Exposure rate of needlestick and sharps injuries among Australian veterinarians

Background  

Needlestick and sharps injuries (NSI) represent an important occupational health issue in veterinary practice. Little is known about the distribution and correlates of NSI among Australian veterinarians.     

护士针刺伤综合干预效果分析

目的探讨对护士进行针刺伤综合干预的效果。方法采取规范操作流程、职业安全培训、操作演练和督查相结合的方法对护士进行针刺伤综合干预,比较干预前后护士针刺伤发生情况。结果 2012年护士针刺伤发生率为2.38%,低于2011年的11.44%,差异有统计学意义(χ2=20.022,P0.001)。2012年护士临床工作中拔针环节、注射及采血环节针刺伤发生率较2011年明显降低(均P0.01),差异均有统计学意义(均P0.05)。结论对护士实施针刺伤综合干预,可以有效减少其针刺伤的发生,值得推广应用。     

监狱干警组织支持感与工作满意度关系

目的 探讨监狱干警组织支持感与工作满意度的关系,以及组织承诺在两者之间的中介作用.方法 采用整群抽样的方法对辽宁省3所监狱的1 048名干警进行问卷调查,采用SPSS 17.0和Amos 7.0软件进行数据分析.结果 监狱警察的组织支持感与工作满意度呈明显正相关(β=0.621,P<0.001),其对工作满意度的变异解释度为38.1%;组织承诺与工作满意度也呈明显的正相关(β=0.287,P<0.001),其对工作满意度的变异解释度为7.6%;组织支持感对工作满意度的直接效应为0.53,间接效应为0.13,总效应为0.66.结论 组织支持感和组织承诺是工作满意度的重要预测变量,组织承诺在组织支持与工作满意度的关系中起部分中介作用,组织支持对工作满意度的直接作用大于间接作用.     

监狱警察工作绩效现状及其影响因素

目的了解监狱警察工作绩效现状及其影响因素,为有效开展警察绩效管理提供参考。方法采用随机整群抽样方法对辽宁省3所监狱抽取的1 048名监狱警察进行问卷调查。结果监狱警察工作绩效总分为(74.11±12.82)分,工作奉献、任务绩效、人际促进3个维度得分分别为(26.53±5.35)、(23.50±4.34)、(24.08±4.29)分;分层回归分析结果表明,将控制变量、自变量、调节变量和交互作用变量全部放入回归模型后,监狱警察工作绩效的主要影响因素为:回报(β=0.224)、超负荷(β=0.084)、工作-家庭冲突(β=0.293)、家庭-工作冲突(β=-0.307)、组织支持感(β=0.277)、回报×组织支持感(β=0.130)、超负荷×组织支持感(β=-0.081)、工作-家庭冲突×组织支持感(β=-0.171)和家庭-工作冲突×组织支持感(β=0.119),对工作绩效解释的变异量为32.1%。结论付出-回报失衡、工作-家庭冲突、组织支持感对监狱警察工作绩效有较好的预测作用。     

Preventing needlestick injuries among healthcare workers: a WHO-ICN collaboration

Effective measures to prevent infections from occupaonal exposure of healthcare workers to blood include mmunization against HBV, eliminating unnecessary injections, implementing Universal Precautions, eliminating needle recapping and disposing of the sharp into a sharps container immediately after use, use of safer devices such as needles that sheath or retract after use, provision and use of personal protective equipment, and training workers in the risks and prevention of transmission. Post-exposure prophylaxis with antiretroviral medications can reduce the risk of HIV transmission by 80%. In 2003, the World Health Organization and the International Council of Nurses launched a pilot project in three countries to protect healthcare workers from needlestick injuries. The results of the pilot will be disseminated worldwide, along with best policies and practices for prevention.     

