Conhecimento e adesão como fatores associados a acidentes com agulhas contaminadas com material biológico: Brasil e Colômbia / Knowledge and compliance as factors associated with needlestick injuries contaminated with biological material: Brazil and Colombia / Conocimiento y adhesión como factores asociados a los accidentes con agujas contaminadas con material biológico: Brasil y Colombia

Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.

Abstract This was a cross-sectional study to start a cohort in two University Hospitals of two countries - Brazil and Colombia - for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.

Resumen Hicimos estudio transversal como punto de partida de estudio de cohorte en dos Hospitales Universitarios en dos países - Brasil y Colombia - para evaluar la prevalencia de accidentes con material biológico (AT-MB), el nivel de adhesión a las Precauciones Estándares (PUs) y el conocimiento sobre patógenos transmisibles y factores asociados entre trabajadores y estudiantes de la Salud en el marco de la implementación de la norma NR-32. Creamos escalas para evaluar el conocimiento y la adhesión con base en 12 e 11 preguntas respectivamente. Utilizamos Regresión de Poisson-Tweedie para evaluar asociación entre el conocimiento y la adhesión a las PUs con sufrir AT-MB. Evaluamos 965 individuos (348 estudiantes e 617 profesionales). El puntaje medio de conocimiento fue 10,98 con mediana de 11 (10, 12) y α-Cr de 0,625. La media de adhesión fue de 30,74 con mediana de 31 (28, 34) e α-Cr de 0,745, asociándose a país, grupo (estudiantes) e percepción de riesgo. Entre los factores asociados al relato de AT-MB encontramos conocimiento, adhesión a las PUs, país de origen y tener el esquema completo de vacunación contra Virus da Hepatitis B. Concluimos que el nivel de conocimiento y adhesión fueron adecuados, aunque mejores entre los participantes del Brasil y se asociaron a los AT-MB.

Requirements and Evaluation of Sharps Injury Prevention Devices / 中国医疗器械杂志

Accidental sharps injuries are a serious problem in healthcare, many healthcare workers acquire infectious diseases from bloodborne pathogens by sharps injuries during their work. The cost of injury and exposure takes an emotional and financial toll, which has attracted worldwide attention. This paper analyzed the regulatory requirements on sharps injury prevention devices in the United States and the European Union, described the classification and basic requirements of sharps injury prevention devices, evaluation of protective functions, risk identification and control to provide references for regulation and development of such products in our country.

Needlesticks with safety devices and accident prevention: an integrative review / Agujas con dispositivos de seguridad y prevención de accidentes: revisión integrativa / Agulhas com dispositivos de segurança e a prevenção de acidentes: revisão integrativa

ABSTRACT Objective: To identify in the literature the efficacy of needlesticks with safety devices to reduce the occurrence of occupational accidents with exposure to biological material among health workers. Method: Integrative literature review, structured in the stages: Guiding question, search, categorization of studies, evaluation, discussion and interpretation of results, and synthesis of knowledge. Search for original articles and systematic reviews on the main bases of the Health area, published from 2000 to 2016 in Portuguese, English and Spanish, with descriptors: needlesticks injuries, exposure to biological agents, needles, protective devices, occupational accidents, accident prevention and health personnel. Results: We selected eleven articles, most characterized the passive safety devices as more effective in reducing the occurrence of injuries by needlesticks. Conclusion: The use of needlesticks with safety devices reduces the occurrence of accidents, bringing greater solvency when combined with the training of workers.

RESUMEN Objetivo: Identificar en la literatura la eficacia del uso de agujas con dispositivos de seguridad para reducir la ocurrencia de accidentes del trabajo con exposición a material biológico entre trabajadores de la salud. Método: Revisión integrativa de la literatura, estructurada en las etapas: Cuestión orientadora, búsqueda, categorización de los estudios, evaluación, discusión e interpretación de los resultados, y síntesis del conocimiento. Busca artículos originales y revisiones sistemáticas en las principales bases del área de la salud, publicados desde 2000 hasta 2016 en Portugués, Inglés y Español, con descriptores: lesiones por pinchazo de agujas, exposición a agentes biológicos, agujas, equipos de seguridad, accidentes de trabajo, prevención de accidentes y personal de salud. Resultados: Se han seleccionado once artículos, la mayoría caracterizó los dispositivos de seguridad pasivos como más efectivos en la disminución de la ocurrencia de lesiones por agujas. Conclusión: La utilización de agujas con dispositivos de seguridad reduce la ocurrencia de los accidentes, trayendo mayor resolutividad cuando aliada a la capacitación de los trabajadores.

