectious materials, leading to risks of transmitting bloodborne pathogens. Nursing students, often in direct contact with patients, face heightened risks due to their duties.

METHODS

First, we conducted a cross-sectional survey using a OBEs questionnaire to explore the knowledge, attitudes, practices, and needs regarding OBEs among nursing students. Subsequently, we used a randomized controlled trial (RCT) to compare the impact of the Presentation-Assimilation-Discussion (PAD) method with the traditional lecture-based learning (LBL) method on OBEs education for nursing students. Pre-test, post-test, and retention test were used to observe the teaching effectiveness, and the students' feedback on the teaching method was also observed.

RESULTS

In the cross-sectional survey, we found that nursing students lacked sufficient knowledge and management skills regarding OBEs but recognized the importance of standard precautions and expressed a desire for systematic OBEs training during their education and internships. In the RCT, the total, theoretical, and practical scores of the PAD and LBL groups were comparable in the pre-test (56.70 ± 3.47 vs. 56.40 ± 3.95, 33.09 ± 3.39 vs. 33.33 ± 2.44, 23.61 ± 4.66 vs. 23.07 ± 4.84, p > 0.05). After training, the PAD model demonstrated an advantage over the LBL model in immediate total (84.25 ± 4.06 vs. 78.95 ± 4.23, p < 0.001), theoretical (54.32 ± 2.43 vs. 51.44 ± 2.58, p < 0.001), and practical scores (29.93 ± 3.90 vs. 27.51 ± 4.33, p < 0.01). It also showed superior retention of total (69.05 ± 3.87 vs. 65.77 ± 2.94, p < 0.001) and theoretical scores (39.05 ± 3.05 vs. 36.23 ± 3.18, p < 0.001). However, there was no significant difference in the retention of practical scores between the two groups (30.00 ± 4.76 vs. 29.53 ± 3.73, p > 0.05). The PAD group benefited more across various learning dimensions but reported a higher study load.

CONCLUSIONS

Our study reveals that the PAD model could be a valuable approach for teaching OBEs to nursing students.

Attitudes towards people living with HIV/AIDS through the EAPVVS-E: A descriptive analysis in nursing students

BACKGROUND

Despite advances in antiretroviral treatment, stigma towards people with HIV/AIDS continues to exist. Nursing students, as future key players in health care, must advocate for the elimination of stigma through education, empathy and the creation of a supportive environment. This holistic approach is crucial to improving their quality of life and moving towards the eradication of HIV/AIDS.

AIM

To identify nursing students' attitudes towards people living with HIV or AIDS and their relationship with sociodemographic and academic-cultural variables of the participants.

DESIGN

A cross-sectional study was performed.

SETTINGS

The research was carried out in the Nursing Degree of the Faculty of Health Sciences of the Ceuta Campus of the University of Granada.

PARTICIPANTS

Convenience sampling was used to recruit 284 students of the degree in Nursing.

METHODS

Data were collected voluntarily and on an anonymous basis, using the "Attitudes Towards People Living with HIV/AIDS Scale in Nursing Students". Bivariate and multivariate analyses were performed.

RESULTS

Factors 1 (Professional Practice), 2 (Social Integration) and 3 (Partner and Family) exhibited mean scores considered to be favourable attitudes (>4 points). In contrast, Factor 4, called Benevolent Stigma, had a mean score of 3.68 ± 0.97. Religious beliefs, academic year, sexual orientation, academic practices and age are considered influential variables in the different factors.

CONCLUSIONS

Nursing students present attitudes with favourable scores. However, these results highlight the importance of influencing the different factors, especially in the second year of the Bachelor's Degree in Nursing in our sample. Thus, an educational intervention in this area would be necessary to reinforce the values of humanised care.

Midwives' compliance with post-exposure prophylaxis guidelines in Tshwane District, South Africa

BACKGROUND

 Human immunodeficiency virus (HIV) remains a major public health concern. Midwifery practitioners as frontline healthcare workers (HCWs) remain susceptible to occupational exposure to infections while performing their routine duties. It is estimated that 90% of occupational exposures occur because of a lack of awareness and training regarding prevention and measures to be taken in case of accidental exposure.

OBJECTIVES

 The study aimed to assess the knowledge, attitudes and compliance of midwifery practitioners regarding post-exposure prophylaxis (PEP) guidelines.

METHOD

 Concurrent mixed-methods research approach with qualitative nested in quantitative design was followed. A random simple sampling technique was used to collect quantitative data from 71 midwifery practitioners. Simultaneously, a purposive non-probability sampling technique was used for the qualitative approach with two occupational health and safety (OHS) practitioners and 13 midwifery practitioners. Data were collected through questionnaires and semi-structured interviews. Quantitative data were analysed with SPSS version 24 and presented in tables and figures, and thematic analysis was employed for the qualitative strand.

RESULTS

 The midwifery practitioners have good knowledge about PEP for HIV. However, the study revealed the underreporting of accidental exposures to blood and body fluids (BBFs) and the underutilisation of available PEP services.

CONCLUSION

 Maternity units are high-risk clinical environments. Underreporting of incidents of exposure remains prevalent among midwifery practitioners.Contribution: The findings will inform policy development structures and hospital management regarding knowledge and implementation gaps related to PEP guidelines in the specific hospitals. Strategies to improve compliance with PEP among midwifery practitioners were developed as a derivative from study findings.

Factors Influencing Occupational Health and Safety among Nursing Students in Their Clinical Placements: A Cross-Sectional Study

Occupational health and safety aims to promote and maintain optimal physical, mental, and social health for workers in their occupations. Within Saudi Arabia, adequate information must be gathered to address the various factors influencing occupational health and safety among nursing students to minimize occupational health hazards and ensure a safe clinical environment. This cross-sectional study was conducted in Riyadh, Saudi Arabia, between April and September 2023, involving 150 nursing students. Data collection included questions to gather sociodemographic information, and contained an instrument assessing the participants' knowledge of occupational health and safety and evaluation of risk control in clinical environments. Blood and other bodily fluids, workplace violence, needle-stick injuries, and injuries caused by sharp instrument tools were identified as the most prevalent occupational risks among the participants. Most nursing students were aware of occupational health and safety, with a high level of compliance with occupational health and safety measures and personal protective equipment use. We also identified a statistically significant correlation between occupational health and safety knowledge and risk control evaluation among nursing students. To ensure a safe and beneficial clinical training area, student nurses must complete extensive occupational health and safety courses before moving to clinical areas to reduce potential hazards that may affect their lives.

