The Influence of Knife Sharpness on Forearm Wounds in Knife Slash Cases / 医用生物力学

Objective To quantitatively explore the influence of knife sharpness on forearm wounds in knife slash cases. Methods The finite element models of the upper limb and knives with 3 degrees of sharpness (with sharp blade, blunt blade, wide blade) were developed based on human CT images and prototype of slash knife. The slash by 3 kinds of knives on the forearm at velocity of 4 m/s and duration of 10 ms was simulated, so as to analyze changes in contact forces, wound dimensions and energy. Results During the slash by knives with sharp, blunt, wide blade, the blades reached the ulna at about 65, 85, 95 ms, respectively. The corresponding slash forces were 846, 1 064 and 1 865 N; the wound lengths were 135.64, 105.47 and 99.23 mm; the wound depths were 38.77, 27.81 and 18.74 mm. With the sharpness of blade decreasing, the wound formation was slowed, the length and depth decreased and the slash force increased. The model system for slash knife with sharp blade had obviously greater total energy and inner energy, but smaller kinetic energy, compared with slash knife with blunt blade and wide blade. Conclusions The method for quantitatively assessing wound formation in knife slash upon the forearm was developed. The research findings deepen the understanding of biomechanical mechanism of wound formation by knife slash, and provide new scientific means for forensic investigation and court trial of knife slash cases.

Development of a new type of ampoule cutter / 中国实用护理杂志

Objective@#To develop a new practical ampule cutter with simple operation.@*Methods@#According to the actual clinical situation, the structure of the ampoule cutting device were designed, which was mainly divided into three parts: the handle, the ampoule cutting tube and the ampoule cutting device.@*Results@#The device can effectively cut the bottleneck of ampoule bottle and avoid the injury of sharp instrument and drug contamination caused by traditional breaking the bottleneck of ampoule bottle.@*Conclusion@#This kind of ampoule cutter can break the bottleneck of ampoule effectively, avoid the cross infection of medical staff, improve the work efficiency of medical staff and the effective utilization rate of medicine.

Development of a new type of ampoule cutter / 中国实用护理杂志

Objective To develop a new practical ampule cutter with simple operation. Methods According to the actual clinical situation, the structure of the ampoule cutting device were designed, which was mainly divided into three parts: the handle, the ampoule cutting tube and the ampoule cutting device. Results The device can effectively cut the bottleneck of ampoule bottle and avoid the injury of sharp instrument and drug contamination caused by traditional breaking the bottleneck of ampoule bottle. Conclusion This kind of ampoule cutter can break the bottleneck of ampoule effectively, avoid the cross infection of medical staff, improve the work efficiency of medical staff and the effective utilization rate of medicine.

Application situation, existing problems, and improvement ideas of sharps containers / 中国感染控制杂志

Sharp injury is a common occupational injury occurs in hospital, it is also an important way for health care workers to be infected with blood-borne pathogens, standardized use of sharps containers can effectively prevent the occurrence of sharp injury.Sharps containers are widely used in China, but the specifications are limited and the products are single, there is still room for improving safety performance.In view of the problems existing in clinical use, Chinese scholars have made a lot of improvements on sharps containers.The author suggests that relevant units should consider the design concept of clinic to develop and popularize more reasonable safe sharps containers for clinical application, and take other comprehensive behavioral control measures, so as to effectively reduce the occurrence of sharp injury.