RESUMO Objetivo: Identificar na literatura a eficácia do uso de agulhas com dispositivos de segurança para reduzir ocorrência de acidentes de trabalho com exposição a material biológico entre trabalhadores de saúde. Método: Revisão integrativa da literatura, estruturada nas etapas: Questão norteadora, busca, categorização dos estudos, avaliação, discussão e interpretação dos resultados, e síntese do conhecimento. Busca a artigos originais e revisões sistemáticas nas principais bases da área da Saúde, publicados de 2000 a 2016 em português, inglês e espanhol, com descritores: ferimentos penetrantes produzidos por agulhas, exposição a agentes biológicos, agulhas, equipamentos de proteção, acidentes de trabalho, prevenção de acidentes e pessoal de saúde. Resultados: Foram selecionados onze artigos, a maioria caracterizou os dispositivos de segurança passivos como mais efetivos na diminuição da ocorrência de lesões por agulhas. Conclusão: A utilização de agulhas com dispositivos de segurança reduz a ocorrência dos acidentes, trazendo maior resolutividade quando aliada à capacitação dos trabalhadores.

Percepção das precauções padrão, prática do reencape de agulhas e condutas frente a acidente com material biológico de equipes de saúde bucal do serviço público odontológico / Perception of the standard precautions, practice of re-capping of needles and practices when facing an accident involving biological material of dental health teams at dental public service

Resumo: O presente estudo objetivou verificar o conhecimento e adesão às precauções padrão (PP), em especial a prática de não reencapar agu lhas; as ações a serem tomadas diante acidentes e aspectos relativos à prevenção de infecções, pelas equipes de saúde bucal da rede públi ca de um município do Estado de São Paulo, Brasil. Também observar os materiais descartados nos recipientes do grupo E em todas as unidades de atendimento odontológico do município. Aplicou-se um questionário semiestruturado, com perguntas direcionadas ao tema. Dos 79 pesquisados, 60 responderam ao questionário, onde 33 (55%) eram cirurgiões-dentistas. 34 (56,6%) profissionais não sabiam o que eram as PP e 43 (71,6%) afirmaram reencapar agulhas. 27 (44,9%) já sofreram algum tipo de acidente com material perfurocortante, contaminado ou sangue e 44 (73,3%) desconheciam ou se equivocaram sobre quais os cuidados imediatos em caso de exposição cutânea ou percutânea. Em relação à análise dos recipientes de descarte, observaram-se 5.193 agulhas descartadas, sendo 3.790 (73%) reencapadas em um, ou ambos os lados. Também o descarte incorreto de materiais não perfurocortantes. Conclui-se que existe falha no conhecimento sobre precauções padrão e condutas em casos de acidentes com mate rial biológico, além do incorreto descarte de materiais nos recipientes do grupo E.

Abstract: This study aimed to verify the knowledge and adoption of the stan dard precautions (PP), especially in the practice of not re-capping needles; the actions to be taken in relation to accidents and aspects related to the prevention of infections, by the dental health teams of the public service of a city in the State of São Paulo, Brazil. We also assessed the materials discarded in the containers of group E in all dental care units of the city. A semi-structured questionnaire was applied, with questions about the theme. Of the 79 subjects surveyed, 60 answered the questionnaire, where 33 (55%) were dental surgeons. 34 (56.6%) professionals did not know what PP were and 43 (71.6%) reported re-capping needles. 27 (44.9%) had already suffered some kind of accident with sharp tools or contaminated material with blood and 44 (73.3%) were unaware or made mistakes about the immediate care in case of skin or percutaneous exposure. Regarding the analysis of the disposal containers, 5,193 discarded needles were observed, of which 3,790 (73%) were re-capped on one or both sides. Also, we observed the improper disposal of non- sharps material. We concluded that there is a lack of knowledge about standard precautions and conducts in cases of accidents with biological material, besides the incorrect disposal of materials in the containers of group E.

