Prevalence of injuries and reporting of accidents among health care workers at the University Hospital of the West Indies

HIV/AIDS post-exposure prophylaxis knowledge and uptake among health professionals in Africa: Systematic review and meta-analysis

BACKGROUND

Healthcare workers in developing countries are at particularly increased risk of infections from blood-borne pathogens because of the high prevalence of such pathogens in their communities as well as the lack of basic personal protective equipment, such as gloves, gowns and goggles. For those exposed healthcare workers, the immediate administration of antiretroviral drugs following exposure to potentially infected blood or other bodily fluids is essential in order to minimize the risk of acquiring HIV infection. This review is aimed at estimating the pooled prevalence of knowledge and uptake of post-exposure prophylaxis among healthcare providers in Africa.

METHODS

We accessed PubMed, Science Direct, Google Scholar, SCOPUS, African Journals Online (AJOL), Journal Storage (JSTOR) and EMBASE. The search for unpublished studies included Google and institutional repositories were also used. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of studies was assessed using the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out with a random-effects method using STATA v.14 software.

RESULTS

Out of 654 692 studies retrieved, 37 studies from four African regions involving 6482 healthcare providers were included in this meta-analysis. The overall estimated pooled uptake and knowledge of HIV/AIDS post-exposure prophylaxis among healthcare providers in Africa using a random-effects model were 40.09% (95% CI: 30.14-50.04) and 57.67% (95% CI: 44.32-71.01) respectively, whereas the highest uptake and knowledge were 45.48% (95% CI: 24.79-66.17) and 61.37% (95% CI: 46.39-76.36) in the southern and eastern regions, respectively.

CONCLUSIONS

The results of this meta-analysis indicated that the knowledge and uptake of post-exposure prophylaxis, one of the best approaches to tackling HIV/AIDS transmission, are significantly low. Therefore, healthcare organizations should work on strategies to increase knowledge and uptake of post-exposure prophylaxis among healthcare providers.

REGISTRATION

Prospero (ID: CRD42021244003).

Health and Mortality in Korean Healthcare Workers

BACKGROUND

To evaluate the health status of healthcare workers (doctors and nurses) compared to those in the general population based on the National Health Insurance Service database and the cause of death data from Statistics Korea.

METHODS

The subjects of this study were 104,484 doctors and 220,310 nurses working in healthcare facilities from 2002 to 2017, and who had undergone at least one general medical examination. Based on the subject definition, the subject data were extracted from the National Health Insurance healthcare facility database and qualification database. We collected medical use details included in the research database, general medical examination results, medical history included in the health examination database, and additional data on the cause of death from the National Statistics database to analyze the main cause of death and mortality.

RESULTS

In terms of the major causes of death and mortality among healthcare workers, the mortality rate associated with intentional self-harm, injury, transportation accident, heart disease, addiction, and falling was significantly higher than that in the general population. Further, the prevalence of respiratory and gastrointestinal diseases was high. When analyzing the proportional mortality ratio (PMR) by cause of death for healthcare workers, the PMR values for death related to malignant neoplasm was the highest. In terms of diseases, both doctors and nurses had higher rates of infectious diseases such as maternal sepsis, rubella, and measles.

CONCLUSION

The health status of healthcare workers differs from that of the general population. Thus, it is important to consider the occupational characteristics of healthcare personnel. This study is unique in that it was conducted based on medical use indicators rather than survey data.

Factors influencing knowledge, awareness, and compliance with standard precautions among psychiatric nurses

This study aimed to assess the level of knowledge, awareness, and compliance with standard precautions and to examine individual factors related to compliance with standard precautions among psychiatric nurses. Data were collected from September 2020 to March 2021. A total of 160 questionnaires were distributed, and a total sample of 134 valid questionnaires was analyzed. Compliance with standard precautions was significantly correlated with knowledge and awareness. Awareness (β = 0.547, p < .001) was a significant factor of compliance with a total explanatory power of 35.0% (F = 7.27, p < .001). Thus, the current coronavirus disease pandemic has significantly influenced the mental health infection system. These findings highlighted that psychiatric nurse must continue their efforts to improve compliance with infection prevention to prepare for an uncertain future with potential pandemics.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia

Background

Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia.