Awareness of standard precautions, circumstances of occurrence and management of occupational exposures to body fluids among healthcare workers in a regional level referral hospital (Bertoua, Cameroon)

BACKGROUND

Healthcare workers (HCW) are exposed to infectious agents within biological materials including blood, tissues, other body fluids and on medical supplies, contaminated surfaces within the care delivery environment. Trends in occupational injuries are influenced by the level of awareness and observance of standard precautions (SP) among HCWs. This study aimed to assess the level of awareness of SP, exposure to body fluids, reporting pattern and management among HCWs in a Referral Hospital.

METHODS

The present hospital-based cross-sectional study was carried out from 1st November 2020 to 31st May 2021. The exhaustive sampling method was used and a total of 120 consenting HCWs were invited to participate. A self-administered questionnaire addressed questions related to knowledge, experience, circumstances of exposure, reporting, management of occupational exposure to body fluids, hepatitis B vaccination status. Data were analyzed using R Statistic version 4.3.1. A p-value < 0.05 was considered significant.

RESULTS

Out of the 120 participating HCWs, 104 (86.7%) reported at least one accidental exposure to body fluids over the last year. Men (aOR = 4.19; p = 0.277) and HCWs aged 35 and over (aOR = 4.11; p = 0.114) were more at risk for AEB even though the difference was not statistically significant. Nurses/midwives (aOR = 65.9; p-value = 0.0005) and cleaners (aOR = 14.7; p-value = 0.0438) faced the highest risk of exposure. Lack of knowledge (79%) and patient agitation (49%) were the most reported reasons for exposure. Half of the participants (53%) reported that they used a personal protective equipment during care. Face mask (59.2%) and gowns (30.8%) were the most commonly used PPE. Most HCWs (62%) did not report AEB. Half of the affected HCWs (50.8%) received a course of post-exposure antiretroviral therapy. Few HCWs (4.2%) were fully immunized against Hepatitis B.

CONCLUSIONS

Most HCWs reported an accidental exposure to body fluids over the last year. Midwives and nurses were disproportionally affected socio-professional groups. Two-thirds of the AEB were undeclared. Only half of the participants reported using PPE systematically. Hepatitis B vaccination coverage was low. There is need to strengthen the observance of standard precautions, including preventive vaccination and the systematic reporting and management of AEB.

Splash of body fluids among healthcare support staff in Ghana: a cross-sectional study

Background

Exposure to splash of body fluids is one of the common ways of transmitting blood-borne infections from patients to healthcare practitioners. Globally, there is a paucity of evidence on exposure to splash of body fluids among hospital housekeepers. This study, therefore, investigated splash of body fluid and its predisposing factors among healthcare support staff in the Greater Accra region, Ghana.

Methods

An analytic cross-sectional survey was conducted among support staff in 10 major hospitals between 30 January and 31 May 2023. A multi-stage sampling procedure was the overarching technique employed, and study participants were recruited through simple random and probability proportional-to-size sampling techniques. The data analyses were conducted using STATA 15 software. The preliminary association between exposure to splash of body fluids and predisposing factors was established through Chi-square, Fisher's exact, and Mann-Whitney U tests. Log-binomial regression analyses were employed to validate the factors related to splash of body fluids at a significance level of p-value < 0.05.

Results

The investigation was conducted among 149 healthcare support staff. The exposure to splash of body fluids over the past 1 year was 53.7% (95% CI: 45.3%-61.9%). The types of body fluids that were mostly encountered through these splash exposures were amniotic fluids (36.3%) and urine (23.8%). Several factors were found to be significantly associated with splash of body fluids, namely: employed as a healthcare assistant [APR = 1.61 (1.16, 2.22)], holding a supervisory position [APR = 0.24 (0.11, 0.51)], having a system in place for reporting body fluid splashes [APR = 0.61 (0.44, 0.85)], male healthcare support staff [APR = 0.62 (0.41, 0.93)], and adherence to standard precautions most of the time [APR = 1.66 (1.11, 2.48)].

Conclusion

Healthcare support staff were highly exposed to splash of body fluids. Gender, supervisory role, category of worker, reporting systems, and adherence to standard precautions were associated with exposure to splash of body fluids. Facility managers are advised to enhance the efficiency of reporting systems.

Descriptive correlational study of knowledge, attitudes and practices related to blood exposure accidents among operating room nurses in the two university hospitals of Sousse

INTRODUCTION

The occupational infectious risk in the health care environment is potentially ubiquitous. Several infectious agents are transmitted to healthcare professionals, especially by blood and body fluids.

AIM

To describe the knowledge; attitudes and practices related to blood exposure accidents (BEA) among operating room nurses and to determine their associated factors.

METHODS

A descriptive correlational study was conducted from February 24 to April 10, 2022, among nurses of the operating rooms in the two university hospitals of Sousse using an auto administrated questionnaire inspired from the literature.

RESULTS

Our population was composed of 133 nurses. The average age was 38.79 ±7.75 years and the average length of work was 12.02 ±7.8 years. Overall, the respondents had moderate knowledge about BEA. Indeed, 17.3% did not know the meaning of the acronym BEA. Concerning the attitudes, almost (63.1%) had been the victim of at least one BEA. The most frequent types of BEA were pricks (81%), cuts (37%) and splashes (33.3%). The mechanisms of occurrence were mainly recapping (91.7%) and disposal of health care waste (74.4%). Only 48.1% of respondents had received training on BEA. The systematic use of gloves for health care procedures was unsatisfactory (66.2%). According to the studied practices, in case of injured skin, (82.7%) of the respondents wore gloves if they had any skin lesions. Almost all respondents (90.2%) were vaccinated against hepatitis B. Women had better knowledge about the meaning of the acronym BEA (p=0.011). The comparison of practices showed that recapping dirty needles after use was significantly higher among females than males (p=0.011).

CONCLUSION

The solid knowledge about the BEA and systematic application of standard precautions in health care settings must be concretely manifested in the daily practices of health professionals.

Medication error and associated factors among adults admitted to emergency ward at the university of Gondar comprehensive specialized hospital, North-West Ethiopia: a cross-sectional study, 2022

BACKGROUND

Medication errors are the most common cause of preventable adverse drug events at the emergency ward.

OBJECTIVES

This study assessed medication errors and associated factors among adult patients admitted to the emergency ward at the University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia.

METHODS

A cross-sectional study was conducted from June 1, 2022, to August 30, 2022. Data were entered into EpiData Manager 4.6.0.0 for clearing and exported to SPSS version 24 for analysis. Descriptive statistics such as frequencies, medians with an interquartile range and inferential statistics like binary logistic regression were used for data analysis. The level of significance was declared at a p value less than 0.05 with a 95% confidence interval.

