일개 종합병원 수술실 의료인의 혈액 및 체액 노출 실태조사
Exposure to Blood and Body Fluid in Operating Room Personnel in One Acute Care General Hospital
1
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Purpose: The purpose of this study was to assess the frequency and characteristics of occupational blood and body fluid exposure for operating room personnel during surgical procedures and identify risk factors. Methods: A self-report questionnaire was used to survey 519 operating room personnel who participated in 132 surgeries in an acute care hospital in Seoul between April 12 and 20, 2006. Results: The response rate was 82% (530/646) and analyzed total 519 except for improper 11 questionnaires. Exposure rate was 45.5% (60/132) during operations and 20.4% (106/519) for operating room personnel. By job categories, the exposure rate was as follows; anesthesiologists and nurses 31.2% (44/141), operators and assistants 22.1% (32/145), circulating nurses 12.0% (11/92), scrub nurses 11.4% (14/123). The mucous membrane-eye exposure with a high risk of transmitting infection was 6.6% (7/106) and the most frequent route of exposure was blood and body fluid touching unprotected skin. In multivariate analysis, the risk factors of exposure were services, duration of operation, a patient who had a peripheral arterial catheter line, and job category. Conclusion: Educational programs and appropriate use of personal protective equipment are necessary to prevent operating room personnel from being exposed to blood and body fluid.
Abstract
Purpose: The purpose of this study was to assess the frequency and characteristics of occupational blood and body fluid exposure for operating room personnel during surgical procedures and identify risk factors. Methods: A self-report questionnaire was used to survey 519 operating room personnel who participated in 132 surgeries in an acute care hospital in Seoul between April 12 and 20, 2006. Results: The response rate was 82% (530/646) and analyzed total 519 except for improper 11 questionnaires. Exposure rate was 45.5% (60/132) during operations and 20.4% (106/519) for operating room personnel. By job categories, the exposure rate was as follows; anesthesiologists and nurses 31.2% (44/141), operators and assistants 22.1% (32/145), circulating nurses 12.0% (11/92), scrub nurses 11.4% (14/123). The mucous membrane-eye exposure with a high risk of transmitting infection was 6.6% (7/106) and the most frequent route of exposure was blood and body fluid touching unprotected skin. In multivariate analysis, the risk factors of exposure were services, duration of operation, a patient who had a peripheral arterial catheter line, and job category. Conclusion: Educational programs and appropriate use of personal protective equipment are necessary to prevent operating room personnel from being exposed to blood and body fluid.
참고문헌 (24)
- 김옥선, "병원직원의 주사바늘 찔림 실태 및 위험요인 분석", 석사, pp.1997
- 박미라, "서울경기지역 병원직원의 혈행성 감염노출에 대한 다기관 조사 연구", 병원감염관리, 8(1), pp.35~45 (2003)
- 오향순, "일 대학병원의 병원직원들이 보고한 혈행성 감염질환 노출 사고에 대한 연구", 병원감염관리, 7(1), pp.51~64 (2002)
- 최정실, "일개 종합병원의 특수부서에서 근무하는 의료진의 혈액 및 체액의 노출 실태와 이에 대한 예방지식 및 대처 행위에 관한 연구-중환자실, 응급실, 투석실, 수술실, 미생물검사실을 중심으로", 석사, pp.1998
- Allen-Bridson, K., "APIC Text of infection control and epidemiology" (2002), APIC
- Bell, D, M., "AIDS focus. Surgical practice in hospitals: HIV and the surgical team", Todays OR Nurse, 12(11), pp.24~27 (1990)
- Updated U.S. public health service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommandations for postexposure prophylaxis, "CDC", MMWR, 1~42, pp.Recommendations and Reports, 50(RR-11) (2001)
- "Exposure to blood: What healthcare personnel need to know" (2003)[URL]
- Cutter, J., "Uptake of guidelines to avoid and report exposure to blood and body fluids", Journal of Advanced Nursing, 46(4), pp.441~452 (2004)
- Endo, S., "Risk of facial splashes in four major surgical specialties in a multicentre study", Journal of Hospital Infection, 67(1), pp.56~61 (2007)
- Esteban, J. I., "Transmission of hepatitis C virus by a cardiac surgeon", New England Journal of Medicine, 334(9), pp.555~560 (1996)
- Gerberding, J. L., "Risk of exposure of surgical personnel to patients blood during surgery at San Francisco general hospital", New England Journal of Medicine, 322(25), pp.1788~1793 (1990)
- Hentz, V. R., "Surgeon-patient barrier efficiency monitored with an electronic device in three surgical settings", World Journal of Surgery, 25(9), pp.1101~1108 (2001)
- "Blood and Body Fluid Exposure Report/OR" (2002)[URL]
- Jagger, J., "A study of patterns and prevention of blood exposures in OR personnel", Association of Operating Room Nurses Journal, 67(5), pp.979~996 (1998)
- Nelsing, S., "Noncompliance with universal precautions and the associated risk of mucocutaneous blood exposure among Danish physicians", Infection Control and Hospital Epidemiology, 18(10), pp.692~698 (1997)
- Panlilio, A. L., "Blood exposures during surgical procedures", Journal of the American Medical Association, 265(12), pp.1533~1537 (1991)
- Perry, J., "EPINet Report: 2003 Percutaneous Injury Rates", Advances in Exposure Prevention, 7(4), pp.42~45 (2005)
- Sharma, J. B., "Facial and body blood contamination in major gynecologic surgeries", Journal of Obstetric and Gynaecology Research, 29(6), pp.402~405 (2003)
- Stringer, B., "Quantifying and reducing the risk of bloodborne pathogen exposure", Association of Operating Room Nurses Journal, 73(6), pp.1135~1146 (2001)
- Thomas, S., "Intraoperative glove perforation single versus double gloving in protection against skin contamination", Postgraduate Medical Journal, 77(909), pp.458~460 (2001)
- Tokars, J. I., "Skin and mucous membrane exposures with blood during surgical procedures: Risk and prevention", Infection Control and Hospital Epidemiology, 16(12), pp.703~711 (1995)
- White, M. C., "Blood exposure and exposures among operating room personnel: A multicenter study", American Journal of Infection Control, 21(5), pp.243~248 (1993)
- Wong, D. A., "Risk of blood contamination of health care workers in spine surgery: A study of 324 cases", Spine, 23(11), pp.1261~1266 (1998)