中国护士静脉采血针刺伤现状调查

目的了解护理人员静脉采血过程中针刺伤现状,探讨有效防护策略。方法采用分层整群抽样的方法对中国临床一线护士进行问卷调查。问卷内容包括护士的一般资料及护理人员静脉采血培训与管理状况、采血前戴手套依从性、近一年因静脉采血发生针刺伤的情况等。结果共发放问卷2 861份,回收有效问卷2 575份。护士定期参加静脉采血培训的占93.17%;定期进行静脉采血考核的占87.15%;仅72.74%护士在采血前了解患者是否患有血源性传染病;采血时坚持佩戴手套的仅61.01%;近一年,因采血发生针刺伤的占20.78%。使用三种不同针具静脉采血时针刺伤的发生率比较,差异无统计学意义(Pearsonχ2=1.649,P=0.438)。48.21%的静脉采血针刺伤发生在整理医疗废物时。结论中国护士静脉采血培训与管理较好,但针刺伤发生率仍较高。预防针刺伤应制定静脉采血安全操作规程,规范操作流程,明确培训内容,以改变护理人员不安全的行为。     

医务人员针刺伤现况调查分析

目的分析目前掌握的针刺伤发生特点,寻找医护人员发生针刺伤的根本原因并制定整改措施,以减少针刺伤的发生,保护医护人员的职业安全。方法收集某医院2011-2012年发生针刺伤医务人员及相应患者的资料,分析针刺伤发生特点,采用根本原因分析法寻找针刺伤的直接原因和根本原因。结果 2011-2012年共发生针刺伤58人,其中护理人员39人占67.2%,实习生22人占37.9%;针刺伤发生频率为2.4人/月,每年的8月份发生频率最高,为16人占27.6%,81.0%的锐器暴露过患者的体液;发生针刺伤的根本原因是静脉输液多、工作量大、人员配备不齐;缺乏预防针刺伤的标准操作流程,职业防护教育宣传不到位。结论针刺伤的危害不容忽视,依据针刺伤的根本原因,制定相应的整改措施,以减少类似不良事件发生。     

An exploratory study of poor adjustment styles among retirees

This paper focuses on the one third of retirees who report difficulty in making the transition from work to retirement. On the basis of Levy's [16] research, it is hypothesized that there are different styles of poor adjustment that have different consequences for the retirees experiencing them. Data from 487 male and female retirees identify four poor adjustment styles--poor health, negativism, change adaptation and retirement reluctance. While the latter two responses to retirement tend to be problems only in the short term, the former two may have far reaching consequences. Health related retirement and negativism about retiring were linked with low activity and involvement, poor physical and mental health, inadequate income and low life satisfaction in the years following retirement.     

Self-care among healthcare social workers: An exploratory study

Despite growing interest in self-care, few studies have explicitly examined the self-care practices of healthcare social workers. This exploratory study investigated self-care among practitioners (N = 138) in one southeastern state. Overall, data suggest that healthcare social workers only moderately engaged in self-care. Additionally, analyses revealed significant differences in self-care practices by financial stability, overall health, and licensure status, respectively. Interestingly, perceived health status and current financial situation were significant predictors for overall self-care practices. After a brief review of the literature, this narrative will explicate findings, elucidate discussion points, identify salient implications, and conclude with areas for future research.     

Risk of transmission of tuberculosis among inmates of an Australian prison

In a prison in Victoria, Australia, our objectives were contact tracing of inmates and staff at risk of exposure to an identified index case; and to determine risk factors for prevalent and incident infection. Inmates and staff who were potentially exposed to the index case were screened with a Mantoux skin test and a questionnaire. Inmate movements within the prison were compared to movements of the index case. Logistic regression was used to determine risk factors for infection. The index case had smear positive, cavitating pulmonary tuberculosis (TB), which was undiagnosed for 3 months. This was the period of potential exposure. The prevalence of positive skin test reactions in 190 inmates and staff at the prison was 10%. Significant predictors of a positive skin test were being an inmate (odds ratio (OR) 15.5), older age (OR 8.3) and being born overseas (OR 10.7). Bacille Calmette Guerin (BCG) vaccination, proximity to the index case in various prison sites, duration of incarceration, number of incarcerations and number of inmates per cell were not significant. There were three recent skin test conversions from negative to positive, representing a conversion rate of 3.5%. We did not find evidence of significant transmission of TB from a single index case. The prevalence of infection in this Australian prison was lower than published rates in other countries. Better prison conditions and different demographics of prison inmates in Australia may explain these differences.     

Impact of a shielded safety syringe on needlestick injuries among healthcare workers.

