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Implicações pessoais e profissionais do acidente com material biológico para o trabalhador da saúde / Personal and professional implications of accidents with biological material among healthcare workersMelo, Dulcelene de Sousa 31 January 2014 (has links)
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Previous issue date: 2014-01-31 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / INTRODUCTION: The health of workers, in their everyday work, are exposed to various risks, among which, biological. This represents a danger important to public health, which may, in addition to physical injury, have broader implications, and impact various aspects of their lives. OBJECTIVE: To analyze the personal and professional implications of exposure to biological material for healthcare workers. METHODOLOGY: A qualitative study conducted with ten workers in the healthcare field who experienced accidents with biological material and who were treated by a reference healthcare service in Goiania, Brazil. Data were collected between October and November 2012, through interviews using the critical incident technique. Data processing used the content analysis methods proposed by Bardin, with the additional aid of Atlas ti 6.0 software. The discussion of findings was presented using theoretical frameworks of complex thinking from the perspective of Edgar Morin, as well as cultural theory of risk by Douglas. RESULTS: From the narratives of those experiences, for ten healthcare workers treated by three units of reference specializing in situations of exposure to biological material, four categories of analysis emerged: personal implications; professional implications, the workplace and risk management, and reference service and risk management. The results showed great psychological distress expressed through feelings of fear of contamination of self and family, worry, despair, lack of protection, guilt, anger, insecurity, introspection, helplessness, uncertainty, and awkwardness, among others. This suffering was reflected in the three spheres of interaction, as well as relationships between exposed workers. On the other hand, some might experience the solidarity from co-workers, patients, and professionals during service, through gestures and relationships that help in coping with tensions when such a situation arises. The structures in place at work and in referral services showed contradictions in such situations: support / helplessness; commitment / disengagement; climate of security / insecurity; careful / careless; organization / disorganization, respect / disrespect; acceptance / leaving at the mercy of fate. The accident was established as the driving force for workers to pay attention to their own safety and change their routines in this context, extending this reflection not only to themselves, but for those who they interact with professionally interaction. CONCLUSION: The experiences of these workers shows antagonistic, contradictory, and complementary aspects of complex systems for the health services worker. It suggests the need for a greater appreciation and consideration of the psycho-emotional consequences experienced by workers, along with review of treatment procedures as to their effectiveness and problem solving that improve quality of life to the healthcare worker. / INTRODUÇÃO: Os trabalhadores da área da saúde, no cotidiano laboral, estão expostos a diversos riscos, dentre os quais o biológico. Esse representa um agravo de importância para a saúde pública, que pode, para além da injúria física, gerar implicações e repercussões de ordem diversas em suas vidas. OBJETIVO: Analisar as implicações pessoais e profissionais da exposição ao material biológico para o trabalhador da área de saúde. METODOLOGIA: Estudo qualitativo realizado com dez trabalhadores da área da saúde, acidentados com material biológico e atendidos pelos serviços de saúde de referência do município de Goiânia - GO. Os dados foram coletados no período entre outubro e novembro de 2012, por meio de entrevista utilizando a técnica do incidente crítico. Para o tratamento dos dados utilizou-se a análise de conteúdo proposta por Bardin, com auxílio complementar do programa Atlas ti 6.0. A discussão dos achados se deu sob vários referenciais teóricos, dentre os quais a teorias do pensamento complexo e cultural do risco. RESULTADOS: Das narrativas das experiências/vivencias, socializadas por dez trabalhadoras da área da saúde, que foram atendidas por três das unidades de referência para a assistência em situação de acidente com material biológico emergiram duas unidades temáticas: implicações pessoais e profissionais do acidente ocupacional com material biológico; o serviço de saúde e a gestão do risco. Os resultados evidenciaram grande sofrimento psíquico expresso por meio dos sentimentos de medo de contaminação para si e família, preocupação, desespero, desproteção, culpa, indignação, insegurança, introspecção, desamparo, incerteza, constrangimento, entre outros. Esse sofrimento repercutiu nas três esferas do convívio e inter-relação das trabalhadoras acidentadas. Por outro lado, puderam experienciar a solidariedade por parte de colegas de trabalho, paciente e profissional, durante o atendimento, por meio de gestos e relações que ajudam no enfrentamento das tensões que tal situação aflora. As estruturas de atendimento no local de trabalho e nos serviços de referência demonstraram a contradição em tais situações: apoio-desamparo; compromisso-descompromisso; clima de segurança-insegurança; cuidado-descuidado; organização-desorganização; respeito-desrespeito; acolhendo ou deixando-o à mercê da própria sorte. Observou-se que o acidente constitui-se como força propulsora na perspectiva de olhar para a própria segurança e alterar a rotina no contexto laboral com extensão não só para si, mas para aqueles que estão no seu convívio profissional. CONCLUSÃO: A vivencia/experiência do trabalhador evidencia aspectos antagônicos, contraditórios e complementares dos sistemas complexos: trabalhador-serviços de saúde. Sugere a necessidade de uma maior valorização e consideração dos aspectos psico-emocionais vivenciados pelos trabalhadores, revisão da linha de cuidados de atendimento quanto à sua efetividade e resolutividade que agreguem qualidade de vida ao trabalhador da área da saúde.