Ficha clínica de atendimento ao cliente com diabetes mellitus do tipo 1 / Type 1 diabetes mellitus customer clinical care history sheet

Diabetes Mellitus é um dos principais problemas de saúde pública, sendo a Diabetes Mellitus tipo 1 (DM1) o distúrbio endócrino-metabólico mais comum na infância. Durante o atendimento ambulatorial ao cliente com DM1, foi observado que o registro da consulta era feito em uma folha pautada apenas, sem qualquer orientação para seu preenchimento, mesmo diante de uma patologia complexa, com inúmeros dados e informações. A questão norteadora foi à necessidade de uma sistematização para um registro adequado do atendimento. O objetivo deste estudo foi elaborar uma Ficha Clínica (FC) padronizada para acompanhamento ambulatorial do cliente com DM1, com o intuito de melhorar a assistência e a segurança dos dados coletados. Ao mesmo tempo, teve o propósito de servir como instrumento facilitador para acadêmicos e profissionais de saúde para melhor aprendizagem e a avaliação dos casos. O método utilizado foi à revisão narrativa do assunto para selecionar dados e parâmetros de avaliações essenciais para compor a referida FC. Foram selecionados artigos de revisão e consensos publicados na base de dados PUBMED, LILACS, Cochrane e Scielo, produzidos no Brasil e no exterior, com a utilização dos descritores "Diabetes Mellitus tipo 1", "Guideline", além de livros atualizados sobre o tema, publicados entre os anos de 1988 a 2016. Da mesma forma, foi realizada outra revisão narrativa da literatura para aprofundar conhecimentos sobre as orientações e leis que regem o descarte correto dos resíduos sólidos perfurocortantes em domicílio, devido à extrema relevância que o tema demonstrou na assistência ao cliente com DM1. Além da elaboração de artigos sobre os temas estudados, os produtos dessas duas revisões foram: (1) "Folheto educativo (FC) para profissionais de saúde sobre destinação ambientalmente correta de perfurocortantes em domicílio" e (2) o produto principal "Ficha Clínica de atendimento ao cliente com diabetes Mellitus Tipo 1" e seu instrutivo para preenchimento. Conclusão: O estudo atingiu o objetivo proposto, com a elaboração não só de uma FC sistematizada para consulta inicial, mas também para acompanhamento da evolução clínica do diabético. Além disso, o Folheto explicativo dirigido aos profissionais de saúde sobre o descarte de resíduos perfurocortantes domiciliares complementa essa ficha clínica e possibilita uma assistência mais completa ao portador de DM1

Diabetes Mellitus is one of the main public health problems, with Diabetes Mellitus type 1 (DM1) being the most common endocrine-metabolic disorder in childhood. During ambulatory care with the DM1 client, it was observed that the registration of the consultation was done on a standardized sheet only, without any orientation for its completion, even in the face of a complex pathology, with numerous data and information. The guiding question was the need for systematization for an adequate record of care. The objective of this study was to develop a standardized Clinical Record (CR) for outpatient follow-up of patients with DM1, in order to improve the care and safety of the data collected. At the same time, it was intended to serve as a facilitating tool for academics and health professionals for better learning and case assessment. The method used was the narrative review of the subject to select data and evaluation parameters essential to compose said clinical record. We selected articles of review and consensus published in the PUBMED, LILACS, Cochrane and Scielo database, produced in Brazil and abroad, using the descriptors "Diabetes Mellitus type 1", "Guideline", and updated books on the subject , published between 1988 and 2016. In the same way, another narrative review of the literature was carried out to deepen knowledge about the guidelines and laws that govern the correct disposal of solid residues at home, due to the extreme relevance that the topic demonstrated in customer service with DM1. In addition to the elaboration of articles on the subjects studied, the products of these two reviews were: (1) "Educational brochure for health professionals about the environmentally correct destination of sharps at home" and (2) the main product "Clinical file with Type 1 Diabetes Mellitus" and it's instructive to fill. Conclusion: The study reached the proposed goal, with the elaboration not only of a systematized CR for initial consultation, but also for monitoring the clinical evolution of the diabetic. In addition, the explanatory brochure addressed to health professionals on the disposal of household hazardous waste complements this clinical file and enables a more complete assistance to the DM1 patient

