Lesão Cortoperfurante complicada numa Enfermeira dos Cuidados de Saúde Primários: um Relato de Caso

Abstract

Introduction Accidents at work resulted from sharp injuries are frequent and preventable events among health care professionals. The prevalence of secondary infection depends on several factors related to the patient itself, the health care worker and the adherence to preventive protocols. In this article, the authors pretend to present a case report of an accident involving a primary health care professional that suffered a sharp injury and, also, to alert about the significance of appropriately reporting. Case Description Woman, 54 years old, a nurse in primary care with 27 years of experience. Background history, among others, ulcerative colitis under immunosuppressive therapy. At the end of shift, she cuts herself with a contaminated scalpel blade while draining a panaritium, resulting in a superficial wound in the second finger of right hand. Notification of the occurrence was made 36 hours after the accident due to the development of local cellulitis. Later, the infection complicated with likely osteomyelitis. Two cycles of antibiotic therapy have been completed and the imagiological revaluation showed bone integrity and signs of tenosynovitis of the second finger flexors. The nurse is absent from work for 15 weeks and awaits a Physical and Rehabilitation Medicine evaluation. Discussion Health care professionals are at greater risk of accident at work, namely, of suffering sharp objects injuries. According to the literature, accidents of this nature are more frequent among female nurses and occur mainly on hands, as in the case described. Among the factors that increase the probability of these occurrences are the high workload and the number of hours worked. Standing out as a particularity of this case is the acquired immunodeficiency secondary to methotrexate therapy as the main condition of the more prolonged disease. This AW had an impact on the professional and the dynamics of the work team, with the need to adjust tasks and temporarily hire another professional. Conclusion As sharp injuries are frequent and preventable, it is important to encourage their reporting. On one hand, to protect the health of injured professionals and on the other hand, so that preventive and corrective measures can be developed. Additionally, it is relevant to know the history of the patient, of the health care professional and the mechanism of injury, to stratify the risk of associated secondary infection. In conclusion, the cooperation of Occupational Health services with other health professionals is important for the adequate management of occupational risks. KEYWORDS: occupational accidents; sharps injuries; incident reporting; family practice; occupational medicine; workplace conditions.