Medical trainees (medical students and resident physicians) are at high risk of sharps injury (needlestick injury). High rates of sharps injury in this population and the risk incurred by exposure to bloodborne pathogens poses a threat both to medical trainees who are at risk for bloodborne pathogen exposure and to training institutions for legal and financial reasons. This study examines the prevalence of sharps injuries in medical trainees at the University of South Florida and compares that to data on sharps injuries in US medical trainees. Data from the present study was compared to previously collected USF medical trainee sharps injury data. Results from this study demonstrated that residents had higher rates of sharps injury than medical students. A prior USF study of similar data from academic years 2002-2008 had similar findings. This study demonstrated a peak in sharps injury rate in first year residents, similar to the prior USF study. Resident rates remained highest in Surgery and lowest for Psychiatry and Pediatrics. This information can be used to focus hazard analysis and risk reduction efforts at USF Health. This data can also be combined with the known efficacy of simulated training experience should encourage increased use of USF’s center for advanced medical simulation (CAMLS) to increased procedural experience in medical students and junior residents and decrease their exposure to bloodborne pathogens by increasing knowledge and procedural safety.

Medicinos darbuotojai dėl kasdieninio kontakto su žmogaus organizmo skysčiais priskiriami didžiausios biologinių veiksnių rizikos grupei. Incidentų – mikrotraumų ir ekspozicijos krauju, rizika yra susijusi su kraujo keliu plintančiomis infekcijomis (HBV, HCV, ŽIV). Darbo tikslas: Nustatyti medicinos darbuotojų profesinių biologinių veiksnių riziką ir paplitimą Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose. Tyrimo metodika. Vykdytas retrospektyvinis tyrimas 2006 m. 1-6 mėnesių, duomenys rinkti Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose. Atlikta anketinė apklausa. Išdalintos 347 anoniminės anketos, atsako dažnis 89,6 % (311). Statistiniam duomenų apdorojimui naudotas SPSS 11.0 programinis paketas. Rezultatai. 64,5% respondentų patyrė mikrotraumą, 71,1 % – ekspoziciją biologiniais skysčiais, mikrotraumą, ir ekspoziciją patyrė 39,6% darbuotojų. Visais mikrotraumų atvejais buvo sužeistos rankos, ekspozicijų metu 63% respondentų apsitaškė sveiką odą, 20% – akis. Dažniausiai darbuotojai apsitaškė krauju (60%). Gydytojai mikrotraum��� dažniausiai patyrė operacijų metu (79,3%), slaugytojos – apruošdamos instrumentus (35,1%), pagalbiniai darbuotojai – tvarkydami atliekas (75,8%). Gydytojai dažniausiai susižeidė chirurgine adata (72,4%), slaugytojos – injekcine adata (72,4%), pagalbiniai darbuotojai – stiklu (60,6%). 86% respondentų nebuvo pasiskiepiję HB vakcina. Mikrotraumų metu 14,5%, ekspozicijų metu 5% respondentų asmeninių apsaugos... [toliau žr. visą tekstą] / The health care workers are attributed to the highest biological factors risk group, as they daily come into contact with fluids of human body. Risk of incidents – sharps injuries and blood exposure – is related to the infections, spread by blood (HBV, HCV, HIV). Aim of the study. Determine the professional biological risk factors for health care workers and their incidence in the surgical departments of Kaunas Medical University Hospital. Methods. Retrospective study of 1-6 months of year 2006 was performed; data was collected in the surgical departments of Kaunas Medical University Hospital. Anonymous questionnaire survey was performed. 347 questionnaires were distributed; rate of response was 89.6% (311). SPSS 11.0 software was used for statistical data processing. Results. 64.5% of respondents had experienced sharps injury, 71.1% were exposed to the biological fluids, and 39.6% of workers had experienced the injury and the exposure. The hands were injured during all the sharps injury cases; 63% of respondents were drabbled by blood on the healthy skin and 20 % were drabbled into the eyes during the blood exposure. In most cases worker were drabbled by blood (60%). Physicians mostly experience the sharps injury during the surgery (79.3%), nurses – during the preparation of instruments (35.1%), supporting staff – disposing the waste (75.8%). Commonly physicians were injured by the surgical needle (72.4%), nurses – by needlestick (72.4%), and the supporting staff – by glass... [to full text]