Occupational exoosures to body fluids and behavors regarding their prevention and post-exposure among medical and nursing students at a Brazilian public university / Exposicoes ocupacionais a fluidos corporais e comportamentos em relacao a sua prevencao e pos-exposicao entre estudantes de medicina e de enfermagem de universidade publica brasileira

A cross-sectional study was conducted to assess the frequencies and characteristics of occupational exposures among medical and nursing students at a Brazilian public university, in addition to their prevention and post-exposure behavior. During the second semester of 2010, a self-administered semi-structured questionnaire was completed by 253/320 (79.1%) medical students of the clinical course and 149/200 (74.5%) nursing students who were already performing practical activities. Among medical students, 53 (20.9%) suffered 73 injuries, which mainly occurred while performing extra-curricular activities (32.9%), with cutting and piercing objects (56.2%), in the emergency room (39.7%), and as a result of lack of technical preparation or distraction (54.8%). Among nursing students, 27 (18.1%) suffered 37 injuries, which mainly occurred with hollow needles (67.6%) in the operating room or wards (72.2%), and as a result of lack of technical preparation or distraction (62.1%). Among medical and nursing students, respectively, 96.4% and 48% were dissatisfied with the instructions on previously received exposure prevention; 48% and 18% did not always use personal protective equipment; 67.6% and 16.8% recapped used needles; 49.3% and 35.1% did not bother to find out the source patient's serological results post-exposure; and 1.4% and 18.9% officially reported injuries. In conclusion, this study found high frequencies of exposures among the assessed students, inadequate practices in prevention and post-exposure, and, consequently, the need for training in “standard precautions” to prevent such exposures.

Estudo transversal foi realizado para verificar, entre estudantes de medicina e de enfermagem de universidade pública brasileira, as frequências e características de exposições ocupacionais e seus comportamentos na prevenção e pós-exposição. Durante o segundo semestre de 2010, questionário autoaplicável e semiestruturado foi completado por 253/320 (79,1%) estudantes de medicina do curso clínico e por 149/200 (74,5%) estudantes de enfermagem que já exerciam atividades práticas. Entre os estudantes de medicina, 53 (20,9%) sofreram 73 acidentes, que ocorreram principalmente em atividades extracurriculares (32,9%), com objetos pérfuro-cortantes (56,2%), na sala de emergência (39,7%) e em decorrência de despreparo técnico ou distração (54,8%). Entre os alunos de enfermagem, 27 (18,1%) sofreram 37 acidentes, que ocorreram principalmente com agulhas ocas (67,6%), no centro cirúrgico ou enfermarias (72,2%) e em decorrência de despreparo técnico ou distração (62,1%). Entre os alunos de medicina e de enfermagem, respectivamente, 96,4% e 48% estavam insatisfeitos com orientações previamente recebidas de prevenção de acidentes, 48% e 18% nem sempre utilizam equipamento de proteção individual, 67,6% e 16,8% reencapam agulhas usadas, 49,3% e 35,1% não se preocuparam em conhecer os exames sorológicos do paciente-fonte pós-exposição e 1,4% e 18,9% relataram o acidente oficialmente. Em conclusão, neste estudo verificaram-se altas frequências de exposições entre os estudantes avaliados, práticas inadequadas na prevenção e pós-exposição e, consequentemente, a necessidade de treinamento nas “precauções padrão” para prevenção de tais exposições.

Needle Stick Injuries among Junior Doctors.