Sharp injuries among health care workers in Xuzhou / 中国感染控制杂志

Objective To investigate the occurrence and reporting of sharp injuries among health care workers (HCWs)at all levels of hospitals in Xuzhou City,provide evidences for formulating protective measures against sharp injuries and improving the reporting system.Methods From July to August 2016,13 hospitals in Xuzhou City were randomly selected by multi-stage stratified random sampling method,the general information,occurrence of sharp injuries,and reporting situation was performed questionnaire survey.Results A total of 2 694 valid question-naires were collected,incidence,case incidence,and reporting rate of sharp injuries were 10.32%,12.84%,and 30.64% respectively.Case incidence of sharp injuries among HCWs in primary,secondary,and tertiary hospitals were 44.83%,11.53%,and 12.52% respectively,case incidences of sharp injuries in different levels of hospitals were significantly different (χ2＝55.148,P＜0.001).The main opportunity for sharp injuries was when HCWs re-turned needle cap (79 cases,22.83%),the main device involving sharp injuries was hollow-bore needle (297 cases, 85.84%).Incidences of sharp injuries among HCWs receiving different training were significantly different (χ2＝66.760,P＜0.001).Conclusion Current situation of sharp injuries among HCWs in this region is not optimistic, there are some problems such as poor training efficacy,low reporting rate and low use rate of safety devices,effec-tive measures should be taken to establish an effective monitoring and tracking system for sharp injuries,so as to re-duce the occurrence of sharp injuries.

Current status and strategies of occupational exposure among health care workers / 中国感染控制杂志

Objective To understand the current situation and characteristics of occupational exposure(OE)among health care workers(HCWs),and provide basis for making preventive measures.Methods Self-designed question-naire about OE was adopted,OE among all HCWs in a hospital in January-December 2015 were surveyed and statis-tically analyzed.Results A total of 1888 HCWs were surveyed,there were 304 cases of OE,the mean OE rate in the whole hospital was 16.10%;OE occurred 370 times(19.60%).Doctors,trainees,and HCWs who worked for≤1 year had relatively higher OE rates,which were 23.18%(102/440),17.88%(49/274),and 18.34%(95/518) respectively.Sharp injury is the main OE mode,accounting for 83.24%(n=308),sharp injuries mainly occurred before disposing the used devices and during the process of use,accounting for 37.99%(n=117)and 36.69%(n=113)respectively.Among 370 times of OE,315 could be traced to the sources of exposure.Among the known ex-posure sources,OE of bloodborne pathogens accounted for 24.13% (n=76).59 of 370 times of OE implemented complete local treatment and reporting procedures,reporting rate of OE was 15.95%.Conclusion Hospital should take comprehensive measures to promote occupational safety precaution,and reduce the incidence of OE.

Comparison of bacterial contamination status of drug injection and nurses' work efficiency by using different ampoule products / 重庆医学

Objective To explore the effect of small package plastic ampoule products in preventing bacterial contamination of injectable drugs.Methods A retrospective study was carried out.In August 2015,78 first-line nurses in our hospital were recruited to the observation group using convenience sampling method,and the other 78 first-line nurses in the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected as the control group at the same period.The control group utilized glass ampoule products in intravenous infusion of drugs,while the observation group utilized plastic ampoule products.Recorded the incidence of bacterial contamination of injectable drugs and sharp instrument injury.Results The incidence rate of bacterial contamination of injectable drugs in the observation group (1.3 ％) was obviously lower than that in the control group (10.2 ％),there was statistically significant difference (P＜0.05).The times expended in opening and identifying ampoule products in the observation group were (20.42±3.22)s and (28.40-4-4.20)s,which were significantly shorter than times expended in the control group[(40.20±4.10)s and (34.20±t5.21)s],there were statistically significant differences (P＜0.05).No sharp instrument injury was observed in the observation group,and the incidence rate of sharp instrument injury in the control group was 5.1 ％,the incidence rate of the observation group was significantly lower than that of the control group (P＜0.05).Conclusion Clinical application of plastic ampoule products can shorten the nurses operating time,effectively prevent the bacterial contamination of injectable drugs,and reduce the occurrence of sharp instrument injury during operation.

