对尼日利亚南部地区医护人员尖锐伤害发生率、接触后预防知识和利用情况的比较评估

Ehimen Fa, Ogbetere Yn, Betiku Bo, Ehimen So, Alenoghena I
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摘要

在全球范围内,锐器伤仍是接触血液和体液的最常见原因。防止接触血液和体液是最大限度地减少医护环境中人体免疫缺陷病毒、乙型肝炎和丙型肝炎感染传播的最重要策略。然而,接触后预防或管理是预防医护人员血液传播感染所需的完整计划的关键要素。接触后预防(PEP)是指在接触病原体(如致病病毒)后立即开始的任何预防性医疗,目的是防止病原体感染和疾病的发展。目标:评估尼日利亚南部三级医疗保健机构的医护人员锐器伤的发生情况、接触后预防的知识和使用情况。方法:横断面研究对尼日利亚南部三级医疗机构的 492 名医护人员进行了横断面研究。本研究采用多阶段抽样技术招募医护人员,并使用 SPSS 进行数据分析。研究结果三级医疗机构中超过三分之一的医护人员报告曾受到利器伤害,但与其他医疗机构相比,初级医疗中心的大多数医护人员(50.4%)更多地接触到血液和体液(BBF)。 初级保健中心的大部分医护人员(83.7%)和二级保健中心一半以上的医护人员对预防接种知识知之甚少,而三级保健中心只有 27.4% 的受访者对预防接种知识知之甚少。此外,各级医疗机构对暴露后预防措施的利用率普遍较低;初级保健中心工作人员的利用率较高(15.6%),而二级医疗机构的利用率最低(14.30%)。结论尽管暴露后预防在控制职业性血源性感染(暴露后感染)方面发挥着不可或缺的重要作用,但令人痛心的是,大多数医护人员对暴露后预防的了解和利用率都很低。此外,大多数医护人员在护理病人的过程中都曾被锐器刺伤。因此,有必要对医护人员进行定期培训,提高他们对接触后预防原则和遵守标准预防措施的认识。
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Comparative Assessment of Occurrence of Sharp Injuries, Knowledge and Utilization of Post-exposure Prophylaxis among Health care workers In South-South Nigeria
Worldwide, sharp injuries remain the most common cause of exposure to blood and body fluids. Preventing this exposure to blood and body fluid is the most important strategy of minimizing transmission of Human immuno-deficiency virus, Hepatitis B and Hepatitis C infections in health care setting. However, post exposure prophylaxis or management are key element of the complete program needed in preventing blood borne infections among HCWs. Post Exposure prophylaxis (PEP ) is any preventive medical treatment  started immediately after exposure to a pathogen (such as a disease-causing virus), in order to prevent infection by the pathogen and the development of disease. Objectives: To assess the occurrence of sharp injuries, knowledge and utilization of post exposure prophylaxis among Health Care Workers at the three level of health care delivery in South-south Nigeria. Methods: The cross sectional study was carried out among 492 Health Care Workers at the three level of health care delivery in South-south Nigeria. Multi stage sampling technique was used to recruit health care workers into this study and SPSS was used in data analysis. Results: More than one-third of the health care workers at the three levels of health care delivery reported having sharps injuries, however, majority (50.4%) of HCWs in the primary health care centres had more exposure to Blood and body fluids (BBFs) compared to the other level of care.  A large proportion of the health care workers (HCWs) in the primary health care workers (83.7%) and more than half of their counter parts at the secondary health care (SHC) had poor knowledge of PEP compared to the teritiary health care (THC) where only 27.4% of the respondents had poor knowledge of PEP. Moreover, the utilization of post exposure prophylaxis was generally low at all levels of health care; it was higher (15.6%) among the PHC workers and least (14.30%) at the secondary health care level. Conclusion: Despite the essential and indispensable role of post exposure prophylaxis in controlling occupational blood borne infections (post exposure infections), it was sad to note that most of the HCWs had poor knowledge and utilization of post exposure prophylaxis. Also, most HCWs had sharp injuries during their course of patient care. Therefore, there is need for regular training and sensitization of HCWs on the principles of post exposure prophylaxis and adherence to standard precautions.
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