Effect of Sharps Injury Prevention Program on the Incidence and Reporting of Sharp Injury among Nurses / 병원감염관리

BACKGROUND: This study aimed to identify the effects of a multifaceted needlestick injury (NSI) prevention program on changes in knowledge about bloodborne infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting pre- and post-intervention among nurses. METHODS: A total of 429 and 420 nurses participated in the pre- and post-intervention periods, respectively. The intervention was performed from April to September 2007, comprising NSI guideline education, the use of containers with enhanced engineering, and the supply of safety devices. RESULTS: The average score of knowledge about bloodborne infectious diseases increased significantly from 8.3 to 8.9 out of 14 points (P<0.001), but the change in score of knowledge about postexposure coping was insignificant. The average score of attitude toward postexposure reporting increased significantly from 8.9 to 9.6 out of 12 points (P<0.001). Preventive measures such as "gloves are provided whenever needed" (P<0.001), "use one-hand technique" (P<0.001), and "needle containers are provided whenever needed" (P=0.031) increased significantly. The number of NSIs decreased by 40.4%, and the postexposure reporting rate increased by 552.8%. CONCLUSION: The multifaceted NSI prevention program positively affected knowledge about infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting after intervention. Therefore, we recommend that this program be applied to various healthcare workers in hospitals.

Knowledge and Attitude towards Pathogen Transmission Precautions among Healthcare Workers in a General Hospital

BACKGROUND: Pathogen-transmission precautions (PTP), including standard precautions, have been introduced to control the transmission of pathogens among patients and healthcare workers. The aim of this study was to assess the level of knowledge regarding PTP and the attitude towards these precautions among healthcare workers in a hospital setting. METHODS: A cross-sectional survey was performed from March to April 2007 using a self-administered questionnaire completed by 235 physicians, 491 nurses, and 117 laboratory technicians working at a large teaching hospital in urban area in Korea. RESULTS: The overall percentage of correct answers to 13 knowledge-type questions was 66.3%, and the percentage of correct answers differed significantly depending on the profession of the respondents (P<0.001) and exposure to PTP training (P=0.003). The guidelines were the preferred source of information on PTP (57.3%) followed by infection control practitioners (32.0%). The most important obstacles to compliance with PTP guidelines were lack of time (67.5%), forgetfulness (46.8%), lack of knowledge (33.8%), and lack of means (11.0%). CONCLUSIONS: Level of knowledge on the PTP guidelines was low and required improvement. Lack of time was the most important factor reported leading to poor compliance with the PTP guidelines.

Comparison of Catheter-associated Urinary Tract Infection Rates by Perineal Care Agents in Intensive Care Units

PURPOSE: This study compared the catheter-associated urinary tract infection (CAUTI) rates resulting from the use of four perineal care agents (soap-and-water, skin cleansing foam, 10% povidone-iodine, and normal saline) among patients in intensive care units (ICUs). METHODS: This four-group experimental study was done with 97 adult patients who had urinary catheters over 2 days in three ICUs between April and July 2008. The patients received one of the four types of perineal care. Data collected included the incidence of CAUTI at baseline (prior to perineal care) and 1 week, 2 weeks, and 4 weeks after beginning perineal care. Patients were divided into UTI and non-UTI groups based on the Centers for Disease Control and Prevention/National Healthcare Safety Network UTI definition to calculate incidence rates. The hazard ratio (HR) and 95% confidence intervals were calculated by Cox's proportional hazard analysis. RESULTS: The cumulative incidence of CAUTIs per 100 urinary catheter days were 3.18 episodes during 1 week with urinary catheter, 3.31 during 2 weeks, and 3.04 during 4 weeks. No statistically significant difference in hazard ratios of CAUTIs for each perineal care agent was evident with reference to soap-and-water at 1 week, 2 weeks, and 4 weeks after beginning perineal care after controlling for age, use of antibiotics, fecal incontinence, consciousness level, fever, and diabetes. CONCLUSIONS: The type of perineal care does not influence the incidence of CAUTIs. Further confirmatory studies with a larger patient population should be conducted, as well as determining perineal agent preference.