Objective: To determine the prevalence of needle stick injuries (NSIs) among junior doctors of RIMS and to assess the measures undertaken by the respondents after the NSI. Methods: A cross sectional study was conducted in RIMS, Imphal, Manipur among internees, house officers and post graduate trainees from Sept to Oct 2011. Self-administered questionnaire was used to collect data. Descriptive statistics like mean, percentage and standard deviation were used. Analysis was done using Chi square test. And P-value of <0.05 was taken as significant. Results: Out of 382 eligible respondents, 289 participated in the study. Males were 70.2% (n=203). Prevalence of NSI among junior doctors within the last one year was 39.4% (N=114). Of the three designations, NSI was highest among the house officers. Most NSI took place while blood withdrawal (33.3%), suturing (27.3%), giving injections (16.6%) and recapping (14.9%). Majority of those doctors injured, 56.1% attributed NSI during rush hour. Around fifty-four percent of them were not wearing gloves during the NSI. Nearly forty-five percent of the doctors washed their injured part with water and soap and also applied antiseptic as immediate measures after NSI. Only 10 (8.8%) took Post Exposure Prophylaxis (PEP). Conclusion: Needle stick injuries among junior doctors are common and often not reported and majority of them did not take post exposure prophylaxis. These findings warranted the need for ongoing attention to strategies to reduce such injuries in a systematic way and to improve reporting system so that appropriate medical care can be delivered.

[Epidemiological features of needle stick injuries among nursing staff]

Injury with contaminated sharp devices like used needles is the great potential risk factor in nursing staff. Severity of infectious complications of these injuries demonstrated the value of prophylactic activities. To evaluate epidemiologic features of needle stick injuries and coverage of Hepatitis B vaccine among nursing staff in Bualisina hospital in Qazvin from March 2007 to March 2008. In this cross sectional descriptive study, data of needle stick injuries if staff was gathered by direct interview. For statistical analysis were used t student, chi square and Fisher exact test. P value above 0.05 was considered statistically significant. In this period among 172 nurses, 55 subjects experienced needle stick injuries [32%]. There was no statiscally relationship between needle stick injuries with educational level, gender, and related training courses; but there was a statiscally relationship between the injuries and the number of continous shifts. Reporting the injury to the hospital supervisors was statiscally significant in nurses who had university education. According to undesirable complications of needle stick injuries, it is considered to organize educational programs in order to decreasing continues shifts in nursing staff and emphasis major priority of prevention methods

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.

Rede de Prevenção de Acidentes de Trabalho: uma estratégia de ensino a distância / Red de Prevención de Accidentes deTrabajo: una estrategia para enseñanza a la distancia / Network Prevention of Accidents at Work: a strategy for distance education

Estudo quase-experimental cujo objetivo foi avaliar o treinamento interativo proposto, como estratégia de mudança no comportamento de trabalhadores para o adequado uso de luvas na administração de medicamentos endovenosos. O treinamento, estruturado no Modelo de Promoção da Saúde de Pender, foi realizado a distância pelo web site da Rede de Prevenção de Acidentes de Trabalho (REPAT), disponível em: http://repat.eerp.usp.br/estrategia/index.php e aplicado a 60 trabalhadores de enfermagem de dois hospitais estado de São Paulo. Antes do treinamento 58,3 por cento dos trabalhadores usavam luvas para administrar medicamentos endovenosos na semana que antecedeu o treinamento e 83,3 por cento trabalhadores informaram intenção do uso de luvas após o treinamento. Conclusão: a ferramenta interativa facilitou a aplicação da estratégia educativa no trabalho e pode auxiliar a mudança do comportamento do uso de luvas.

Quasi-experimental study that aimed at evaluating the proposed interactive training, as a strategy for change in the behavior of workers, seeking the appropriate use of gloves in the administration of intravenous drugs. The interactive training was structured in the Model of Health Promotion of Pender, conducted through access to the web site of the Network Prevention of Accidents at Work (REPAT) available from: http://repat.eerp.usp.br/estrategia/index.php and applied in 60 workers nursing from two hospitals in the state of Sao Paulo. On the week before the training 58.3 percent of the workers were wearing gloves to administrate intravenous drugs and 83.3 percent of the workers informed the intention of wearing gloves after the training. Conclusion: the use of interactive tool facilitated the implementation of educational strategy in work and showed that training can help in changing behavior.