OBJECTIVES: Evaluate the impact of a shielded 3 cc safety syringe on needlestick injuries among healthcare workers. DESIGN: Surveillance study. SETTING: Three medical centers. RESULTS: The total number of needlesticks from all sources rose from 134 during the baseline period to 140 during the study phase. However, the overall rate of needlesticks involving 3 cc syringes decreased from 14/100,000 inventory units to 2/100,000, and the frequency declined substantially at each of the participating medical centers. CONCLUSIONS: These results suggest that shielded syringes and related technology may offer potential for reducing the risk of needlestick injuries among hospital and other healthcare employees. This study should be viewed as a preliminary effort to assess the potential of shielded-syringe technology for reducing the risk of needlestick injuries among healthcare workers. The results are encouraging, but more clinical experience with this new device and longer follow up are essential to provide the data necessary for a definitive assessment of efficacy.     

Work schedule, needle use, and needlestick injuries among registered nurses.

OBJECTIVE: To examine the association between working conditions and needlestick injury among registered nurses. We also describe needle use and needlestick injuries according to nursing position, workplace, and specialty. DESIGN: Three-wave longitudinal survey conducted between November 2002 and April 2004. SETTING AND PARTICIPANTS: A probability sample of 2,624 actively licensed registered nurses from 2 states in the United States. Follow-up rates for waves 2 and 3 were 85% and 86%, respectively. Respondents who had worked as a nurse during the past year (n=2,273) prior to wave 1 were included in this analysis. RESULTS: Of the nurses, 15.6% reported a history of needlestick injury in the year before wave 1, and the cumulative incidence by wave 3 was 16.3%. The estimated number of needles used per day was significantly related to the odds of sustaining a needlestick injury. Hours worked per day, weekends worked per month, working other than day shifts, and working 13 or more hours per day at least once a week were each significantly associated with needlestick injuries. A factor combining these variables was significantly associated with needlestick injuries even after adjustment for job demands, although this association was somewhat explained by physical job demands. CONCLUSIONS: Despite advances in protecting workers from needlestick injuries, extended work schedules and their concomitant physical demands are still contributing to the occurrence of injuries and illnesses to nurses. Such working conditions, if modified, could lead to further reductions in needlestick injuries.     

应用信息化技术调查护生针刺伤现状

目的 了解护生针刺伤发生现状，探讨有效的职业暴露应对策略。方法 回顾性调查某院2016—2018年临床实习护生针刺伤发生情况。护生在进入临床实习前，统一登记基本资料，并对其进行感染预防及控制相关知识培训，告知护生发生针刺伤后应经蓝蜻蜓医院感染实时监控管理系统上报。通过蓝蜻蜓系统导出护生针刺伤相关数据进行统计、分析。结果 共调查2 099名护生，其中男生256名，女生1 843名；大专生1 117名，本科生921名，国内硕士研究生34名，外籍硕士研究生27名。发生针刺伤232例次，针刺伤发生率为11.05%。不同性别、学历、实习阶段、科室护生针刺伤发生率比较差异有统计学意义（均P<0.05）。在操作环节分布上，分离针头、拔针和回套针帽时针刺伤所占比率分别为28.88%、21.55%和18.10%。在暴露源的分布上，HBV和梅毒分别占21.12%、6.90%。在暴露场所分布上，发生在病房的针刺伤占32.33%。结论 该院护生针刺伤发生率较低，但女性实习生、学历较低者、实习第一阶段、分离针头时、回套针帽时针刺伤发生率较高。应加强安全注射规范化培训，制定个性化培训方案等。     

应用信息化技术调查护生针刺伤现状

目的了解护生针刺伤发生现状,探讨有效的职业暴露应对策略。方法回顾性调查某院2016—2018年临床实习护生针刺伤发生情况。护生在进入临床实习前,统一登记基本资料,并对其进行感染预防及控制相关知识培训,告知护生发生针刺伤后应经蓝蜻蜓医院感染实时监控管理系统上报。通过蓝蜻蜓系统导出护生针刺伤相关数据进行统计、分析。结果共调查2 099名护生,其中男生256名,女生1 843名;大专生1 117名,本科生921名,国内硕士研究生34名,外籍硕士研究生27名。发生针刺伤232例次,针刺伤发生率为11.05%。不同性别、学历、实习阶段、科室护生针刺伤发生率比较差异有统计学意义(均P0.05)。在操作环节分布上,分离针头、拔针和回套针帽时针刺伤所占比率分别为28.88%、21.55%和18.10%。在暴露源的分布上,HBV和梅毒分别占21.12%、6.90%。在暴露场所分布上,发生在病房的针刺伤占32.33%。结论该院护生针刺伤发生率较低,但女性实习生、学历较低者、实习第一阶段、分离针头时、回套针帽时针刺伤发生率较高。应加强安全注射规范化培训,制定个性化培训方案等。     