RESULTS

From 422 study participants, medication errors were found in three-fourths (74.4%) of study participants. The most frequent type of medication error was omitted dose (26.27%). From a total of 491 medication errors, 97.75% were not prevented before reaching patients. More than one-third (38.9%) of medication errors had potentially moderate harmful outcomes. More than half (55.15%) of possible causes of medication errors committed by staff are due to behavioral factors. Physicians accepted 99.16% and nurses accepted 98.71% of clinical pharmacist intervention. Hospital stay ≥ 6 days (AOR: 3.00 95% CI 1.65-5.45, p < 0.001), polypharmacy (AOR: 5.47, 95% CI 2.77-10.81 p < 0.001), and Charlson comorbidity index ≥ 3 (AOR: 1.94, 95% CI (1.02-3.68), p < 0.04) significantly associated with medication error.

CONCLUSIONS

About three-fourths of adult patients admitted to the emergency ward experienced medication errors. A considerable amount of medication errors were potentially moderately harmful. Most medication errors were due to behavioral factors. Most clinical pharmacists' interventions were accepted by physicians and nurses. Patients who stayed longer at the emergency ward, had a Charlson comorbidity index value of ≥ 3, and were on polypharmacy were at high risk of medication error. The hospital should strive to reduce medication errors at the emergency ward.

Patient Safety in the Surgical Field: A Cross-Sectional Study Among Al-Baha University Medical Students

Background Patient safety and quality of surgical care are crucial in healthcare. Adequate knowledge and attitudes among healthcare providers regarding differentiating malpractice from surgical complications are essential for preventing adverse events. We aimed to assess medical students' knowledge and attitudes toward patient safety in surgical procedures. Methodology A cross-sectional study was conducted among clinical years of medical students and interns at Al-Baha University, Saudi Arabia, from June 15, 2023, to August 1, 2023. Exclusion criteria were students from basic years, pharmacology students, applied medical science, dental students, and students from other universities. A self-administered questionnaire collected data on participants' demographics, knowledge, attitudes, and practices related to patient safety in surgical procedures. Results A total of 271 medical students participated, exceeding the target sample size of 181. Participants' ages ranged from 20 to 28 years, with the majority between 23 and 25 (60.5%). Males accounted for 63.8% of participants. The largest group was fourth-year students (31.7%), followed by interns (23.6%), those in sixth year (23.2%), and those in fifth year (21.4%). Moreover, 82.7% of participants demonstrated good knowledge of patient safety concepts. The highest level of knowledge was noted among fourth-year students (89.5%), and the lowest was among fifth-year medical students (75.9%), but was not statistically significant (p=0.701). Most participants demonstrated appropriate attitudes and practices (83.6%); however, 9.2% refused to perform surgery on a patient with active hepatitis B due to concerns for their own safety. Conclusion The majority of participants exhibited suitable knowledge and attitudes toward patient safety in surgical scenarios, but there was deficient knowledge among fifth- and sixth-year students. Moreover, a negative attitude regarding patient safety was noticed, exemplified by refusing surgeries on patients with active hepatitis B.

Occupational exposure to blood and body fluids among prehospital emergency medical services workers in Mashhad, Northeast of Iran

BACKGROUND

This study aimed to assess occupational exposure to blood and body fluids (BBFs) and the use of protective equipment among prehospital emergency medical services (EMS) workers in Mashhad, Iran.

METHODS

This cross-sectional questionnaire survey-based study was conducted from July 2020 to March 2021 in Mashhad. All prehospital EMS workers of Mashhad were invited to participate in the study using the census technique. The questionnaire was about occupational exposure to BBFs, infection control, protective measures, health program, and demographic information.

RESULTS

In total, 442 participants answered the questionnaire (response rate: 82.77%). Based on the findings, 420 (95.2%) and 402 (91.2%) participants had been exposed to BBFs as prehospital EMS workers. Moreover, 31.5% and 38.5% of these exposures were caused by contaminated needles and lancets, respectively. The BBFs incidents have occurred despite 98% of the EMS workers reporting there is a needle safety disposable box in the ambulance. The relationship between awareness of precaution measures after exposure to BBFs and training course completion was significant (P < .0001).

CONCLUSION

This study demonstrated the high prevalence of occupational exposures to BBFs among prehospital EMS workers. Considering the significant relationship between the completion of standard precautions courses and awareness of BBFs' postexposure measures, it is recommended to consider multi-faceted strategies for continuous monitoring, training, and follow-up of prehospital EMS workers.

HIV sero-status of healthcare workers in Addis Ababa public hospitals post exposure to infected blood and body fluids: A cross-sectional study, October 2022

The study investigated the sero-status of human immunodeficiency virus among healthcare workers in Addis Ababa public hospitals. A multi-centered, institutional-based, cross-sectional study was conducted from 18 September 2022 to 30 October 2022. A simple random sampling method and a semi-structured, self-administered questionnaire were used to collect the data, which were analyzed using the Statistical Package for Social Sciences (SPSS) version 25. A binary logistic regression model was used to identify the factors associated with the human immunodeficiency virus sero-status of healthcare workers post exposure to infected blood and body fluids. Of the 420 study participants who were exposed to blood and body fluids, 403 (96%) were non-reactive. Healthcare workers who had 20-29 years of work experience had approximately six times higher odds of testing positive for the human immunodeficiency virus (AOR = 6.21, 95% CI: 2.39, 9.55). Healthcare workers who did not use personal protective equipment properly had five times higher odds of testing positive for the human immunodeficiency virus (AOR = 5.02, CI: 3.73, 9.51). This study showed that, among those healthcare workers who tested positive for the human immunodeficiency virus infection, the majority were from the emergency department. Healthcare workers who did not use personal protective equipment properly had higher odds of testing positive for the human immunodeficiency virus.