Estudio casi-experimental cuyo objetivo fue evaluar el proyecto de formación interactiva, como una estrategia para el cambio en el comportamiento de los trabajadores, buscando el uso apropiado de guantes en la administración de drogas por vía intravenosa. La capacitación interactiva se estructuró en el Modelo de Promoción de la Salud de Pender, se llevó a cabo a través del acceso al sitio Web de la Red de Prevención de Accidentes de Trqabajo (REPAT), disponible en: http://repat.eerp.usp.br/estrategia/index.php y se aplicó en 60 trabajadores enfermería de dos hospital en el estado de Sao Paulo. En la semana antes del entrenamiento 58,3 por ciento de los trabajadores usaron guantes en la administración de drogas por vía intravenosa y, después del entrenamiento, 83,3 por ciento de los trabajadores informaron intención de usar guantes. Conclusión: la herramienta interactiva facilitado la aplicación de la estrategia educativa para la Promoción de la Salud en el Trabajo permitir que los trabajadores participen en las diferentes realidades de la vida y el trabajo.

Needle stick injuries among health care workers in a tertiary care hospital of India.

Background & objectives: Percutaneous injuries caused by needlesticks, pose a significant risk of occupational transmission of bloodborne pathogens. Their incidence is considerably higher than current estimates, and hence a low injury rate should not be interpreted as a non existent problem. The present study was carried out to determine the occurrence of NSI among various categories of health care workers (HCWs), and the causal factors, the circumstances under which these occur and to, explore the possibilities of measures to prevent these through improvements in knowledge, attitude and practice. Methods: The study group consisted of 428 HCWs of various categories of a tertiary care hospital in New Delhi, and was carried out with the help of an anonymous, self-reporting questionnaire structured specifically to identify predictive factors associated with NSIs. Results: The commonest clinical activity to cause the NSI was blood withdrawal (55%), followed by suturing (20.3%) and vaccination (11.7%). The practice of recapping needles after use was still prevalent among HCWs (66.3%). Some HCWs also revealed that they bent the needles before discarding (11.4%). It was alarming to note that only 40 per cent of the HCWs knew about the availability of PEP services in the hospital and 75 per cent of exposed nursing students did not seek PEP. Interpretation & conclusions: The present study showed a high occurrence of NSI in HCWs with a high rate of ignorance and apathy. These issues need to be addressed, through appropriate education and other interventional strategies by the hospital infection control committee.

Occupational risks and hepatitis B vaccination status of dental auxiliaries in Nigeria

To assess the occupational exposure to needlestick and sharps injuries and hepatitis B vaccination status among dental auxiliaries. A descriptive cross-sectional survey of 83 dental auxiliaries was conducted that included 12 technologists, 11 therapists, 53 nurses/surgical assistants, and 7 record officers. The survey included demography, history of needlestick and sharps injury, hepatitis B vaccination, knowledge and attitude towards HIV-infected patients, and the dental auxiliaries' information needs on HIV-related issues. Of the 83 dental auxiliaries, 34 [41%] had experienced needlestick and sharps injury in the last 12 months. At the time of the study, only 43 [51.8%] had been immunized against hepatitis B. 62 [74.7%] of the respondents thought that it was easier to contract HIV than hepatitis B through needlestick in a dental clinic. 21 [25.3%] would not assist dentists treating HIV-positive patients. However, 76 [91.6%], a majority, agreed that they needed more information on HIV-related issues, with 59 [71.1%] specifying a single area of need and 17 [20.5%] more than one area of need. The single areas of need specified in descending order were infection control [n=22, 26.5%], HIV counseling [n=12, 14.5%], oral manifestations of HIV/AIDS [n=11, 13.3%], postexposure prophylaxis [n=9, 10.8%], and antiretroviral therapy [n=5, 6.0%]. The data from this survey underscore the urgent need for educational interventions to encourage safe work practices. Hepatitis B vaccination, HIV-related knowledge and proper postexposure prophylaxis are needed to prevent occupational transmission of blood-borne viruses