Comparison of bacterial contamination status of drug injection and nurses' work efficiency by using different ampoule products / 重庆医学

Objective To explore the effect of small package plastic ampoule products in preventing bacterial contamination of injectable drugs.Methods A retrospective study was carried out.In August 2015,78 first-line nurses in our hospital were recruited to the observation group using convenience sampling method,and the other 78 first-line nurses in the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected as the control group at the same period.The control group utilized glass ampoule products in intravenous infusion of drugs,while the observation group utilized plastic ampoule products.Recorded the incidence of bacterial contamination of injectable drugs and sharp instrument injury.Results The incidence rate of bacterial contamination of injectable drugs in the observation group (1.3 ％) was obviously lower than that in the control group (10.2 ％),there was statistically significant difference (P＜0.05).The times expended in opening and identifying ampoule products in the observation group were (20.42±3.22)s and (28.40-4-4.20)s,which were significantly shorter than times expended in the control group[(40.20±4.10)s and (34.20±t5.21)s],there were statistically significant differences (P＜0.05).No sharp instrument injury was observed in the observation group,and the incidence rate of sharp instrument injury in the control group was 5.1 ％,the incidence rate of the observation group was significantly lower than that of the control group (P＜0.05).Conclusion Clinical application of plastic ampoule products can shorten the nurses operating time,effectively prevent the bacterial contamination of injectable drugs,and reduce the occurrence of sharp instrument injury during operation.

Monitoring on occupational exposure among 3 362 medical postgraduates / 中国感染控制杂志

Objective To realize basic status of occupational exposure among medical postgraduates,and provide theoretical evidence for making occupational precaution measures.Methods Data about occupational exposure among medical postgraduates in a teaching hospital between January 2011 and December 2013 were analyzed retro-spectively.Results A total of 3 362 medical postgraduates were monitored,56 (1 .67%)sustained occupational ex-posure.The most common occupational exposure sites were left hand thumbs(n=15,26.79%),occupational expo-sure most frequently occurred during operation(n=29,51 .79%),a total of 40(71 .43%)occupational exposure oc-curred during the process of operation and invasive procedure,all were sharp injuries.46(82.14%)exposure sources were with bloodborne-transmitted diseases.Surgery students accounted for 66.07%(n =37)of students sustained occupational exposure,exposure rate in master’s candidates was higher than doctoral candidates(2.31 % vs 0.28%,χ2 =18.325,P <0.001 ).After timely treatment and preventive medication,none of the students were infected. Conclusion It is necessary to strengthen the occupational safety education for medical postgraduates,improve pre-caution awareness,standardize all kinds of procedures,and implement standard precaution;timely and effective treatment after exposure is important for reducing occupational injury among medical postgraduates.

Occupational exposure among health care workers at a tertiary comprehensive hospital / 中国感染控制杂志

Objective To investigate occupational exposure among health care workers (HCWs)in a tertiary comprehen-sive hospital,and analyze the causes and preventive measures of occupational exposure.Methods 134 cases of occupational exposure among HCWs in a hospital from January 2010 to December 2013 were analyzed.Results Of HCWs sustained oc-cupational exposure,doctors,nurses,and technicians accounted for 59.70%,19.40%,and 9.70% respectively.The main cause for occupational exposure was non-standardized management of the sharps (46.27%,n=62),followed by unex-pected operation(42.54%,n=57)and inadequate protective measures (11.19%,n=15);The main exposure mode was sharp injury(94.78%,n=127),mucosal exposure accounted for 5.22% (n= 7);42.54% of exposure sources were not clear,57.46% of exposure sources were clear,35.82%,12.69%,3.73%,and 2.24% of which were hepatitis B virus (HBV),hepatitis C virus(HCV),Treponema pallidum(TP),and human immunodeficiency virus(HIV);2.24%(n=3)of exposure sources were co-infection of HBV and HCV;0.74% (n = 1 )was co-infection of HIV,HBV,HCV,and TP. 95.52%of occupational exposures were treated correctly.Conclusion The high-risk population for occupational exposure are nurses,standard occupational precautions and management of the sharps can reduce the occurrence of occupational expo-sure among HCWs.

