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Physical and psychological impacts from high infection risk percutaneous injuries on healthcare workers
percutaneous injury (PI),high infection risk,Exposure Prevention Information Network (EPINet),seroconversion,psychological impact,
|Publication Year :||2015|
Percutaneous injury (PI) is the most common occupational hazard for healthcare workers (HCWs), especially the high infection risk PI from source patients who are positive blood-borne pathogens (BBP). These include risk of infection and seroconversion, impacts to physical health due to post-exposure prophylaxis and even threat of death. Even more crucial are feeling psychological harm and unsafe working environment. All of these risks have great impacts to HCWs and healthcare settings.
This study includes three parts. First is to estimate the incidence of PI in Taiwan so as to understand PI occurring trend and to provide baseline data before mandatory usage of safety needles; Second is to further analyze high infection risk PI to different job category of HCWs and estimate risk of seroconversion; The final part is to conduct qualitative in-depth interviews with HCWs experiencing high infection risk PI to understand their psychological impacts. Through these three parts, the study aims to provide more precise references and suggestions to medical practice environment.
The first and second parts of the study adopted a retrospective secondary data analysis approach, with reporting and tracking data from Chinese Exposure Prevention Information Network (EPINet) of the Center for Medical Employees’ Safety and Health being analyzed and estimated by using statistical software JMP and SAS. The third of the study was designed using qualitative methods and purposive sampling approach. In-depth interviews were conducted for data collection, qualitative content analysis was performed and also the stringency rigor of the research was taken into account.
The results of the first part revealed a national estimate of PI between 6710 and 8319 in 2011 by using estimated number of hospital beds, full-time HCWs, and days of inpatient care, which are similar to a previous study using 2004 data. There are increasing trend in reporting numbers of physicians and high infection risk PI of HIV.
The second part’s results showed that high infection risk PI for physicians often occur in delivery room, examination room and operation room; for nurses in dialysis room, ICU, and ward; and for medical technologists in ICU, blood collection counter; while for support personnel in ward. In addition, the notification data in 2012 revealed the incidence of any positive high infection risk PI for HCWs is 0.87 cases/100 full-time HCWs. The estimated annual number of high infection risk PI is 52~133 persons due to HBV, 41~82 to HCV and <1~5 to HIV.
The qualitative study results of the third part of analyzing psychosocial impacts of infectious PI had been extracted into five themes: emotional distress, perceived threat of seroconversion, perceived lacking humanity support from work, altered professional enthusiasm, and positive adjustment.
Conclusions and Suggestions
The study suggests healthcare settings should provide different prevention education training and relevant preventive interventions to HCWs based on their job categories as location and mechanisms for highly infectious PI are different. It is necessary for healthcare settings to set up a single window reporting system and standard procedures after PI. Healthcare settings should also provide the most updated information and protect such HCWs’ rights as taking work-related injury leave and making referral to psychological consultations. The study also suggests government authorities supervise and audit healthcare settings to ensure their PI reporting and replace rates of using safety needles are in compliant with regulations. Furthermore, it may be necessary to conduct a cost and benefit analysis to explore whether the use of safety needles could reduce the PI incidence rate so as to reduce economic cost. The study results may also be used as a reference for future policy making.
|Appears in Collections:||護理學系所|
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