Risk of needlestick injuries by injection pens

Injection pens are used by patients when auto-administering medication (insulin, interferon, apokinon etc.) by the subcutaneous route. The objective of this study was to evaluate the rate of injection pen use by healthcare workers (HCWs) and the associated risk of needlestick injuries to document and compare injury rates between injection pens and subcutaneous syringes. A one-year retrospective study was conducted in 24 sentinel French public hospitals. All needlestick injuries linked to subcutaneous injection procedures, which were voluntarily reported to occupational medicine departments by HCWs between October 1999 and September 2000, were documented using a standardized questionnaire. Additional data (total number of needlestick injuries reported, number of subcutaneous injection devices purchased) were collected over the same period. A total of 144 needlestick injuries associated with subcutaneous injection were reported. The needlestick injury rate for injection pens was six times the rate for disposable syringes. Needlestick injuries with injection pens accounted for 39% of needlestick injuries linked with subcutaneous injection. In all, 60% of needlestick injuries with injection pens were related to disassembly. Injection pens are associated with needlestick injuries six times more often than syringes. Nevertheless, injection pens have been shown to improve the quality of treatment for patients and may improve treatment observance. This study points to the need for safety-engineered injection pens.     

An exploratory pilot study of childhood injuries on cattle farms in Jalisco, Mexico

Childhood agricultural injuries have been a concern in the United States for many years. Much research has been performed on the cause and prevention of such injuries. The North American Guidelines for Children's Agricultural Tasks (NAGCAT) have been developed in the United States to address the common agricultural tasks and injuries sustained by children. Data are lacking concerning the common agricultural tasks and injuries of children working on Mexican farms. The goal of the study was to determine if the NAGCAT guidelines developed for the United States may be applicable to children in Jalisco, Mexico. Interviews of local physicians were performed regarding their perception of common childhood agricultural injuries. Interviews about common childhood agricultural tasks and injuries were performed at 27 farms through the help of a local cooperative. Work practices at these farms were also observed. Emergency department records were reviewed for childhood agricultural injuries. Surveys of local cattle farms revealed the most common childhood agricultural tasks were feeding animals, milking cows, and cleaning corrals. Through the same cattle farm interviews, the most common childhood agricultural injuries included being kicked by an animal, scorpion bites, cuts, and falls. Physician interviews revealed machinery, poisonings, cuts, and lacerations as the most common injuries. Due to the lack of adequate documentation, the emergency department medical record review was not useful. The NAGCAT guidelines address many of the common tasks and injuries in the Tepatitlán area, including animal care, operating machinery, and cleaning corrals. There are other common injuries in the Tepatitlán area such as scorpion bites for which no NAGCAT guidelines currently exist but for which guidelines could be developed. Once translated to Spanish and adjusted for cultural relevancy, the NAGCAT guidelines would address many of the common agricultural tasks and injuries of children in Jalisco, Mexico.     

Reported needlestick and sharp injuries among health care workers in a Greek general hospital

Between July 1990 and June 1996, 284 exposures to infectious material were reported by 247 health care workers (HCWs) at AHEPA University Hospital, Thessaloniki, Greece, representing an overall rate of 2.4% reported injuries per 100 HCWs/year. Nurses reported the highest rates of incidents (3.0%) and in all but one working group women exhibited higher injury rates per year than male HCWs. Young workers (21-30 years old) were primarily affected in incidents (P < 0.001). Needles were the most common implement causing injury (60.6%) and resheathing of used needles as well as garbage collection were common causes of injury. None of the HCWs seroconverted in exposures where immune status to blood-borne pathogens was estimated. Efforts by the infection control committee need to be more intense, in order to increase the rate of reported staff injuries. This will facilitate identification of unsafe practices and provide more adequate preventive measures.     

Nine prison officers charged in beating of HIV-positive inmate

John Edwards, an HIV-positive inmate at Charlotte Correctional Institution, attempted suicide after several corrections officers and supervisors allegedly punched and kicked him over a period of three days. When Edwards was found, his wounds were bandaged, and he was chained to a bed in the psychiatric unit. The abuse by the officers continued, and eventually Edwards died due to blood loss. After assaulting Edwards, the officers discussed how to prepare false reports justifying their use of force. The officers were indicted on civil rights charges and for witness tampering.