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Patterns of occupational exposure to patients' body fluids among health care workers in Tikuranbesa University Hospital, Addis Ababa, EthiopiaWondwossen Desta Atlaw 24 October 2013 (has links)
Background: Accidental exposure to patients’ body fluids (BFs) is an occupational hazard among health care workers (HCWs). The study aimed at describing the patterns of exposure to patients’ BFs among HCWs at a university hospital in Ethiopia.
Methods: A contextual descriptive cross-sectional design was used for this study. Self-administered questionnaires were used to collect data.
Results: The one year and professional life prevalence of occupational exposure to patients’ BFs among HCWs was 33.5% and 66.5% respectively. Circumstances that led to participants’ exposures to patients’ BFs include needle stick injuries to fingers and splashes to the eyes (82.4%); conducting procedures included blood withdrawal (10.8%) and inserting intravenous infusions (8.1%) and recapping of used needles (12.2%).
Conclusion: Findings of this study generally indicated that occupational exposures to patients’ BF of different types and circumstances were common among all categories of HCWs in the study site. This high finding of BF exposure should not be over looked. HCWs should follow the universal precaution protocol and PEP need to be strengthened / Health Studies / M.A. (Public Health)
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Patterns of occupational exposure to patients' body fluids among health care workers in Tikuranbesa University Hospital, Addis Ababa, EthiopiaWondwossen Desta Atlaw 24 October 2013 (has links)
Background: Accidental exposure to patients’ body fluids (BFs) is an occupational hazard among health care workers (HCWs). The study aimed at describing the patterns of exposure to patients’ BFs among HCWs at a university hospital in Ethiopia.
Methods: A contextual descriptive cross-sectional design was used for this study. Self-administered questionnaires were used to collect data.
Results: The one year and professional life prevalence of occupational exposure to patients’ BFs among HCWs was 33.5% and 66.5% respectively. Circumstances that led to participants’ exposures to patients’ BFs include needle stick injuries to fingers and splashes to the eyes (82.4%); conducting procedures included blood withdrawal (10.8%) and inserting intravenous infusions (8.1%) and recapping of used needles (12.2%).