Methods

An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs.

Main findings

The prevalence of NSSIs was 29.5% (95% CI: 24.2–35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18–4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10–5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13–4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14–4.41).

Conclusion

This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

A Retrospective Analysis of Non-Sharps-Related Injuries in a Dental School

OBJECTIVES

Workplace non-sharps injuries are a common occurrence in a dental school setting. In dentistry, the importance of preventing non-sharps injuries is often overlooked due to emphasis on sharps-related injuries. The aim of this research was to analyse the incidences of non-sharps injuries over an 11-year period in a dental school to identify trends and the possible causative factors for these injuries.

METHODS

Injury reports lodged with the University of Queensland Workplace Health and Safety databases between 2009 and 2019 were categorised and analysed.

RESULTS

Of 1156 incidents reported, 35.7% (n = 413) were non-sharps injuries, and the most common type of non-sharps injury was general incidents (48.4%, n = 200). The most common body site for injury was the hands (19.4%, n = 80), and the most common location where an injury occurred was in clinical patient care (53.8%, n = 222). The personnel type most at risk of a non-sharps injury fluctuated between students and staff throughout the study period.

CONCLUSIONS

All personnel, including students and staff, are at similar risk of experiencing a non-sharps injury within a dental school setting. The equipment and facilities of a dental clinic as well as the level of adherence to safe working procedures are contributing factors. Continuous quality improvement is essential for minimising these injuries.

The impact of occupational splash, sharps and needlestick injuries (SSNIs) on the quality of life of healthcare workers in a Kenyan university hospital

BACKGROUND

Infection as a consequence of splash sharps and needlestick injuries (SSNIs) is a hazard faced by healthcare workers. Little is known about the impact this has on quality of life particularly in countries where the risk of infection is high.

OBJECTIVE

This study aims to describe the impact SSNIs have on the quality of life of healthcare workers in Kenya, where blood borne illness prevalence is high.

METHODS

A hospital-wide survey of a facility in Nairobi was conducted. Data was collected online from at risk healthcare workers using Burckhardt and Anderson's Quality of Life Scale (QOLS) and a 10-item symptoms questionnaire.

RESULTS

Of the 416 participants, 192 (46.2%) had experienced SSNIs. Their mean QOLS scores were considerably lower than that predicted for a healthy population. The relationship between symptoms and QOLS scores showed a strong positive correlation (Pearson's r = 0.753). Tests of association between QOLS scores and SSNI type, anti-retroviral (ARV) drug use, educational level and staff cadre revealed significant association (p < 0.05). However, on key demographic variables, the association was non-dependent, indicating that the impact was felt similarly by many staff.

CONCLUSIONS

SSNIs clearly impact on healthcare workers quality of life. Hospital management should ensure measures are taken to reduce SSNIs and provide appropriate personal protection equipment. For staff experiencing an SSNI, psychological wellbeing should be assessed and appropriate expert help provided.

Detection of hepatitis C virus (HCV) among health care providers in an Egyptian university hospital: different diagnostic modalities

Background

Hepatitis C virus (HCV) infection has received much attention and is placed at the core of the infection control agenda. It is considered as a major public health problem in Egypt, where the highest prevalence of HCV exists. The great risk of exposure to infection of health care providers (HCPs) has highlighted the urgent need for implementing an infection control program.

Objective

The purpose of this study was to detect the prevalence of HCV infection among HCPs in Zagazig University Hospitals and to assess the performance of different diagnostic modalities.

Methodology

Blood, polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), and saliva tests were performed in enrolled HCPs.

Results

This study compared HCV diagnosis Hepanostika HCV Ultra ELISA as a screening test and PCR as gold standard test, which resulted in 40.6% positive results by ELISA compared to 34.8% by PCR (p<0.0001), while OraQuick HCV rapid antibody compared to PCR shows that 37.7% of the participants were positive by OraQuick HCV rapid antibody test. Application of standard precautions while dealing with blood has negative significant correlation with HCV infection (r_s=−0.265, p=0.03).