Occupational exposure to HIV and utilization of post-exposure prophylaxis among healthcare workers at St. Peter's specialized hospital in Addis Ababa, Ethiopia

Healthcare workers are susceptible to blood borne pathogens, such as human immunodeficiency virus (HIV). Occupational exposure to HIV infection among healthcare workers is becoming a global public health concern. However, there is limited evidence about occupational exposure of healthcare workers to HIV and utilization of post-exposure prophylaxis in Addis Ababa, Ethiopia. Accordingly, this study was conducted to assess the prevalence of occupational exposure to HIV and utilization of post exposure prophylaxis among healthcare workers at St. Peter's specialized hospital, Addis Ababa, Ethiopia. A health facility-based cross-sectional study was conducted among 308 randomly selected healthcare workers in April 2022. Structured and pretested self-administered questioner was used to collect data. Occupational exposure to HIV was taken as any percutaneous injury or blood or other body fluids exposure while administering medications, specimen collection, and other procedures with HIV confirmed patients. Multivariable binary logistic regression analysis was used to identify factors associated with occupational exposure to HIV and utilization of post-exposure prophylaxis. Statistically significant association was declared on the basis of adjusted odds ratio with 95% confidence interval and p-value less than 0.05. The study found that 42.3% (95% CI 36.6, 47.9%) of the healthcare workers had occupational exposure to HIV during their career time, out of whom 16.1% (95% CI 11.9, 20.3%) used post-exposure prophylaxis. Healthcare workers with lower-level education such as diploma (AOR: 0.41, 95% CI 0.17, 0.96) and BSc (AOR: 0.51, 95% CI 0.26, 0.92), and healthcare workers who received infection prevention training (AOR: 0.55, 95% CI 0.33, 0.90) had less risk of exposure to HIV. On the other hand, nurses (AOR: 1.98, 95% CI 1.07, 3.67), midwifes (AOR: 3.79, 95% CI 1.21, 11.9), and physicians (AOR: 2.11, 95% CI 1.05, 4.22) had high risk of exposure to HIV compared with other professionals. Moreover, healthcare workers with BSc degree compared with healthcare workers with masters degree (AOR: 3.69, 95% CI 1.08, 12.6), healthcare workers with long service year (AOR: 3.75, 95% CI 1.64, 8.57), and healthcare workers who are working in facilities where prophylaxis is available (AOR: 3.41, 95% CI 1.47, 7.91) had higher odds to utilize post-exposure prophylaxis. Significant proportion of healthcare workers included in the current study had occupational exposure to HIV and very few of them used post-exposure prophylaxis. Healthcare workers need to use appropriate personal protective equipment, safely manage contaminated equipment, and safely administered medications and collect specimen to protect themselves from exposure to HIV. Moreover, use of post-exposure prophylaxis should be promoted when exposure exists.

Logistical, technical, and radiation safety aspects of establishing a radiopharmaceutical therapy program: A case in Lutetium-177 prostate-specific membrane antigen (PSMA) therapy

Prostate-specific membrane antigen (PSMA) is a cell surface protein highly expressed in nearly all prostate cancers, with restricted expression in some normal tissues. The differential expression of PSMA from tumor to non-tumor tissue has resulted in the investigation of numerous targeting strategies for therapy of patients with metastatic prostate cancer. In March of 2022, the FDA granted approval for the use of lutetium-177 PSMA-617 (Lu-177-PSMA-617) for patients with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor pathway inhibition and taxane-based chemotherapy. Therefore, the use of Lu-177-PSMA-617 is expected to increase and become more widespread. Herein, we describe logistical, technical, and radiation safety considerations for implementing a radiopharmaceutical therapy program, with particular focus on the development of operating procedures for therapeutic administrations. Major steps for a center in the U.S. to implement a new radiopharmaceutical therapy (RPT) program are listed below, and then demonstrated in greater detail via examples for Lu-177-PSMA-617 therapy.

Occupational Exposure to Blood and Body Fluids Among Nurses in the Emergency Department and Intensive Care Units of Public Hospitals in Addis Ababa City: Cross-sectional Study

AIMS AND OBJECTIVES

This study investigated occupational exposure to blood and body fluids among nurses at the emergency department and intensive care units of public hospitals in Addis Ababa city.

METHODS

A cross-sectional study was conducted from June 18, 2021 to September 20, 2021. A simple random sampling method and semi-structured, self-administered questionnaires were used to collect the data, which were analyzed using SPSS version 25. A binary logistic regression model was used to identify factors associated with exposure to blood and body fluids on the AOR with a 95% confidence interval at a P-value of <.05.

PATIENT AND PUBLIC INVOLVEMENT

No patients were involved in this study.

RESULTS

Of the total study participants (260), 198 (76%) nurses had been exposed to blood and body fluids in their professional live, and 167 (64%) were exposed to blood and body fluids in the last 12 months. Being male (AOR = 2.88, 95% CI: (1.35, 6.12), lacking access to handwashing facilities (AOR = 5.02, 95% CI: (3.73, 14.51)), not consistently wearing all the required types of personal protective equipment (AOR = 6.21, 95% CI: (2.39, 9.55)), and the lack of the required personal protective equipment (AOR = 5.53, 95% CI: (1.87, 10.38)) were all significant factors that were positively associated with exposure to blood and body fluids.

CONCLUSION

This study showed that a higher proportion of nurses in the emergency department and intensive care unit were exposed to blood and body fluids in the study setting. Most nurses do not consistently wear all the required types of personal protective equipment, putting them at a higher risk of acquiring blood-borne pathogens. The authors recommended that there is a need to implement and strengthen appropriate and consistent use of all required personal protective equipment during any procedure, and patient care to reduce exposure to blood and body fluids.

RELEVANCE TO CLINICAL PRACTICE

This study provides baseline information for other action-based studies to assess exposure to blood and body fluids among nurses in emergency and intensive care units.

STROBE CHECKLIST

This manuscript was prepared based on the strobe checklist guidelines.

IMPACT STATEMENT

The study's findings and recommendations might be used for healthcare providers, non-governmental organizations, and policymakers for appropriate planning and interventions to minimize or safeguard nurses' exposure to blood and body fluids.

HIV Sero-Status of Health Care Workers in Addis Ababa Public Hospitals After Post-Exposure Blood and Body Fluids: A Cross-Sectional Study, October 2022

Objectives

The study investigated the sero-status of human immunodeficiency virus among healthcare workers in Addis Ababa public hospitals.

Methods

A multi-centered, institutional-based cross-sectional study was conducted from September 18, 2022, to October 30, 2022. A simple random sampling method and semi-structured, self-administered questionnaires were used to collect the data, which were analyzed using statistical package for social science version 25. A binary logistic regression model was used to identify factors associated with the sero-status of healthcare workers' post-exposure blood and body fluids for the human immunodeficiency virus.

Results

Of the 420 study participants who were exposed to blood and body fluids, 403 (96%) were non-reactive. Healthcare workers who had 20 to 29 years of work experience had approximately 6 times higher odds of testing positive for human immunodeficiency virus (AOR = 6.21, 95% CI: (2.39, 9.55). Healthcare workers who did not use personal protective equipment properly had 5 times higher odds of testing positive for human immunodeficiency virus (AOR = 5.02, CI: 3.73, 9.51).

Conclusion

This study showed that a higher proportion of healthcare workers at the emergency department were positive for human immunodeficiency virus infection among healthcare workers who were exposed to blood and body fluids and tested immediately. Healthcare workers who did not use personal protective equipment properly had higher odds of testing positive for human immune-deficiency virus.