Conclusion: Findings of this study generally indicated that occupational exposures to patients’ BF of different types and circumstances were common among all categories of HCWs in the study site. This high finding of BF exposure should not be over looked. HCWs should follow the universal precaution protocol and PEP need to be strengthened / Health Studies / M.A. (Public Health)
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Registros de Acidentes com Material Biológico na Prática Odontológica no Estado de Goiás, 1996-2010 / Records of accidents with biological material in professional dental care practice in the state of Goias, 1996-2010Lima, Liwcy Keller de Oliveira Lopes 07 May 2012 (has links)
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Previous issue date: 2012-05-07 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / The dental care practice is characterized by the constant possibility of the staff and
patients exposure to biological material (BM) potentially contaminated with infectious
various agents, and requiring the epidemiology expertise of these exposures in order
to develop the risk management procedures. The present study aimed to analyze
the epidemiology of occupational accidents with exposure to BM among dental
professionals and students in the State of Goias, and as specific goals, to ferify the
frequency and profile of the accidents with biological material exposure among the
dental care students and professionals enrolled in a reference hospital with service in
compliance with occupational exposure to BM, to characterize the pre-and postexposure
behavior and monitoring program recommended for this population and to
analyze the socio-demographic and labor factors related to the accidents with BM by
percutaneous exposure between dental care professionals and students assisted in a
reference service. This is an epidemiological, retrospective and analytical study
developed in a referral hospital for the treatment of occupational accidents with
exposure to BM of the State of Goiás. All records of the accidents with BM between
dental care professionals and students attended in this institution by December 2010
were analysed. Data were collected by completing a standardized form containing
personal information, description of the accident, time elapsed between the accident
and the first service, and post-exposure and prophylaxis procedures. The data were
analyzed by SPSS 15.0 and the OpenEpi 2.3.1., Statistical analysis was performed
by descriptive frequency measures and univariate analysis using qui-square and
Fisher exact test. 628 accidents were recorded between dental care professionals
and students from 1996, the year of first registration, to 2010, in which 77.1% were
women. Some individuals reported more than one accident, totalling 701 accidents
with exposure to BM that comprise the study population. Among the accidents, the
majority (97, 13.8%) occurred in 2008 and 48.6% between dentists. In 92.2% of
cases, hepatitis B vaccination status of the victims was described, and out of these,
70.8% received all three doses. In 84.9% of cases there was no record of the
completion of anti-HBs by the victims. The accidents were predominantly (658,
93.9%) percutaneous, being the needle the instrument that caused the injury in
49.7%. Performing any dental care procedure was the most comum circumstance in
which the accidents occurred most frequently (388, 55.4%), and the finger, the body
area most affected (493, 70.3%). We highlight the lack of information in many cases,
especially in relation to BM involved in the accident, the use of personal protective
equipment at the time of the accident, where the victims performed their activities at
the time of the accident and / or were linked and fullfilling of Work Accident
Communication form. With the post-exposure procedures, the majority (635, 90.6%)
of the institution accidents enrollments occurred within 72 hours, however only 44.9%
were in the first two hours. The use of chemoprophylaxis and prophylaxis of hepatitis
B in 14.8% and 12.8% of the cases, respectively were recommended. In 82.6% of
the accidents, the patients were identified, and their HIV, HBV and HCV condition
ignored in 93.6% of records. Among the accidents in which the victim must return to
the intitution for the post-exposure follow up (264, 37.7%), only 20.8% returned and
3.8% were discharged. Accidents by percutaneous exposures showed a high
prevalence for all variables analysed. It was observed that the higher is the demand
for the service the less is the individual chance to undergo a percutaneous exposure
(p = 0.000). The occurrence of accidents among dental auxiliaries was significant (p
= 0.016) compared to dentists. The lack of data in the records of the institution
reveals the need for greater disclosure of ministerial protocols for caring the victims
of occupational accidents by BM among professionals responsible for this service.