O HIV e o trabalhador de enfermagem frente ao acidente com material perfurocortante: [revisão] / HIV and the nursing professional in face of needlestick accidents: [review] / El VIH y el trabajador de enfermería frente a accidentes con material punzocortante: [revisión]

O estudo tem como objetivo identificar a produção científica sobre o acidente de trabalho do profissional de enfermagem com material biológico contaminado por HIV e caracterizar os fatores predisponentes aos acidentes de trabalho, assim como os procedimentos realizados pós-exposição ao material perfurocortante potencialmente contaminado pelo HIV. É uma revisão de literatura, cuja busca bibliográfica por palavras-chave foi realizada por meio da base de dados LILACS a partir de 2000. Constatou-se que os fatores predisponentes à ocorrência dos acidentes de trabalho com perfurocortantes estão relacionados tanto às condições de trabalho, como as condições individuais. Frente a estes acidentes, os trabalhadores de enfermagem têm necessidade de conhecer as condutas pós-exposição ao material perfurocortante potencialmente contaminado pelo HIV. Concluímos que a adoção das precauções-padrão no trabalho em saúde é condição fundamental para a segurança dos trabalhadores, independente da área de atuação, pois o número de casos de HIV é crescente.

The goal of this study was to identify the scientific production about work-related needlestick accidents among nursing professionals involving HIV-contaminated biological material, as well as to characterize the pre-existing factors to such accidents, such as procedures occurring after the exposure to potentially HIV-contaminated needlestick material. This is a literature review, whose bibliographic search for keywords was carried out within the LILACS databases from the year 2000 onward. This study confirms that pre-existing factors for the occurrence of work-related needlestick accidents are related to work conditions as much as to individual conditions. In face of these accidents, the nursing workers need to know the conducts concerning post-exposure to potentially HIV-contaminated needlestick material. We conclude that the adoption of standardized precautions when working in healthcare is a fundamental condition for worker safety, independently of their area of expertise, given the increasing number of HIV cases.

El estudio tiene como objetivo identificar la producción científica sobre accidentes de trabajo de profesionales de enfermería con material biológico contaminado por VIH y determinar las características de los factores que los favorecen, así como los procedimientos realizados posteriores al accidente con material punzocortante potencialmente contaminado por VIH. Revisión bibliográfica a través de palabras claves en la base de datos LILACS a partir del año 2000. Se constató que los factores que predisponen estos accidentes de trabajo se relacionan tanto con las condiciones de trabajo como con las condiciones individuales. Es necesario que los trabajadores de salud conozcan las conductas en casos de accidente punzocortante por VIH. Concluimos que la adopción de medidas patrón es una condición fundamental para la seguridad de los trabajadores, independientemente del área de trabajo, pues el número de casos con VIH esta en aumento.

impact of U.S. policies to protect healthcare workers from bloodborne pathogens: the critical role of safety-engineered devices

In the United States [U.S.], federal legislation requiring the use of safety-engineered sharp devices, along with an array of other protective measures, has played a critical role in reducing healthcare workers' [HCWs] risk of occupational exposure to bloodborne pathogens over the last 20 years. We present the history of U.S. regulatory and legislative actions regarding occupational blood exposures, and review evidence of the impact of these actions. In one large network of U.S. hospitals using the Exposure Prevention Information Network [EPINet] sharps injury surveillance program, overall injury rates for hollow-bore needles declined by 34%, with a 51% decline for nurses. The U.S. experience demonstrates the effectiveness of safety-engineered devices in reducing sharps injuries, and the importance of national-level regulations [accompanied by active enforcement] in ensuring wide-scale availability and implementation of protective devices to decrease healthcare worker risk

Perception of risk and potential occupational exposure to HIV/AIDS among medical interns in Delhi.