Prevalence and influence factors of occupational exposure to blood and body fluids in registered Chinese nurses: a national cross-sectional study

BACKGROUND

Occupational exposure to blood and body fluids poses a threat to medical providers and to nurses especially. This harm is not only physical, but psychology as well and can ultimately impact patient safety. This study aims to understand the prevalence of occupational exposure to blood and body fluids among Chinese registered nurses and explores the factors that influence this exposure.

METHODS

A cross-sectional online survey was conducted for 31 province-level divisions in China, using a self-created questionnaire entitled Status Survey on Occupational Exposure in Nurses. Descriptive statistics were used to describe both the demographic characteristics of the respondents and the characteristics of occupational exposure. Categorical variables were presented as frequencies and percentage, and the relationship between possible influential factors and the occurrence of occupational exposure was determined using binary logistic regression.

RESULTS

Out of a total of 20,791 nurses analyzed, over half (52.1%) of them had experienced occupational exposure to blood or body fluids, but over 1/3 (34.6%) of them did not ever report their exposures to a supervisor/official. The top three causes of under-reporting were: the source patient failed to test positive for infectious pathogens (43.6%), perception of a burdensome reporting process (24.6%), and indifferent attitude towards being infected (16.9%). Nurses who worked over 8 hours per day had higher risks of exposure (OR 1.199, 95% CI 1.130 to 1.272, P < 0.001, respectively). The occupational exposure risk from providing 1-2 types of PPE is 1.947 times that of providing 9-10 types of PPE (OR 1.947, 95% CI 1.740 to 2.178, P < 0.001). Likewise, the occupational exposure risk of providing 1-2 types of safety-engineered injection devices is 1.275 times of that of providing 5-6 types (OR 1.275, 95% CI 1.179 to 1.379, P < 0.001).

CONCLUSIONS

Occupational exposure to blood and body fluids in registered nurses is common, but the rate of under-reporting such exposure is high. Implementing engineered "sharp" injury prevention devices, following exposure prevention procedures, giving sufficient education and training to healthcare personnel on exposure prevention and control, and developing exposure reporting policies are all steps that can both reduce exposure and increase its reporting.

Global Occupational Exposure to Blood and Body Fluids among Healthcare Workers: Systematic Review and Meta-Analysis

Background

Occupational exposure to blood and body fluids has become a serious public health problem for healthcare workers and is a major risk for the transmission of various infections such as human immune-deficiency virus, hepatitis B virus, and hepatitis C virus. This systematic review and meta-analysis aims to determine the career time and previous one-year global pooled prevalence of occupational exposure to blood and body fluids among healthcare workers.

Methods

For the review, the articles published in English were searched using the electronic databases (SCOPUS/Science Direct, PubMed, Web of Science, Google Scholar, CINAHL, MEDLINE, Cochrane Library, DOAJ, and MedNar) with a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords. A quality assessment was conducted to determine the relevance of the articles using JBI critical appraisal tools. Furthermore, several steps of assessment and evaluation were taken to select and analyze the relevant articles.

Results

Of the 3912 articles identified through the electronic database search, 33 that met the inclusion criteria were included in the final analysis. The current study found that the global pooled prevalence of blood and body fluids among healthcare workers during career time and in the previous one year accounted for 56.6% (95% CI: 47.3, 65.4) and 39.0% (95% CI: 32.7, 45.7), respectively. Based on subgroup analysis by publication year, survey year, and World Health Organization regions, the highest prevalence of blood and body fluid exposure in the last 12 months was observed among articles published between 2004 and 2008 (66.3%), conducted between 2003 and 2008 (66.6%), and conducted in the Southeast Asia Region (46.9%). The highest career time prevalence was 60.6%, 71.0%, and 68.4% for articles published between 2015 and 2020, conducted between 2015 and 2019, and reported in the African region, respectively.

Conclusion

The current study revealed a high prevalence of occupational exposure to blood and body fluids among healthcare workers and suggests the need to improve occupational health and safety services in healthcare systems globally.

Impact of occupational exposure on job satisfaction and overall happiness among Chinese physicians and nurses: A cross-sectional study

AIMS

To investigate the impact of occupational exposure on job satisfaction and overall happiness, and to identify related factors of job satisfaction and overall happiness among physicians and nurses.

BACKGROUND

Occupational exposure against physicians and nurses has become one of the most serious public health issues worldwide.

METHODS

A cross-sectional study was conducted among physicians and nurses from 14 public tertiary hospitals using purposive sampling. Propensity score matching was used to compare job satisfaction and overall happiness among physicians and nurses with and without occupational exposure. Furthermore, binary logistic regression analysis was used to identify and analyze the influencing factors of job satisfaction and overall happiness.

RESULTS

A total of 2139 physicians and nurses (55.59%) from 3791 participants had experienced occupational exposure hazards. Before matching, the job satisfaction and overall happiness among the physicians and nurses was 38.54% and 42.14%, respectively. Participants who experienced occupational exposure were more likely to develop job dissatisfaction (OR = 1.08, 95%CI: 0.90-1.28) and overall unhappiness (OR = 1.24, 95%CI: 1.05- 1.46) than those who did not. Participants' work experience, self-evaluated health status, satisfaction with the work environment, evaluation of doctor-patient relationship, and stress were common factors affecting job satisfaction and overall happiness.

CONCLUSIONS

Our findings suggest that physicians and nurses who experience occupational exposure are more likely to develop job dissatisfaction and overall unhappiness, especially if they have shorter work experience and a tense or neutral relationship with patients.

IMPLICATIONS FOR NURSING MANAGEMENT

It is necessary to pay attention to the occupational exposure. When physicians and nurses experience occupational exposure, managers could provide support to prevent job dissatisfaction and unhappiness.

Occupational stressors and work accidents among health workers

OBJECTIVE

To test the association between occupational stressors and work accidents due to exposure to biological material (ATbio) in health workers, considering the isolated and combined analysis of the dimensions of two models, the demand-control model (DCM) and the effort-reward imbalance model (ERI).

METHODS

Cross-sectional study in a representative sample of workers with higher, technical and secondary education, including health agents from primary and medium-complexity care units in five cities in Bahia. Random sampling was selected, stratified by geographic area, level of service complexity and occupation. The outcome variable was ATbio; The main exposure was occupational stressors, assessed by the DCM and ERI. Incidences and relative risks were estimated as a function of the acute, short-term nature of the outcome of interest. Associations between ATbio and isolated and combined DCM and ERI dimensions were tested.