The integration of biosafety, infection control procedures for dental care practice and
prevention and prophylaxis for BM accidents issues with undergraduate, graduate
courses should develop and provide effective behavior changes. / A prática odontológica é caracterizada pela constante possibilidade de exposição
tanto da equipe quanto dos pacientes a material biológico (MB) potencialmente
contaminados com diversos agentes infecciosos, sendo necessário o conhecimento
da epidemiologia dessas exposições para o desenvolvimento de medidas de
gerenciamento de risco. O presente estudo teve como objetivo geral analisar a
epidemiologia dos acidentes ocupacionais com exposição a MB entre profissionais e
estudantes de odontologia em Goiás e como específicos verificar a frequência e o
perfil dos acidentes com MB em estudantes e profissionais de odontologia atendidos
em um serviço de referência para atendimento à exposição ocupacional com MB,
caracterizar as condutas pré e pós-exposição e de acompanhamento recomendadas
para essa população e analisar os fatores sociodemográficos e laborais associados
à ocorrência de acidentes com MB por exposição percutânea entre profissionais e
estudantes de odontologia atendidos em um serviço de referência. Trata-se de um
estudo epidemiológico, retrospectivo e analítico desenvolvido em um hospital de
referência para o atendimento de acidentes ocupacionais com exposição a MB do
Estado de Goiás. Foram analisadas todas as fichas de registro de acidente com MB
entre profissionais e estudantes de odontologia atendidos nessa instituição até
dezembro de 2010. Os dados foram coletados por meio do preenchimento de um
formulário padronizado contendo informações pessoais, descrição do acidente,
tempo decorrido entre o acidente e o primeiro atendimento, condutas pós-exposição
e medidas profiláticas. Os dados foram analisados pelo SPSS 15.0 e pelo OpenEpi
2.3.1., foi realizada análise estatística descritiva pelas medidas de frequência e
análise univariada por meio de testes qui-quadrado e exato de Fisher. Foram
notificados 628 acidentes entre profissionais e estudantes de odontologia no período
de 1996, ano do primeiro registro, a 2010, sendo que 77,1% eram do sexo feminino.
Alguns indivíduos relataram mais de um acidente, totalizando assim 701 acidentes
com exposição a MB que compõem a população do estudo. No ano de 2008 houve
a maior frequência de registros de acidentes (97; 13,8%) e desses 18,6% eram CD.
Em 92,2% dos casos, a situação vacinal contra hepatite B dos acidentados foi
descrita, sendo que desses 70,8% receberam as três doses. Em 84,9% dos casos
não havia registro da realização do anti-HBs pelas vítimas. Os acidentes foram
predominantemente (658; 93,9%) percutâneos, sendo a agulha o instrumento
causador da lesão em 49,7%. Durante a realização de algum procedimento
odontológico, foi a circunstância em que os acidentes mais ocorreram (388; 55,4%),
e o dedo da mão a área corporal mais atingida (493; 70,3%). Destacou-se a
ausência de informações em diversos casos, principalmente em relação ao MB
envolvido no acidente, uso de equipamento de proteção individuaI no momento do
acidente, instituições onde as vítimas exerciam suas atividades no momento do
acidente e/ou eram vinculadas e o preenchimento da Comunicação de Acidente de
Trabalho. Quanto às condutas pós-exposição, na maioria (635; 90,6%) dos
acidentes, o atendimento na instituição ocorreu em até 72 horas, entretanto apenas
44,9% foram nas primeiras duas horas. Foi recomendado o uso de quimioprofilaxia e
profilaxia da hepatite B em 14,8% e 12,8% dos casos, respectivamente. Em 82,6%
dos acidentes, os pacientes-fonte eram passíveis de identificação, sendo a condição
dos mesmos, quanto à infecção pelo HIV, HBV e HCV, ignorada em 93,6% dos
registros. Entre os acidentes em que a vítima deveria retornar ao ambulatório para a
realização do acompanhamento pós-exposição (264; 37,7%), apenas 20,8%
retornaram e 3,8% receberam alta. Os acidentes por exposições percutâneas
apresentaram alta prevalência para todas as variáveis analisadas. Observou-se que
quanto maior a procura pelo atendimento, menor a chance do indivíduo ter sofrido
uma exposição percutânea (p=0,000). A ocorrência de acidentes entre auxiliares de
saúde bucal foi significativa (p=0,016) comparada às CD. A ausência de dados nos
registros da instituição revela a necessidade de maior divulgação dos protocolos
ministeriais para o atendimento às vítimas de acidentes ocupacionais por MB entre
os profissionais responsáveis por esse atendimento. A inserção de conteúdos como
prevenção e controle de infecção na prática odontológica e medidas pré e pósacidentes
com MB, nos cursos de graduação, aperfeiçoamento e pós-graduação têm
o potencial de resultar em mudanças efetivas nas condutas.