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2017-04-04T15:37:56Z No. of bitstreams: 1 Cristiane das Gracas Dias Cavalcante.pdf: 1626896 bytes, checksum: ee11f49fb1b597ed920660b24ef76487 (MD5) / Made available in DSpace on 2017-04-04T15:37:56Z (GMT). No. of bitstreams: 1 Cristiane das Gracas Dias Cavalcante.pdf: 1626896 bytes, checksum: ee11f49fb1b597ed920660b24ef76487 (MD5) Previous issue date: 2016-12-08 / The inadequate disposal of Health Services Waste (HSW) represents a potential risk of contamination to the environment, in addition to the occupational risk to professionals who work directly with the waste collection, as well as to the community, such as cardboard waste pickers in dumps. Sharp objects or E-type waste, such as syringes, lancets, scalpel blades and needles that have been in contact with human blood, can transmit infectious diseases such as HIV and hepatitis. The legislation regarding care with HSW determines that the management of waste E is carried out by establishments of interest to health, stored in appropriate collection boxes, but there is a gap in relation to the material produced by patients in their homes, such as insulin-dependent diabetics. The objective of the study was to analyze how to proceed Technical Manager (TM) of a Basic Health Unit (BHU) on the management of residues E, generated in households, by diabetic insulin users and enrolled in the Capillary Glucose Self Monitoring Program (CGSM), besides, the use of this tool in the annual measurement of household residues generated. This is a single case study, descriptive, qualitative, exploratory, with documentary research based on primary sources extracted from the SIGA Software (where the CGSM is inserted), from October 2014 to October 2015, in addition it was applied a semi-structured questionnaire for the TM. There was a dispensation of 204,990 syringes, 195,221 lancets and 1,919 collecting containers, and no criteria were observed for dispensing containers according to the number of syringes and lancets provided to patients. The BHU supplies containers in 99% of patient care time, but still receives 9% of all sharps residues stored improperly in plastic bottles. / O descarte inadequado de Resíduos de Serviços de Saúde (RSS) representa um risco potencial de contaminação ao meio ambiente, além do risco ocupacional aos profissionais que trabalham diretamente com a coleta do resíduo, bem como para a comunidade, a exemplo dos catadores de papelão em lixões. Objetos perfurocortantes ou resíduo classificado como tipo E, tais como seringas, lancetas, lâminas de bisturi e agulhas que estiveram em contato com sangue humano, podem transmitir doenças infecciosas, como o vírus HIV e hepatites. A legislação referente ao cuidado com o RSS determina que o gerenciamento do resíduo E seja efetuado por estabelecimentos de interesse à saúde, armazenados em caixas coletoras apropriadas, porém existe uma lacuna em relação ao material produzido por pacientes em seus domicílios, a exemplo dos diabéticos insulinodependentes. O objetivo do estudo foi analisar a como o Responsável Técnico (RT) de uma Unidade Básica de Saúde (UBS) procede sobre o gerenciamento de resíduos E, gerados em domicílios, por diabéticos usuários de insulina e cadastrados no programa de Automonitoramento Glicêmico Capilar (AMGC), além do uso desta ferramenta na mensuração anual de resíduos domiciliares gerados. Trata-se de um estudo de caso exploratório descritivo de abordagem qualitativa, com levantamento e pesquisa documental baseada em fontes primárias extraídas do Software SIGA (onde se insere o AMGC), no período de outubro de 2014 a outubro de 2015, além da aplicação de questionário semiestruturado para o RT. Houve a dispensação de 204.990 seringas, 195.221 lancetas e 1.919 recipientes coletores, não foram observados quaisquer critérios de distribuição de recipientes em função da quantidade de seringas e lancetas fornecidas aos pacientes. A UBS fornece recipientes em 99% do tempo de atendimento aos pacientes, mas ainda recebe 9% de todo resíduo perfurocortante armazenados inadequadamente em garrafas plásticas.