Conclusion

HCPs at Zagazig University Hospitals are at high risk for HCV infection. Lack of compliance and awareness of prevention and control of the infection are associated cofactors. Serum HCV-Ab detection by Hepanostika HCV Ultra ELISA and OraQuick HCV rapid antibody test are sensitive and specific serologic assays for diagnosis with correspondent results to that obtained by quantitative real-time PCR.

Prevalence of Needlestick Injuries Among Healthcare Workers in the Accident and Emergency Department of a Teaching Hospital in Nigeria

Background:

Healthcare workers (HCWs) are continually exposed to hazards from contact with blood and body fluids of patients in the healthcare setting.

Aim:

To determine the prevalence of needlestick injuries (NSIs) and associated factors among HCWs in the Accident and Emergency Department of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria.

Subjects and Methods:

This was a cross-sectional study. Data were collected using a structured, self-administered questionnaire and analyzed using IBM SPSS version 20. Univariate, bivariate, and binary logistic regression analyses were done. The level of significance was set at P < 0.05.

Results:

The prevalence of NSIs 12 months preceding the study was 51.0% (50/98). Doctors 8/10 (80.0%) and nurses 28/40 (70.0%) had the highest occurrence. Recapping of needles 19/50 (38.0%) and patient aggression 13/50 (26.0%) were responsible for most injuries. The majority 31/50 (62.0%) of the injuries were not reported. The uptake of postexposure prophylaxis (PEP) was low 11/50 (22.0%). The factors that were significantly associated with NSI include age 30 years and above (odds ratio [OR] =0.28, confidence interval [CI] = 0.11–0.70), work duration of three years and above (OR = 0.29, CI = 0.11–0.75), and being a nurse (OR = 3.38, CI = 1.49–9.93) or a paramedic (OR = 0.18, CI = 0.06–0.52).

Conclusion:

The high prevalence of NSIs among the HCWs, especially in doctors and nurses is an indication that HCWs in UBTH are at great risk of contracting blood-borne infections. Efforts should be made to ensure that injuries are reported and appropriate PEP undertaken following NSIs.

Prevalence and risk factors of needlestick injuries, sharps injuries, and blood and body fluid exposures among operating room nurses in Thailand

BACKGROUND

Operating room nurses are at high risk for occupational exposure to bloodborne pathogens. This study examined the prevalence of and risk factors for needlestick injuries (NSIs), sharps injuries (SIs), and blood and body fluid exposures (BBFEs) among operating room nurses in Thai hospitals.

METHODS

A cross-sectional study was performed in 247 Thai hospitals. Questionnaires eliciting demographic data and information on injury occurrence and risk factors were distributed to 2500 operating room nurses, and 2031 usable questionnaires were returned, for a response rate of 81.2%. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression analysis.

RESULTS

The prevalence of NSIs, SIs, and BBFEs was 23.7%, 9.8%, and 40.0%, respectively. Risk factors for NSIs were training without practice (OR, 1.67; 95% CI, 1.29-2.17), haste (OR, 4.81; 95% CI, 3.41-6.79), lack of awareness (OR, 1.36; 95% CI, 1.04-1.77), inadequate staffing (OR, 1.60; 95% CI, 1.21-2.11), and outdated guidelines (OR, 1.69; 95% CI, 1.04-2.74). One risk factor was identified for SIs: haste (OR, 2.43; 95% CI, 1.57-3.76). Risk factors for BBFEs were long working hours per week (OR, 2.07; 95% CI, 1.06-4.04), training without practice (OR, 1.55; 95% CI, 1.25-1.91), haste (OR, 1.66; 95% CI, 1.30-2.13), lack of awareness (OR, 1.54; 95% CI, 1.22-1.95), not wearing protective equipment (OR, 1.61; 95% CI, 1.26-2.06), and inadequate staffing (OR, 1.63; 95% CI, 1.26-2.11).

CONCLUSION

This study highlights the high prevalence of NSIs, SIs, and BBFEs among Thai operating room nurses. Preventable risk factors were identified. Appropriate guidelines, adequate staffing, proper training, and self-awareness may reduce these occurrences.