A multicenter cross-sectional survey on influencing factors for sharp injuries among workers in central sterile supply departments / 中国感染控制杂志

Objective To investigate the incidence and influencing factors for sharp injuries occurred in workers in central sterile supply departments (CSSDs).Methods In October-November 2012,a multicenter cross-sectional survey was conducted,a total of 95 workers in CSSDs of 16 hospitals in Hunan Province were surveyed through questionnaires.Results A total of 89 workers (93.68%)in CSSDs sustained sharp injuries,46 (48.42%)of whom sustained 1 -5 times of sharp injuries,22(23.16%)sustained 6-10 times of sharp injuries,and 11 (11 .58%)sus-tained for at least 10 times of sharp injuries.81 workers (85.26%)sustained at least one time of sharp injuries one year before survey,52 (54.73%)of whom were injured by contaminated needles or other sharps.Logistic regression analysis revealed that higher educational background was protective factor for sharp injuries(OR 90%CI :0.05-0.87);while poor sleep quality(OR 90%CI :1 .03-17.94),frequent touching sharps(OR 90%CI :1 .11 -12.15),and irrational placing of objects by the other medical stuff (surgeons and nurses in operating rooms)(OR 90%CI :1 .23-16.98)were the risk factors for sharp injuries.Conclusion The incidence of sharp injuries among workers in CSSDs is high,which is related to personal factors and environmental factors.It is suggested to strengthen staff training to enhance their awareness of precaution.

Occupational exposure among health care workers in a hospital / 中国感染控制杂志

Objective To understand the characteristics of population distribution,risk factors and risk links of occupational exposure among health care workers(HCWs)in a hospital.Methods Occupational exposure among HCWs between January 2011 and June 2014 were monitored,data about occupational categories of HCWs,expo-sure locations,exposure links and exposure modes were analyzed statistically.Results Among 286 occupational ex-posure cases,the female and male HCWs accounted for 22.03% (n=63)and 77.97% (n=223)respectively;the incidence of occupational exposure in 2011 ,2012,2013 and January-June of 2014 was 38.81 %(n=111),26.22% (n=75),23.43% (n=67)and 11 .54% (n=33)respectively;occupational exposure of junior nurses,doctors,nurs-ing attendants,technicians,senior nurses and cleaners was 31 .97%,19.90%,15.79%,7.64%,4.17%,and 2.84% respectively;exposure mainly occurred at the time of sorting waste,withdrawing or changing needles,dis-carding sharps into sharps containers,surgical suturing or instruments passing,and puncturing (including drawing blood),the constituent ratio was 22.38%,19.58%,14.34%,12.94% and 11 .19%,respectively;the main loca-tions where exposure occurred were wards,operating rooms and injection (treatment)rooms,the constituent ratio was 51 .40%,19.58% and 11 .54% respectively.Conclusion Hospital should establish comprehensive occupational exposure monitoring and risk management system,strengthen standard prevention,enhance the training about occu-pational exposure among high-risk population,and monitor and intervene on risk factors and links,so as to reduce the incidence of HCWs’occupational exposure.

Intraoperative occupational exposure to blood among surgeons / 中国感染控制杂志

Objective To investigate the occurrence of intraoperative occupational exposure to blood among sur-geons in a hospital,so as to make effective precaution measures.Methods Combined with questionnaires,the mo-nitoring data of occupational exposure to blood among surgeons from June 2011 to June 2013 were analyzed statisti-cally.Results A total of 49 surgeons sustained 115 times of occupational exposure to blood,including 42 times (36.52%)in general surgery surgeons,36 (31 .30%)in orthopedic surgeons,31 (26.96%)in obstetrics and gyne-cology surgeons,and 6(5.22%)in urinary surgery surgeons.The main occupational exposure were sharp injuries (n=71 ,61 .74%),blood and body fluid splashing were 44 times (38.26%);the top two exposed sites were hands (49.57%)and faces (17.39%).88.70% of exposed cases were given emergent treatment,and 55.65% of exposed cases were reported.The follow-up found no surgeons were infected after the prompt and correct treatment. Conclusion Surgeons are at high risk of occupational exposure.Occupational precaution should be strengthened, occupational awareness and ability of HCWs should be enhanced,and post-exposure treatment should be improved.