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Acidentes com material biológico entre trabalhadores da área da saúde da região metropolitana de Goiânia-GO: uma análise de 25 anos de registros / Accidents with biological material among health care workers in the metropolitan area of Goiânia-GO: an analysis of 25 years of recordsNeves, Zilah Cândida Pereira das 30 March 2016 (has links)
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Previous issue date: 2016-03-30 / Accidents with biological material are reportable events, health care workers (TAS), victims of
these accidents may be exposed to the hepatitis B and C and HIV, among others. The aims of
this study were: to analyze the epidemiology of occupational accidents with biological material
among health care workers of the metropolitan area of Goiania-GO (general); describe the
socio-demographic and occupational profile of health care workers, victims of occupational
accidents with biological material; describe the profile of accidents with biological material
among health care workers; characterize the adoption of pre-exposure behaviours related to
the latest accident; identify the serological status related to hepatitis B, C and HIV in victims
of occupational accidents involving biological material and source patients, and establish the
demographic and employment factors associated with the occurrence of multiple accidents
among health care workers of the metropolitan area of Goiania-GO. Epidemiological Cross and
analytical study which included all registration records of accidents involving biological
material of HCW from two sources: A - records of injured HCW in a reference hospital for
notification in Goiania, from the first record in 1989 to 2010, and B - records of Sinan,
including the first record in 2006 until those available at 31/12/2014. Linkage of databases
was performed and data analyzed using the Statistical Package for Social Sciences (SPSS).
Socio-demographic and employment variables were the predictor variables and have suffered
more than one accident, the outcome. Univariate analysis was performed and variables with
P<0.10 were included in a logistic regression model. Ethical precepts were followed (Approval
Ethics Committees: 033/2010 and 414.258/2013). A total of 11,536 accidents were recorded
from 1989 to December 2014. Of these, 9,575 (83.0%) occurred among HCW and the
majority was female. It was found that 665 (7.5%) of the HCW experienced more than one
accident, while 70 (0.8%) experienced three or more accidents, totaling 8,825 victims.
Nursing staff, auxiliary cleaning, physician, and dental and laboratory teams were the ones
who were more frequently hurted, respectively. Most of the victims had completed high school
(3,719 (48.0%). Blood/serum/plasma were the biological materials found to be the most
involved (6,480/67.7%), at the time of administering medications/vascular access puncture
occurring in 2.759 (28.9%), and involving needles with and without lumen in 6,097 (63.7%).
A total of 6,653 (75.4%) HCW were vaccinated for hepatitis B. Incomplete information on
Sinan records such as, use of PPE (gloves, masks, boots and safety glasses) and serological
markers (HBsAg; Anti-HBs, Anti-HCV and Anti-HIV) was found to be the major factor that
hampered data analysis. Age, type of material, and organic fluid were predictors risk factor for
multiple accidents involving biological material among health care workers. / Os acidentes com material biológico são eventos de notificação compulsória. Os trabalhadores
da área da saúde (TAS), vítimas desses acidentes, podem se expor aos vírus das hepatites B
e C e HIV, dentre outros. Foram objetivos deste estudo: analisar a epidemiologia dos
acidentes ocupacionais com material biológico entre trabalhadores de serviços de saúde, da
região metropolitana de Goiânia-GO (geral); descrever o perfil sociodemográfico e laboral dos
trabalhadores de serviços de saúde, vítimas de acidentes ocupacionais com material biológico;
descrever o perfil dos acidentes com material biológico entre trabalhadores dos serviços de
saúde; caracterizar a adoção das condutas pré-exposição relacionadas ao último acidente;
identificar a situação sorológica referente às hepatites B, C e HIV, das vítimas de acidentes
ocupacionais com material biológico e dos pacientes-fonte e estabelecer os fatores
sociodemográficos e laborais associados à ocorrência de múltiplos acidentes entre
trabalhadores de serviços de saúde da região metropolitana de Goiânia-GO (específicos).