Factors Associated with Occupational Needle Stick and Sharps Injuries among Hospital Healthcare Workers in Bale Zone, Southeast Ethiopia

BACKGROUND

Needle stick and sharps injuries are occupational hazards to healthcare workers. Every day healthcare workers are exposed to deadly blood borne pathogens through contaminated needles and other sharp objects. About twenty blood borne pathogens can be transmitted through accidental needle stick and sharp injury. The study was conducted to determine the lifetime and past one year prevalence of needle stick and sharps injuries and factors associated with the past one year injuries among hospital healthcare workers in Southeast Ethiopia.

METHODS

An institutional based cross sectional study was conducted in December 2014 among healthcare workers in four hospitals of Bale zone, Southeast of Ethiopia. A total of 362 healthcare workers were selected randomly from each department in the hospitals. Data were collected using self-administered questionnaire. The collected data were entered into Epi-Info version 3.5 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was used to identify the independent effect of each independent variable on the outcome variable. Written informed consent was secured from the participants.

RESULTS

The prevalence of lifetime needle stick and sharp injury was 37.1% with 95% CI of 32.0% to 42.5%. The prevalence of injury within the past one year was 19.1% with 95% CI of 14.9% to 23.3%. Emergency ward was a department with highest needle stick and sharp injury (31.7%). The main cause of injury was syringe needles (69.8%). Participants who practiced needle recapping had higher odds of needle stick and sharp injury within the past 12 months (AOR = 3.23, 95% CI: 1.78, 5.84) compared to their counterparts.

CONCLUSIONS

Nearly one out of five respondents had experienced needle stick and/or sharp injury at least once within past one year. There were practices and behaviors that put healthcare workers at risk of needle stick and sharp injury at the study area. Needle recapping was key modifiable risk behavior. Health policy makers and hospital administrators should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.

Post-exposure prophylaxis in resource-poor settings: review and recommendations for pre-departure risk assessment and planning for expatriate healthcare workers

It is estimated that more than 3 million healthcare workers worldwide suffer needlestick and splash injuries whilst at work resulting in the potential transmission of blood-borne pathogens via exposure to bodily fluids. Under-reporting and the subsequent management of occupational injuries is a problem both in the United Kingdom and abroad. Many expatriate health care workers will work in low resource settings where the risk of transmission is greatest but in contrast to wealthier countries such as the United Kingdom, there is often a lack of effective systems for its safe management. This article provides important information about this risk and how to minimise it. The reasons for an increased risk in transmission, its subsequent management and pre-departure planning are discussed, together with the evidence for initiation of post-exposure prophylaxis; current National and International guidelines as well as the urgent need for International standardisation of these is also discussed.

The comparison of sharps injuries reported by doctors versus nurses from surgical wards in the context of the prevalence of HBV, HCV and HIV infections

The aim of the study was to evaluate the nature and frequency of sharps injuries among doctors and nurses from the same surgical/gynecological wards and the prevalence of HBV/HCV/HIV infection.

MATERIAL AND METHODS

An anonymous cross-sectional sero-survey, with ELISA system used to detect anti-HBc, anti-HCV, anti-HIV, was conducted among 89 doctors and 414 nurses from 16 randomly selected hospitals in West Pomerania, Poland, between January-June 2009.

RESULTS

During the preceding 12 months, 82% doctors and 44.4% nurses (p<0.0001) had sustained at least one sharps injury; 12.3% doctors vs 2.2% nurses (p<0.003) sustained more than 10 injuries. The multivariable regression model revealed that being a doctor was associated with a greater odds (OR 4.2) of being injured with sharps. Sixty nine percent of nurses sustained a hollow-bore needle injury vs 8.9% doctors; p<0.001. Anti-HBc were found in 16.4% of doctors and 11.2% of nurses, p>0.28; anti-HCV - in 1.1% of doctors vs 1.4% of nurses, p>0.79; no anti-HIV positive cases were found. The analysis of potential risk factors for contracting a HBV revealed that for both job categories only length of employment was associated with an increased odds of being infected.

CONCLUSIONS

Although the prevalence of HBV/HCV infection between doctors and nurses does not differ significantly, modifiable risk factors for contracting a BBI such as frequency and nature of sharps injuries may differ, which call for tailoring preventive measures to specific job categories. Long lasting exposure to injury events should be taken into consideration while assessing the risk for accuiring an occupational infection with HBV, HCV or HIV.