Survey on the current status of sharp injury among 11 358 health care workers in Gansu Province / 中国感染控制杂志

Objective To investigate the incidence of sharp injury (SI)among health care workers(HCWs)in dif-ferent levels of hospitals in Gansu Province,so as to improve HCWs’precaution awareness,standardize behavior, and provide guide for making occupational precaution measures.Methods From January to December 2012,HCWs in 38 medical institutes in Gansu Province were selected with stratified random sampling,HCWs were surveyed through questionnaires and interview.Results A total of 11 358 questionnaires were received,the incidence of SI was 9.87%(n=1 121),case rate was 12.60%(n=1 431),the frequency of SI was 1.05 times/(person·month).SI rates of different genders,positions and years of working were statistically different (all P <0.05).The main medical devices cau-sing SI were syringe needle,venous transfusion scalp needle and surgical suture .SI caused by known sources were 1 099 times (76.80%);980 times (68.48%)of SI were induced by contaminated sources,474 (48.37%)of which were blood-borne diseases,bloodborne disease exposure accounted for 33.12%.Among bloodborne disease exposure,hepatitis B virus accounted for 74.25%,Treponema pallidun 13.10%,hepatitis C virus 12.01% ,and human immunodeficiency virus 0.64%.Conclusion There is a high incidence rate of SI among HCWs in Gansu Province,it is a very important public health problem which needs to be solved.

Monitoring on nurses’occupational exposure to bloodborne pathogens dur-ing blood collection process / 中国感染控制杂志

Objective To investigate the activities associated with nurses’occupational exposure to bloodborne pathogens and the source patients’infection status during blood collection process,so as to provide a basis for developing occupational exposure prevention strategies.Methods Data about occupational exposure to bloodborne pathogens during blood collection process in a hospital from August 2011 to September 2013 were monitored.Results A total of 89 times of bloodborne ex-posure occurred among HCWs,including 75 times of arterial blood collection and 14 venous blood collection.The top three procedures of occupational exposures were rebounding of needles after needles were pulled out (28.09%,n=25),concen-trated cleaning up of rubbish at the end of blood collection (20.22%,n=18),and touching blood and body fluids by skin and mucous membrane (14.61%,n=13).48.31% (n=43)source patients infected with at least hepatitis B virus,hepati-tis C virus ,hepatitis E virus,Treponema pallidum,and human immunodeficiency virus ,51.69%(n=46)source patients were not infected ,after proper handling,none of nurses were infected during blood collection .Conclusion Developing safe blood-withdraw needle,putting sharp instrument into sharp instrument container,wearing gloves,and intensifying training of standard and occupational precaution are important strategies for the reducing of the occurrence of bloodborne exposure of clinical nurses during blood collection process .

Analysis of homicidal deaths in and around Bastar region of Chhattisgarh.

FREEDOM FROM VIOLENCE, not necessarily proportional with development in some basic capabilities like nutrition, longevity and literacy which positively related to economic growth. So, dealing with violence in society is intrinsically a matter of public interest. In present study 79 cases of homicidal deaths due to different mechanical injuries was studied in two year period from 1/1/2009 to 31/12/2010. The incidence of homicidal death was 9.13% during this period. Males affected more in comparison to females. Majority of cases were fall in 21-40 yrs. of age comprising 50 cases (63.28%).Injuries by blunt weapons commonly observed in 30 cases (37.97%) which followed by injuries by sharp weapons 19 cases (24.05%). Totally 329 sharp injuries observed in comparison to 152 blunt injuries. Incidences were prevalent at dense forest area 26 cases (32.91%), in married persons 55 cases (69.62%), in between 6 pm to 12 midnight 24 cases (30.37%) and revenge was main motive 23 cases (29.11%).

Knowledge, attitude and practices on needle-stick and sharps injuries in tertiary care cardiac hospital: A survey.

