Summary
OBJECTIVES: The objective of this study was to describe the mechanisms and preventability of occupational percutaneous blood exposure of healthcare workers through needlestick injuries and to discuss rational strategies for prevention. METHODS: To calculate the preventability, we surveyed in a first step the number and kind of needlestick injuries and in a second step the reasons for the injuries and the working conditions of the healthcare workers. Both data sets were collected in independent anonymous questionnaire covering occupational blood exposure among healthcare workers in a German university hospital. RESULTS: Needlestick injuries were caused through unsafe procedures, difficult working conditions and unsafe devices. On average, 50.3% (n = 492/978) of all needlestick injuries could have been avoided by the use of safety devices, whereas only 15.2% could have been prevented by organizational measures. In our study, 31.5% (n = 503/1598) of participant healthcare workers had sustained at least one needlestick injury in the past twelve months. The rate of underreporting was about 75%. After introduction of safety devices, 91.8% of the healthcare workers reported being satisfied with the anti-needlestick devices and 83.4% believed that safety devices would increase the safety of the work environment. CONCLUSIONS: Occupational exposure to blood is a common problem among healthcare workers. The introduction of safety devises is one of the main starting points for avoidance of needlestick injuries, and acceptance among healthcare workers is high. Further targets for preventive measures, such as training in safe working routines, are necessary for improvement of safe work conditions.
Keywords: Bloodborne viruses, Occupational infections, Safety devices
Zusammenfassung
EINLEITUNG: Ziel dieser Studie war die Erhebung der Häufigkeit und Ursachen von Nadelstichverletzungen bei Mitarbeitern im Gesundheitswesen sowie die Darstellung möglicher präventiver Maßnahmen. METHODEN: Mit Hilfe zweier unabhängiger anonymer Fragebogenerhebungen wurden Daten über Nadelstichverletzungen von Mitarbeitern eines deutschen Universitätsklinikum erhoben. Um die Vermeidbarkeit der Nadelstichverletzungen zu kalkulieren, wurden im ersten Studienabschnitt Anzahl und Art der Nadelstichverletzungen ermittelt, im zweiten Abschnitt die Ursachen und die Arbeitsbedingungen der Mitarbeiter. ERGEBNISSE: Nadelstichverletzungen wurden durch unsichere Handlungsabläufe, schwierige Arbeitsbedingungen und unsichere Arbeitsgeräte verursacht. In unserer Studie hatten innerhalb der letzten zwölf Monate 31,5% (n = 503/1598) der Befragten mindestens eine Nadelstichverletzung erlitten. Die Rate des Underreporting lag bei circa 75%. Durchschnittlich 50,3% (n = 492/978) der stattgehabten Nadelstichverletzungen hätten durch die Verwendung von sogenannten sicheren Instrumenten vermieden werden können, wohingegen lediglich 15,2% der Nadelstichverletzungen durch organisatorische Maßnahmen vermeidbar gewesen wären. Nach der Einführung der sicheren Instrumente, gaben 91,8% der Mitarbeiter an, mit den sicheren Instrumenten zufrieden zu sein, 83,4% der Beschäftigten waren davon überzeugt, dass sich durch die Verwendung von sicheren Instrumente die Arbeitssicherheit erhöhen würde. DISKUSSION: Die berufliche Exposition gegenüber Blut ist ein häufiges Problem der Mitarbeiter im Gesundheitswesen. Eine systematische und kontinuierliche Erfassung von Nadelstichverletzungen ist unabdingbar, um riskante Praktiken und Arbeitsbedingungen zu identifizieren. Präventive Maßnahmen, beispielsweise die Einführung von sicheren Instrumenten sowie die Schulung sicherer Arbeitsabläufe, sollten im weiteren Zeitverlauf implementiert werden.
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