三级转诊中心卫生保健工作者病毒性出血热疑似病例管理的应急准备

C. Onubogu, J. Njoku, S. Ushie, R. Egeonu, G. Obasikene, C. Anyaoku, Chinekwu Nwosu, O. Emelumadu
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摘要

背景:有效控制病毒性出血热(VHFs)需要卫生保健工作者(HCWs)充分的应急准备。目的:本研究评估了尼日利亚阿南布拉州Nnamdi Azikiwe大学教学医院(NAUTH)医护人员对甚高频控制的应急准备情况。材料和方法:这是一项横断面研究,在尼日利亚Nnewi的NAUTH进行了345名HCW。数据分析使用社会科学统计软件包(SPSS, IBM, Chicago IL, USA)软件版本21。卡方检验和学生t检验分别用于检验分类变量和连续变量之间的相关性。p值<0.05认为有统计学意义。结果:平均年龄33.9±8.88岁,平均工龄6.6±7.08岁。三分之二是医生、护士和实验室科学家。大部分卫生保健工作者(88.4%)知道VHF可在工作场所获得(83.8%),至少有2项正确特征(74.2%)或1项预防措施(79.1%)。分别只有53.0%和47.2%的受访者知道医院有甚高频控制政策和标准操作程序(SOP)。不同类别医护人员对甚高频的认知差异显著;了解在工作场所感染甚高频的风险、特点或预防措施,以及甚高频控制政策或SOP。医生、护士和实验室科学家在甚高频知识方面的表现优于其他医护人员。医生中曾接受甚高频培训或接触疑似病例的比例最高(P < 0.001),而实验室科学家中个人防护用品供应充足(P < 0.001)或经常使用个人防护用品(P = 0.008)的比例最高。21.2%的卫生保健员遇到疑似甚高频病例,其中26%(19/73)向有关单位报告。只有29.3%的医护人员认为他们单位的甚高频控制是足够的。不同意的最常见原因是缺乏培训(79.2%)、标准预防材料(63.6%)、标准操作规程(59.7%)和医院管理层支持不足(58.4%)。结论:所研究的卫生保健工作者对甚高频控制的应急准备较差。应实施创新的监测/通知系统和感染控制的最佳做法。卫生保健员应接受甚高频控制方面的充分培训。
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Emergency preparedness for management of suspected cases of viral haemorrhagic fever among healthcare workers in a tertiary referral center
Background: Effective viral haemorrhagic fevers (VHFs) control demand adequate emergency preparedness among healthcare workers (HCWs). Objective: This study assessed the emergency preparedness for VHF control among HCWs at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra state, Nigeria. Materials and Methods: It was a cross-sectional study conducted among 345 HCW at the NAUTH, Nnewi, Nigeria. Data was analysed using statistical package for social sciences (SPSS, IBM, Chicago IL, USA) software version 21. Chi square and student’s t-test were used to test associations between categorical and continuous variables, respectively. A p-value of <0.05 was considered statistically significant. Results: Their mean age and length of service were 33.9 ± 8.88 and 6.6 ± 7.08 years, respectively. Two-third were doctors, nurses and lab scientists. A major proportion of the HCWs were aware of VHF (88.4%), and knew it could be acquired at workplace (83.8%) and at least 2 correct features (74.2%) or one preventive measure (79.1%). Only 53.0% and 47.2% knew that the hospital had a VHF control policy and standard operating procedure (SOP), respectively. Different category of HCWs varied significantly in awareness of VHF; and knowledge about the risk of acquiring it at workplace, features or preventive measures, and VHF control policy or SOP. Doctors, nurses and lab scientists performed better than other HCWs in VHF knowledge. Previous training on VHF or encounter with suspected case was highest among the doctors (P < 0.001) while adequate supply (P < 0.001) or regular use (P = 0.008) of PPE was highest among lab scientists. Suspected VHF case was encountered by 21.2% of the HCWs out of which 26% (19/73) notified relevant unit. Only 29.3% of the HCWs agreed that VHF control was adequate in their unit. Commonest reasons cited for disagreeing were lack of training (79.2%), standard precaution materials (63.6%), SOPs (59.7%) and inadequate support by hospital management (58.4%). Conclusion: Emergency preparedness for VHF control was poor among studied HCWs. Innovative surveillance/notification system, and best practices for infection control should be enforced. HCWs should be adequately trained on VHF control.
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