RESULTS

A total of 3,084 workers participated in the study. The global incidence of ATbio was 3.4% and was associated with high psychological demand, high effort and high commitment to work, adjusted for sex, age, education and work shift. High-strain work and a situation of imbalance between efforts and rewards were associated with ATbio. With the combination of the models, an increase in the measure of association with the outcome was observed. Significant associations of greater magnitude were observed in the complete combined models. ATbio’s risk was 5.23 times higher among those exposed in both complete models compared to the absence of exposure in both models.

CONCLUSIONS

Occupational stressors were associated with ATbio. Advantages in using the combined models were observed. The approach of different psychosocial dimensions has expanded the ability to identify exposed groups, offering a solid basis for interventions for ATbio’s prevention in health.

Occupational blood exposure beyond needle stick injuries: hospital-based cross-sectional study among healthcare workers in governmental hospitals of Northern Ethiopia

Background

Occupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids.

Methods

A hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable.

Results

From the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure.

Conclusions

As nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07167-9.

Adherence and Effectiveness of HBV Vaccination among Healthcare Workers in Egypt

Context:

Healthcare workers (HCWs) face a potential risk of acquiring different bloodborne pathogens, by occupational exposure to contaminated blood and body fluids. Hepatitis B vaccine is a safe, effective method of conferring long-term protection against HBV infection.

Aims:

The study aimed to assess the adherence and effectiveness of HBV vaccination among HCWs at Gastrointestinal Surgical Center, Mansoura University, Egypt.

Settings and Design:

A prospective descriptive study was carried out between June 2019 and December 2019 at Gastrointestinal Surgical Center, Mansoura University, Egypt.

Methods and Material:

All HCWs with anti-HBs levels below 10 mIU/mL were advised to receive 3 doses of recombinant HBV vaccine, at 0, 1, and 6 months. The anti-HBs levels were checked 3 months after the third dose of the HBV vaccine.

Statistical Analysis Used:

Data was analyzed using the Statistical Package of Social Science (SPSS) program for windows (version 16).

Results:

A total of 442 healthcare providers were included. Most of them completed the 3 doses of the vaccine (81.7%), 10.2% refused the vaccine, while 0.9% and 7.2% received 1 and 2 doses, respectively. Odds of vaccination were the highest (88.1%, 273/310) among nurses (OR, 4.7; 95% CI, 2.6–5.2; P ≤ 0.001). The overall anti-HBs positivity of 97% (350/361) was observed. The main reasons for not being vaccinated included the fear of vaccine side effects 25/81 (30.9%) and lack of trust in the vaccine effectiveness 18/81 (22.2%).

Conclusions:

The outcome of the present study emphasizes the need to apply alternative and innovative measures to build a positive attitude toward the HBV vaccine among HCWs.

Factors affecting the risk of SARS-CoV-2 transmission to anesthesiologists performing endotracheal intubation in patients with SARS-CoV-2

BACKGROUND

In this study, we estimated the predictive factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in anesthesiologists performing endotracheal intubation in patients with confirmed SARS-CoV-2.

METHOD

We analyzed data from a survey conducted by the Chinese Society of Anesthesiology Task Force on Airway Management on endotracheal intubation in 98 patients with SARS-CoV-2 confirmed through nucleic acid testing and chest computed tomography. The multivariate logistic model with stepwise selection was used for selecting the predictive factors significantly associated with SARS-CoV-2 infection in the corresponding anesthesiologists.

RESULTS

SARS-CoV-2 prevalence in the corresponding anesthesiologists was 20.41% after intubation in patients with SARS-CoV-2. Univariate analysis indicated that intubation for elective treatment, intubation in an operating room or isolation ward, and routine rapid induction with continuous positive-pressure ventilation (PPV) for intubation were associated with a lower SARS-CoV-2 risk in the anesthesiologists. Multivariate analysis revealed that intubation for elective treatment was associated with a significantly decreased SARS-CoV-2 risk (adjusted odds ratio [aOR] = 0.28, 95% confidence interval [CI]: 0.14-0.68, P < 0.0001), and coughing by patients during endotracheal intubation was associated with a significantly increased SARS-CoV-2 risk (aOR = 1.70, 95% CI: 1.39-2.97, P = 0.0404) in the anesthesiologists.

CONCLUSION

Endotracheal intubation for elective treatments, intubation in an operating room or isolation ward, and routine rapid induction with continuous PPV for patients with confirmed SARS-CoV-2 are associated with a lower risk of SARS-CoV-2 transmission in practicing anesthesiologists, and coughing by patients during intubation increases the risk.

Increasing hepatitis B vaccination coverage of healthcare workers - global lessons for South Africa

Healthcare workers (HCWs) are at high risk of contracting hepatitis B (HB), a severe blood-borne vaccine-preventable disease, caused by HB virus (HBV) infection. Low HB vaccine (HepB) coverage has resulted in suboptimal protection and high HBV infection rates in South African HCWs. Studies from Africa have identified cost; unavailability/lack of access to HepB; and lack of awareness/knowledge of HB and HepB, as barriers to HCW uptake. Studies from Europe show little difference in HepB coverage between countries mandating versus recommending HepB. Providing easy and sustained access to free HepB to student HCWs, together with education about HB and HepB, are recommended to create demand for HepB. Only if this fails should mandatory vaccination be considered.

Worldwide Prevalence of Occupational Exposure to Needle Stick Injury among Healthcare Workers: A Systematic Review and Meta-Analysis

Background

Healthcare workers are at high risk of occupational exposure to needle stick injury worldwide. Occupational exposure to needle stick injury represents the most common sources of infection such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Thus, this review aimed to determine the career time and previous one-year global pooled prevalence of occupational exposure to needle stick injury among healthcare workers.

Methods

The review considered articles written in English language and published from 2012 to 2020. The articles were searched using nine electronic databases (PubMed, Google Scholar, CINAHL, MEDLINE, Cochrane library, Web of Science, SCOPUS, MedNar, and ScienceDirect) using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings, and keywords. Quality assessment was performed to determine the relevance of the articles using Joanna Briggs Institute critical appraisal tools. Several steps of assessment and evaluation were taken to select and analyze the relevant articles.

Results

The worldwide pooled prevalence of needle stick injuries among healthcare workers during career time and previous one year was 56.2% (95% CI: 47.1, 64.9) and 32.4% (95% CI: 22.0, 44.8), respectively. The career time pooled prevalence of needle stick injuries based on the socioeconomic development and study area was 54.8% and 55.1%, respectively, and one-year pooled prevalence of needle stick injury was 26.0% and 20.9%.

Conclusion

The review found a high prevalence of occupational exposure to needle stick injury among healthcare workers and suggests the need to improve occupational health and safety services in the healthcare systems.