Estudo epidemiológico, transversal e analítico no qual foram incluídas todas as fichas de
registro de acidentes de trabalho com material biológico de TAS a partir de duas fontes, A prontuários de TAS acidentados em um hospital de referência para notificação no município de
Goiânia, desde o primeiro registro em 1989 até 2010 e B - fichas do Sinan, incluindo o
primeiro registro em 2006, até os disponíveis em 31/12/2014. Foi realizado o Linkage dos
bancos de dados que foram processados e analisados no Statistical Package for the Social
Sciences (SPSS). As variáveis sociodemográficas e laborais foram as variáveis preditoras e ter
sofrido mais de um acidente, o desfecho. Foi realizada a análise univariada, e as variáveis que
apresentaram valor de p < 0,10 foram incluídas em um modelo de regressão logística.
Preceitos éticos foram seguidos (aprovações em Comitês de Ética: 033/2010 e
414.258/2013). Foram registrados 11.536 acidentes, no período de 1989 a dezembro de
2014. Destes registros, 9.575 (83,0%) ocorreram entre os trabalhadores da área de saúde e
a maioria era do sexo feminino. Verificou-se que 665 (7,5%) TAS sofreram mais de um
acidente, 70 (0,8%) apresentaram três ou mais acidentes, perfazendo 8.825 vítimas. A
equipe de enfermagem, o auxiliar de limpeza, médicos e a equipe de odontologia e de
laboratório foram os que mais se acidentaram, respectivamente. A maioria das vítimas
possuía o ensino médio completo 3.719 (48,0%). O sangue/soro/plasma foram os materiais
biológicos mais envolvidos 6.480(67,7%), no momento de administrar medicamentos/punção
de acesso vascular em 2.759 (28,9%), com o envolvimento de agulhas com e sem lúmen em
6.097 (63,7%). Em 6.653 (75,4%) dos TAS vacinaram para hepatite B. Para várias
informações, predominou a falta de registro nas fichas do Sinan que dificultou a análise: uso
dos EPI (luvas, máscaras, botas e óculos) e marcadores sorológicos (HBSAG; Anti-HBs, AntiHCV e o Anti-HIV). Verificou-se que idade, tipo de material, fluido orgânico foram fatores de
risco preditores para múltiplos acidentes envolvendo material biológico, entre os
trabalhadores dos serviços de saúde.
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Comparing adherence patterns to standard precautions and infection control amongst health care providers in public and private hospitals in BotswanaYilma, Nebeyou Aberra 23 January 2015 (has links)
This study aimed to provide evidence on knowledge of attitudes toward standard precautions (SPs) and its practice of Healthcare Workers (HCWs) in government and private hospitals in Botswana. It utilised descriptive cross-sectional methodology. A range of significant findings were revealed. Good practice of SPs was noted more amongst the HCWs in government than in private hospitals. Knowledge of SPs amongst HCWs in government hospital was significantly and positively correlated to good practice of SPs. Registered Nurses (RNs) had better knowledge of SPs than HealthcareAssistants (HCAs).There was no significant difference between RNs and HCAs practice of SPS and attitudes toward the same. No significant difference in the knowledge, attitudes and practice of SPs was noted between General Practitioners (GPs) and RNs. No significant difference in the knowledge, attitudes and practice of SPs was observed between GPs and HCAs. The study findings have implications for the application of SPs in practice / Health Studies / M.A. (Public Health)
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Comparing adherence patterns to standard precautions and infection control amongst health care providers in public and private hospitals in BotswanaYilma, Nebeyou Aberra 23 January 2015 (has links)
This study aimed to provide evidence on knowledge of attitudes toward standard precautions (SPs) and its practice of Healthcare Workers (HCWs) in government and private hospitals in Botswana. It utilised descriptive cross-sectional methodology. A range of significant findings were revealed. Good practice of SPs was noted more amongst the HCWs in government than in private hospitals. Knowledge of SPs amongst HCWs in government hospital was significantly and positively correlated to good practice of SPs. Registered Nurses (RNs) had better knowledge of SPs than HealthcareAssistants (HCAs).There was no significant difference between RNs and HCAs practice of SPS and attitudes toward the same. No significant difference in the knowledge, attitudes and practice of SPs was noted between General Practitioners (GPs) and RNs. No significant difference in the knowledge, attitudes and practice of SPs was observed between GPs and HCAs. The study findings have implications for the application of SPs in practice / Health Studies / M.A. (Public Health)
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