A cross sectional study was conducted among 129 medical interns of Maulana Azad Medical College, New Delhi for assessing the perceived levels of risk of acquiring HIV infection in the health care settings among medical interns, reasons for the same and their exposure to situations having potential of HIV transmission. Majority of the interns (68.3%) perceived themselves to be at a very high/high risk of acquiring HIV infection during their medical career. The common reasons for perceived risk of acquiring HIV infection were getting injuries due to needle pricks/cuts during surgical procedures (32.4%), frequent exposure to the blood/ secretions of patients (28.5%) and insufficient availability of gloves (17.6%). Some (23.2%) were of the opinion that students in future might lose interest in the medical profession due to increasing risk of HIV infection and few (3.1%) were even considering to leave the medical profession for the same reason. Majority of the interns (72.9%) had experienced needle pricks and more than half (53.7%) of them even had had blood splashes in their eyes/ nose/ mouth during surgical procedures. The findings of the study call for efforts for bringing a reduction in the risk perception of the interns through awareness campaigns and reorientation trainings, ensuring availability of gloves and other items necessary for observing universal work precautions and proper disposal of potentially contaminated articles.

[Occupational injuries factors in Hashtrood health network personals]

Health centers are more contaminated and pathogenic- and in briefly more dangerous- than other offices and work places for the employees. The goal for the following research was review of the occupational injuries occurrence and prevalence; and some affective factors among Hashtrood health network employees. This cross sectioned study was conducted by questionnaire distributed to 270 Hashtrood health center employees. Data were analyzed by SPSS through X2, t-test and logistic regression. The incidence and prevalence rates of occupational injuries were 43.8%and 61% respectively. Needles and sharp objects injuries had the highest ratio [Incidence rate 22.4% and 19% respectively, and prevalence rate 34.3% and 25.1% respectively]. Only 32.6% of the employees reported their injuries .In 49.5% of cases they haven't got the proper trains. The rate of occupational injuries among hospital and laboratory employees [70% and 66.7% respectively] is more than other centers [P<0.05]. There was an significant correlation between the employees education level and their occupational injuries, that means the most occupational injuries have been happened for the one who has diploma or less education [P<0.05]. Given to the vast occupational injuries, preventing measures must be considered. To reduce the occupational injuries, we suggest providing the needed training for the new comers and periodically for the employees; and also a proper reporting system by employees especially in hospitals and labs

Needle stick injuries: knowledge and practice among nurses in kingdom of Saudi Arabia

Every day while caring for patients, nurses are at risk to exposure to bloodborne pathogens potentially resulting in infections such as HIV or hepatitis B and C from needle stick injuries [NSI]. The level of risk for acquiring blood-borne infections depends on the number of patients with that infection in the health care facility and the precautions the health care workers perform while dealing with these patients. In Saudi Arabia, hepatitis B and C viruses pose a great threat to health care workers because of their high prevalence rate [8%-10% and 2%-6%] respectively, while HIV has a much lower prevalence rate 0.13%. Ninety Two nurses working at King Fahd University Hospital [KFUH], Al Khobar, Eastern Province, Kingdom of Saudi Arabia constitute the study subject. Astructured questionnaire was used to collect data related to vaccination status, history of exposure to NSI, knowledge regarding biological hazards, preventive measures and post exposure program and an observational checklist was used to assess nursesI competencies in using universal precautions. Results showed that more than half were between 20 to less than 30 years of age, 54.3% were non Saudi, all studied sample held a BSc in Nursing, work experience ranged from one year to 15 years and 85.9%were vaccinated against hepatitis B virus. Also, 11.9% of nurses with less than 5 years experience and 17.4% of nurses with more than 5 years experience had NSI at least once, While more than third 36.4%of those with more than 5 years experience and more than half 56.25% of those with more than 5 years experience report the incidence. Both Saudi and non Saudi nurses [90.5%, 94%] respectively possessed poor knowledge regarding diseases transmitted by NSI, universal precaution, measures to be carried out after NSI, and safer needle devices. Moreover, 50% of Saudi nurses possessed good practice score while 40% of non Saudi nurses possessed good practice score, this difference in total practice score between Saudi and non Saudi nurses regarding their competency in universal precautions is not statistically significant. The total practice score of universal precautions is better than the total knowledge score regarding diseases transmitted by NSI, universal precaution, measures to be carried out after NSI, and safer needle devices among nurses and this difference was statistically significant. The findings of the present study emphasize the importance of increased awareness, training and education of nurses for reporting and prevention of needle stick injuries and risks associated with occupational exposure to blood borne pathogens