Thesis (Master of Nursing)--Cape Peninsula University of Technology, 2019 / Background: Like other health care providers, nursing students are unprotected from occupational dangers such as sharp object injuries (SOIs) due to imperfect knowledge and experience. These students face a great risk of exposure to blood borne infections by pathogens such as HIV and the hepatitis B and C viruses while executing their clinical actions in hospitals. SOIs are a significant problem for nursing students, as they increase the risk of contracting blood-borne infections. Purpose: The purpose of this study was to determine nursing students' knowledge and practices related to SOIs and their management at a university in the Western Cape Province. Objectives: The objectives of this study include determining the occurrence of SOIs, and knowledge of risk of SOIs, as well as the reporting and management of SOIs at a university in the Western Cape. Method and sample: A cross-sectional descriptive survey was conducted with nursing students from the second to fourth year of study, registered at a university in the Western Cape Province for the 2017 academic year. Quota sampling was applied to select respondents who, after providing informed consent, then completed and handed the self- administered questionnaires back to the researcher on the same day that they were distributed. Data were obtained from nursing students about whether or not they had experienced an SOI, what they did after the SOI, their perception of the risk, and management of and preventive measures for SOIs. Validity and reliability were ensured, and all ethical principles were adhered to. SPSS was used for the quantitative data analysis. Results: A total of 252 nursing students from the second to fourth years participated in this study. The average age of respondents was 24 years, with a minimum of 19 and maximum of 46 years; 211 (83.7%) of them were females. During their course 63 (25%) respondents experienced SOIs; only 42 (66.67%; N=63) of them reported the occurrence of an SOI, most (25 or 59.52%) reporting it to the professional nurse in charge. The highest occurrence of SOIs was reported by fourth-year students (26 respondents, 41.3%). It was found that 21 (33.3%) of SOIs were not reported, and the main reason for this was because there was little or no perception of associated risk (15, 71.43%). Forty-six (73.02%) respondents experienced a single SOI, while 11 (17.46%) had two SOIs, 4 (6.35%) reported having had three SOIs, and one each (1.59%) had more than four and more than ten SOIs. The activity causing most of the SOIs was administration of medication by injection (48 cases, 76.2%), and in most cases (57, 90.47%) the instruments causing injury were needles or hollow-bore needles. Most of the affected respondents squeezed the puncture site after the SOI (42, 66.7%), followed by washing the area with water and soap (40; 63.5%), and cleaning the site with antiseptic (15, 23.8%). Among those students exposed to SOIs, only 22 (52.4%) had undergone blood tests, and very few of them took post-exposure prophylaxis or treatment (16, 25.40%). The emotion that most of them felt after the SOI was fear (42, 66.7%), and the main reason for not getting treatment was fear of side effects (18, 38.29%). Also, only 61 (24.2%) respondents reported recapping needles after use, while most reported incomplete vaccination against hepatitis B (195, 77.38%). The main reason for not using personal protective equipment (PPE) was noted as the unavailability thereof at the institution (43, 49.4%). Conclusion: This study documented a low rate of reporting SOIs among nursing students. It is plain that there are inadequate levels of knowledge and practice related to SOI management among these students at a university in the Western Cape. One would imagine that because the majority of nursing students had a measure for the practice of universal precautions and used PPE, their management after exposure to SOIs during work training in hospital would be efficient. This was not the instance in this study, where application of these actions in their practical training was poor.

Bakgrund Operationspersonal är den yrkesgrupp inom vården som är mest utsatt för risk för blodsmitta genom frekvent hantering av stickande och skärande instrument samt exponering av blod. Bland operations­sjuksköterskor finns en stark önskan att arbeta så säkert som möjligt för att minska risken för smittöverföring. Det finns föreskrifter, metoder och hjälpmedel för att förhindra stick- och skärskador men få skriftliga riktlinjer och rutiner. Syfte Syftet med den här studien är att undersöka operationssjuksköterskans hantering av stickande och skärande instrument i operationssalen. Metod Studiens design är en empirisk tvärsnittsstudie med en kvantitativ ansats. En strukturerad observationsstudie utfördes på Södersjukhuset i Stockholm. 18 operationssjuksköterskor observerades under 50 operationer. Resultat Studiens resultat visar på brister inom samtliga områden som observerats. Beskrivna hjälpmedel och metoder för att förhindra stick- och skärskador användes i liten utsträckning.  