Prevalence and associated factors of sharps injuries and other blood/body fluid exposures among healthcare workers: A multicenter study

A multicenter study of sharps injuries (SIs) and other blood or body fluid (OBBF) exposures was conducted among 33,156 healthcare workers (HCWs) from 175 hospitals in Anhui, China. In total, 12,178 HCWs (36.7%) had experienced at least 1 SI in the previous 12 months and 8,116 HCWs (24.5%) had experienced at least 1 OBBF exposure during the previous 12 months.

The Prevalence of Needlesticks and Sharp Injuries, and the Associated Factors Among Midwives and Nurses in North Wollo Zone Public Hospitals, North East Ethiopia: An Institution-based Cross-sectional Study

Background

Health professionals are at high risk of exposure for needlestick or sharp injury due to repeated exposure in clinical areas. This exposure leads to the acquiring of different infectious diseases like human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and other infectious diseases. Nurses and midwives having repeated exposure due to long working time, not wearing personal protective equipment, less work experience, and who are unable to apply infection prevention utilization guidelines are at high risk of needlestick and sharp injuries.

Methods

An institutional-based, cross-sectional study design was conducted in North Wollo Zone public hospitals. A simple random sampling technique was applied to select study subjects. The method of data collection was self-administered questionnaires that are structured and pretested from February to March 2019. The data were analyzed using both descriptive and analytical statistics. Binary logistic regressions were used to test the association between variables. Then, P-value <0.05 was considered as statistically significant in this study.

Results

Of the 147 respondents who participated in the study, 50.3% were female and 49.7% were male. The prevalence of needlestick and the sharp injuries was 75.5%. Recap practice of needle (AOR: 3.880; 95%CI: 1.666–9.036), working room (maternal care room) (AOR: 2.968; 95%CI: 1.012–8.703), and contagious room like emergency room (AOR: 3.587; 95%CI: 1.383–9.301) are significantly associated with needlestick and sharp injuries.

Conclusion

This study showed that three-quarters of the study subjects were exposed to needlestick injury at least once in the past year. Needle recapping practice and working room were associated with needlestick and sharp injuries. Then, health personnel should avoid the practice of recapping a needle and tale care themself to avoid needle and sharp injuries in the workplace.

Occupational exposures to blood and body fluids among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Occupational exposure to blood and body fluids is a major risk factor for the transmission of blood-borne infections to healthcare workers. There are several primary studies in Ethiopia yet they might not be at the national level to quantify the extent of occupational blood and body fluid exposures (splash of blood or other body fluids into the eyes, nose, or mouth) or blood contact with non-intact skin among the healthcare workers. This systematic review and meta-analysis aimed to estimate the pooled prevalence of occupational blood and body fluid exposure of healthcare workers in Ethiopia.

METHODS

PubMed, Science Direct, Hinari, Google Scholar, and the Cochrane library were systematically searched; withal, the references of appended articles were also checked for further possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effects meta-analysis model was used to estimate the lifetime and 12-month prevalence of occupational exposure to blood and body fluids among healthcare workers in Ethiopia.

RESULTS

Of the 641 articles identified through the database search, 36 studies were included in the final analysis. The estimated pooled lifetime and 12-month prevalence on occupational exposure to blood and body fluids among healthcare workers were found to be at 54.95% (95% confidence interval (CI), 48.25-61.65) and 44.24% (95% CI, 36.98-51.51), respectively. The study identified a variation in healthcare workers who were exposed to blood and body fluids across Ethiopian regions.

CONCLUSION

The finding of the present study revealed that there was a high level of annual and lifetime exposures to blood and body fluids among healthcare workers in Ethiopia.

Using bottleneck analysis to examine the implementation of standard precautions in hospitals

BACKGROUND

Service providers are often inadequately compliant with standard precaution protocols. This study used bottleneck analysis to identify the weakest link in standard precaution implementation and its associated challenges in hospitals.

METHODS

Bottleneck analysis was conducted in 12 hospitals in Fujian Province, China. In each hospital, a focus group was organized among the key informants to illustrate the sequential steps of standard precaution implementation graphically. The level of difficulty and the specific challenges associated with each step were discussed.

RESULTS

The sequential activities of standard precaution implementation generally start with making budget for personal protection equipment (PPE), followed by procurement, storage/inventory, in-hospital distribution, in-department distribution, usage/monitoring, and recycling of PPE. Service providers' improper use of PPE was the primary bottleneck. The reasons for improper use of PPE included high workload, time constraints, the sense of wearing PPE would interfere with clinical judgment, and various misconceptions. Making financial planning, recycling, and procurement of PPE were the secondary bottlenecks.

CONCLUSIONS

Bottleneck analysis is useful to illustrate workflow in healthcare systems and pinpoint constraints in standard precaution implementation. Institutional changes, including targeted provider training, adjustment of providers' workloads, and allocation of budget, are suggested strategies to address the identified bottlenecks in standard precaution.

Occupational Exposure to Blood and Body Fluids among Medical Laboratory Science Students of the University of Health and Allied Sciences during Vocational Internship in the Volta Region of Ghana

Medical laboratory science students (MLSS), likewise health care workers (HCW), invariably get exposed to blood and body fluids (BBF) of patients. The degree of exposure of these students is even worsened due to their inexperience, which is usually revealed during their vocational training programme. This study therefore determined the prevalence of exposure to BBF and its risk factors among MLSS at the University of Health and Allied Sciences (UHAS). A cross-sectional survey was employed using simple random sampling to enrol 178 students into the study. The study was conducted from February 1 to March 31, 2018, after the annual vocational training programme completed in August 2017. Self-administered questionnaires based on the objectives of the study were given out to participants to complete after their consent was sought. Descriptive data were reported as absolute number with percentages, whereas bivariate and multiple logistic regressions were done to describe relationship between risk factors and exposure to BBF. The study findings revealed that, out of 178 MLSS that participated, 90 (50.6%) experienced at least one exposure to BBF. Also, work experience before university education increased the chances of exposure to BBF (AOR = 7.37, 95% CI = 1.22–44.43, pvalue = 0.029) compared with those with no experience. In contrast, adequate personal protective equipment (PPE) reduced the tendencies of exposure to BBF (AOR = 0.41, 95% CI = 0.20–0.88, p value = 0.023) compared with students who had insufficient PPE. The study showed high, 50.6% (95% CI: 43.0%–58.1%), exposure to BBF. Work history and sufficient PPE were the most significantly associated risk factors. In view of this, there is the need to promote training and education on exposure to BBF particularly among experienced students and also encourage health facilities to continue providing enough PPE for students during their annual obligatory vocational internship programmes.