Aims: One of the potential hazards for health care workers (HCWs) is needle-stick and sharp injuries (NSSIs). The objective of the study was to assess the knowledge and attitude of health care workers about the NSSIs. Settings and Design: This was a cross-sectional survey conducted in the tertiary care cardiac center. The participants were health care workers including doctors, nurses, technicians, and housekeeping staff from the different areas of the hospital. Methods and Materials: This cross-sectional survey was conducted in the institute using a self-administered validated questionnaire. The participants consisted of a total of 190 HCWs namely doctors, nurses, technicians, and housekeeping staff. Statistical Analysis Used: Nil. Results: Results showed maximum participant were in the age group of 20-30 years. 94.7% were aware about standard precautions. 91.5% knew about the procedure for reporting of NSSIs. Only 50.2% HCWs gave correct answers regarding disease transmission through needle stick and sharp injury. The prevalence of NSSIs was highest among nurses (38.4%), and needle on the disposable syringe (76.9%) was the most common source of NSSIs. Conclusions: The survey revealed few gaps in the knowledge amongst HCWs about NSSIs like risks associated with needle-stick injuries and use of preventive measures, disassembling of needles prior to disposal. These gaps can be addressed by extensive education. As nurses were the most affected victim for the NSSIs, more emphasis should be given towards them for reducing the NSSIs.

Sharp Instrument Injuries of Nurses in Operating Room:Reason Analysis and Precaution / 中华医院感染学杂志

OBJECTIVE To approach the factors and precautions of sharp injuries of nurses in operating room.METHODS We reviewed the literatures and combined the clinical practice,the risk factors and adopted precaution of sharp injuries of nurses in operating room were analyzed and summarized.RESULTS The sharp injuries rate of nurses in operating room was decreased from 54.2% to 4.8%.The rate of reported was increase from 3.1% to 80.0%.So the efficiency and quality of work were elevated.CONCLUSIONS It is the key of protective measure that enhancing the protective consciousness and reducing the factors of the sharp instrument injury.

Sharp Injuries among Nursing Students and Preventive Measures / 中华医院感染学杂志

OBJECTIVE To explore the reason,hazard and preventive method of sharp injuries by analyzing nursing students who had sharp injuries.METHODS A retrospective study of hospital medical sharp injuries were taken among nursing students from Aug 2007 to May 2008.RESULTS There were 30 cases sharp injuries occurred in past year.Needles injuries accounted for 76.7%,and the others for 23.3%.Fifteen cases occurred in operation,and 15 cases occurred after operation.Twenty-three cases worked without gloves;86.7%injuris were on fingers.Hepatitis Bvaccine inoculation rate was 63.3% in 30 cases.CONCLUSIONS Enhancing occupational security education,improving nursing students′ sense of occupational security prevention and standardizing operation progress,can decrease sharp injuries among nursing students.

Sharp Instrument Injuries in Nursing:Analysis and Prevention / 中华医院感染学杂志

OBJECTIVE To explore the incidence of sharp instrument injuries among nurses from the various classes of medical institutions and to analyze the cause and investigate the preventive countermeasures.METHODS To survey the sharp instrument injuries in nursing among 1050 nurses from 50 medical institutions.From 1050 questionaires,1028 were performed.RESULTS Among 1028 nurses from 50 medical institutions,903 nurses suffered different degrees of sharp instrument injuries with 87.84%,of which 40.75% and 31.12% were caused respectively in working age of 6-10 years and 11-15 years.All injury cases added up to 7059,with average of 7.80 times per person and 287(31.78%) cases were with over 10 times.Injuries for ampule in dispensing and clearance of instruments accounted for 70.63% and 15.54%,with the times of 4986 and 1097.Degrees of injury:the light injury of skin accounted for 57.69% with 4076 cases.CONCLUSIONS It is suggested to reform the craft of ampules and safety of instruments continually.Instrument cleaner is recommended if necessary.The key point is to strengthen the education of awareness on occupational protection and do self-protection best,which is sharply important to reduce the incidence of injuries.