Trots detta utfördes viss hantering av vassa instrument på ett säkert sätt. Stundom utfördes arbetet på ett riskfyllt sätt. Slutsats Beskrivna hjälpmedel och metoder för säker hantering av stickande och skärande instrument finns men användes i liten utsträckning vilket resulterar i ett självstyrt säkerhetsarbete i operationssalen. Hjälpmedel bör göras mer tillgängliga, tydliga rutiner och skriftliga riktlinjer för hantering av stickande och skärande instrument behövs. Klinisk betydelse Studien kan fungera som en del av ett utvecklingsarbete på Södersjukhuset gällande hantering av stickande och skärande instrument. Utvecklingsarbetet kan exempelvis leda till en uppdatering av innehållet i kundanpassade operationsset och plocklistor samt att skriftliga riktlinjer tas fram. / Background Operating room personnel are at particularly high risk of injury and blood borne diseases due to handling of sharp items and frequent blood exposure. Operating room nurses aim to perform at a high level of security to reduce the risk of transmission of blood borne diseases. To prevent sharps injuries there are regulations, methods and safety devices but few written guidelines. Aim The aim of this study is to identify how the operating room nurse handles sharps within the operating room. Method A quantitative cross-sectional study was conducted at Södersjukhuset in Stockholm, Sweden. 18 operating room nurses participated in this structured observation study during 50 operations. Results The result indicates shortcomings in obtaining a safe working environment in all observed areas. Safety devices and other methods to prevent sharps injuries were seldom used. Despite this the work with sharps was mainly conducted in a safe way. At times the work was performed in a hazardous manner. Conclusions The safety devices and methods described in the study exist but are seldom used which leads to a subjective work method regarding safety in the operating room. The safety devices need to be made more accessible and explicit guidelines are needed. Clinical significance This study may be part of a quality improvement project at Södersjukhuset regarding handling and routines concerning sharps. The quality improvement effort can result in alterations of the contents in the procedure pack and the development of written guidelines.

Introduktion Operationssjuksköterskor handhar dagligen vassa instrument och har ett nära samarbete med operatören. Det finns risk för stick- och skärskador, varför flera utarbetade preventiva metoder finns att tillgå. Instrumenteringen av vassa instrument ska vara effektiv och säker. Handhavandet kräver kunskap och ställer krav på operationssjuksköterskan. Syfte Syftet med studien var att beskriva operationssjuksköterskors upplevelser av det intraoperativa handhavandet av vassa instrument. Metod Kvalitativ metod med induktiv ansats och individuella semistrukturerade intervjuer. Data analyserades genom manifest och latent innehållsanalys. Resultat Sju underkategorier, tre huvudkategorier samt ett övergripande tema framkom. Operationssjuksköterskorna var trygga i sin roll och arbetade med lugnt och fokuserat förhållningssätt utifrån personligt utformade arbetssätt för att bevara kontrollen. Säkert handhavande hos operatören upplevdes respektfullt och operationssjuksköterskorna anpassade sig och sade ifrån när riskfyllt handhavande observerades. Vid stick- och skärskada var professionellt handlande med bevarad aseptik angeläget. En viss rädsla för blodburen smitta fanns, men de såg samtidigt stick- och skärskador som en del av vardagen i deras arbetsmiljö. Slutsats Operationssjuksköterskorna var trygga i handhavandet av vassa instrument vilket gav dem förmåga till att anpassa sig. Konsekvent användande av personligt utformade arbetssätt upplevdes säkert och bidrog till kontroll. Stick- och skärskadepreventiva metoder användes i synnerhet vid känd blodburen smitta då rädsla förelåg att drabbas av smitta. / Introduction Theatre nurses manages sharp instruments and works closely with the surgeon. There is a risk of sharps injury and several developed preventative methods are avaliable. Instrumentation of sharp instruments must be effective and safe. The management requires knowledge and puts demands on the theatre nurse. Aim To describe the theatre nurses’ experiences of the intraoperative management of sharp instruments. Method Qualitative method with an inductive approach and individual semi-structured interviews. Data was analyzed with manifest and latent content analysis. Results Seven subcategories, three main categories and one covering theme. Theatre nurses were confident in their role and worked with a calm and focused approach with own personal designed work routines to maintain control. Safe management by the surgeon led to feelings of respect towards the theatre nurses and they adapted and reprimanded the surgeon when hazardous management was observed. In case of sharps injury, professional managing with remained asepsis was important. There was some level of fear towards bloodborne pathogen, but at the same time they saw sharp injuries as a common occurrence in their work environment. Conclusion Theatre nurses were confident in the management of sharp instruments which gave them the ability to adapt. Consistent use of personal designed work routines was percieved as safe and contributed to control. Preventative methods against sharps injury were especially used in care of patients with known bloodbourne pathogene as there was a fear of being infected.