Occupational Exposure to Blood and Body Fluids among Health Care Workers in Gondar Town, Northwest Ethiopia: A Result from Cross-Sectional Study

Background

Health care workers are at the greatest risk of developing blood-borne diseases through occupational exposure to blood and other contaminated body fluids. Occupational exposure to blood and body fluids (BBFs) continues to be the major public health problems and serious concern for the health care force in Ethiopia. Therefore, this study was aimed to determine the prevalence of exposure to blood and other body fluids and its associated risk factors among health care workers.

Methods

The institution-based cross-sectional study design was employed from January 20 to February 30, 2018. A stratified random sampling followed by a simple random sampling technique was used to select 286 study participants. Data were collected using a pretested and structured questionnaire. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with occupational exposure to BBFs. The significance level was obtained at a 95% confidence interval (CI) and p value ≤ 0.05.

Results

The prevalence of occupational exposure to blood and body fluids among health care workers in the last 12 months was 65.3% (95% CI: 59.4, 70.9). Lack of readily available personal protective equipment (adjusted odds ratio (AOR)) = 3.01, 95% CI: 1.56, 5.84), lack of training (AOR = 3.36, 95% CI: 1.1, 11.2), Khat chewing (AOR = 2.74, 95% CI: 1.3, 5.8), and being a medical doctor (AOR = 5.1, 95% CI: 1.68, 15.21) were significantly associated risk factors with occupational exposure to blood and other body fluids.

Conclusions

In this study, occupational exposure to blood and other body fluids among health care workers remains a major health problem. Hence, ensuring the availability of personal protective equipment, developing strategies on banning, and strict monitoring of Khat chewing and training on infection prevention should be emphasized to minimize the problem.

Effect of virtual reality training to decreases rates of needle stick/sharp injuries in new-coming medical and nursing interns in Taiwan

PURPOSE

Senior nursing and medical interns' lack of familiarity and confidence with respect to practicing universal precaution for the prevention of occupational needle stick (NSI)/sharp (SI) injuries may harm themselves. Trainees' self-reported NSI/SI rate was known to be especially high during the first two months of internship in Taiwan. This prospective cohort study aimed to know the effect of new developed (virtual reality (VR) game, which uses the Gangne's learning model to improved universal precaution for NSI/SI prevention and decrease the rates of needle stick/sharp injuries in new-coming medical and nursing interns in Taiwan. .

METHODS

From 2017 to 2019, the VR system was developed and applied in training of 59 new-coming nursing and 50 medical interns. Occupational NSI/SI prevention was sought to be achieved through a game of right and wrong choices for safe or unsafe universal precaution behaviors.

RESULTS

In comparison with medical interns, a higher proportion of nursing interns have had the past experiences of deep occupational NSI/SI. Before VR training, the familiarity and confidence for NSI/SI prevention were higher among nursing interns than medical interns. Trainees with past experiences of deep NSI/SI exhibited better performance on the accuracy rate and time need for complete 20 decisions than those without past experiences in VR practice. The performances of all trainees were improved after VR training. A high proportion of trainees reported that the VR-based training significantly decreased their anxiety about NSI/SI prevention.

CONCLUSION

This self-developed VR game system using Gangne's flow improved universal precaution for NSI/SI prevention and reduced the NSI/SI rates in the first two months of nursing and medical internship.

Comparison of hepatitis B vaccine efficacy in Japanese students: a retrospective study

Background

Two types of recombinant hepatitis B virus (HBV) vaccines are available in Japan. One type uses the antigen from genotype A (Heptavax-II®) and the other uses the antigen from genotype C (Bimmugen®). Potential differences in productivity of the hepatitis B virus surface (HBs) antibody between vaccines have not been studied in detail. We investigated the acquired level of immunity against HBV in association with two vaccines, their administration routes, and patient sex. We present the appropriate inoculation method based on the characteristics of each vaccine.

Methods

Data of 1135 medical and nursing students (481 men and 651 women) were used, each of whom was unvaccinated prior to recruitment and subsequently vaccinated three times prior to the study. The vaccine type and administration route differed according to the university department and enrolling year. The students were categorized into the following three groups: Bimmugen®-subcutaneous group, Heptavax-II®-subcutaneous group, and Heptavax-II®-intramuscular group. The total and sex-segregated positive rates of the HBs antibody among the three groups were compared using Pearson’s chi-square test. The effect of time between the HBs antibody test and vaccine administration on the HBs antibody level was also analyzed similarly.

Results

The Bimmugen®-subcutaneous group showed the highest positive HBs antibody rate (92.0%) among the three groups. In the Heptavax-II® group, the positive rate was 66.3% in the subcutaneous injection group and 89.1% in the intramuscular injection group. There was a significant difference among these three groups. In terms of sex, women showed a significantly higher average positive rate than men in each group. In terms of effect of time between the HBs antibody test and vaccine administration, no significant differences were observed.

Conclusions

Bimmugen® is associated with more effective HBs antibody production than Heptavax-II® in Japanese students. However, the Heptavax-II® vaccine is an appropriate choice for HBV vaccination in areas where HB is caused predominantly by HBV genotype C. With both vaccines, women tended to acquire more immunogenicity than men. Intramuscular injection may be the preferred administration route due to the possibility of local reactions.

Prevalence of needlestick injury among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Health facilities can provide diagnostic, curative, and prognostic services for the community. While providing services, healthcare workers can be exposed to needlestick injuries that can transmit pathogenic organisms through body fluids.

OBJECTIVE

The aim was to establish the pooled prevalence of needlestick injuries among healthcare workers in Ethiopia.

METHODS

This systematic review and meta-analysis was conducted according to PRISMA guidelines. Articles were searched from Google Scholar, PubMed, Science Direct, and Scopus databases using a combination of keywords and Boolean functions. All the searched articles were imported into the EndNote X9 software, and then, duplicate data files were removed. Article screening and data extraction were done independently by two authors. Data manipulation and analyses were done using STATA version 15.1 software.

RESULTS

The analysis of 23 full-text articles showed that the prevalence of the 12-month and lifetime needlestick injuries among the primary studies ranged from 13.2 to 55.1% and 18.6 to 63.6%, respectively. The pooled prevalence of needlestick injuries among the Ethiopian healthcare workers was 28.8% (95% CI 23.0-34.5) and 43.6% (95% CI 35.3-52.0) for the 12 months and lifetime, respectively.

CONCLUSIONS

The pooled prevalence of needlestick injuries among Ethiopian healthcare workers was high. Therefore, efforts should be implemented to reduce the occurrence of injuries. Adequate protective equipment and safety-engineered devices should be supplied for the healthcare workers. It could be more effective to reduce the factors contributing to increased exposures through the allocation of adequate numbers of the healthcare workforce and implementing in-service training.