임상병리사들의 주사침 자상 실태에 관한 연구

심문정 ( Moon Jeong Shim ),김각현 ( Kag Hyun Kim ) 대한임상검사과학회 2003 대한임상검사과학회지(KJCLS) Vol.35 No.1

Health care workers are frequently exposed to the danger of infectious agents from needlestick and sharps injuries. Needlestick injuries occur very frequently and commonly so there is a tendency that both hospital and its employees take it lightly, compared to other sorts of injury in the medical field. The purpose of this study is to discuss needlestick injuries which are a major channel of potential vocational infections for medical technologists MTs. We examined the frequency of needlestick injuries that occurred in clinical laboratories, their management, and the possible risk factors. We conducted surveys on needlestick injuries on 243 MTs from the 39 hospitals. The data was analyzed by the SPSSWIN program. According to the results of the study, 90.9% of the MTs have experienced needlestick injuries. The most common frequency of being injured was 1 or 2 times(46.2%), followed by 3 or 4 times(27.3%). 53.4% of MTs surveyed have received moderate injuries and 45.8% received needlestick injuries while withdrawing needles or disassembling devices. 24.8% were injured while recapping used needles. The most common reason of needlestick injuries occurring was carelessness(72.3%). 95.4% of the medical technicians had their injuries disinfected and 20.3% of the MTs checked medical records of the patients who used the same needle before their injury. Only 3.6% of injured MTs consulted doctors and 3.2% were prescribed medicine or treatment. According to the needle disposal system, 99.6% of the MTs collected waste separately. 52.5% dispose of needles after recapping. 64.3% use a plastic can for separate collection. Use of safer devices and continuing education programs for needlestick injuries are needed in order to reduce the occupational risk of infection.

병원종사자의 주사바늘 상해에 관한 연구

황희자,김용배,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

Needlestick injuries have been a recognized problem in hospitals for many years. In order to identify the needlestick injury rate among hospital personnel and to obtain basic information for the prevention of it, author investigated 330 hospital personnel who were working in two general hospital located in Chunan. The job category of hospital personnel were medical doctor, registered nurse, assistant nurse and clinical pathology technician. 174 study subjects were came from A hospital and 156 study subject were came from B hospital. Structured questionnaire were provided to get the information about needlestick injury rate over 1 year period and related information such as cause of injuries, the situation of surrounding environment at the injuries, the condition of proper treatment, existence of proper reporting action and proper action for treatment, and disposal method of accident needle. The questionnaire also checked what was the possible suspected disease due to needlestick injuries and what is most desirable item of preventive program for the prevention of accidental needlestick injuries. The results obtained were as follows: 1. A total of 282 medical personnel(85.5%) reported needlestick injuries during study period. Annual needlestick injury rate of study population (330 medical personnel) was 3.9/person/year. There was no difference of percent of needlestick injuries and annual injury rate between two general hospital. 2. The highest needlestick injury rate was observed in nurses(87.6%) among 4 job category and followed by medical doctors(83.1%), assistant nurses(80.8%) and clinical pathology technician (75%). 3. While most frequent needlestick injuries were occurred in the year of internship and 1st resident training period in medical doctor group, those in registered nursing group were occurred in intensive care unit, and followed by emergency room and operation room, respectively. 4. While the disposable needle was most frequent cause of injuries(78.8%) and carelessness was major cause of injuries. The most common situation for needlestick injuries was reported as the application of venous blood injection (26.0%). 5. Only 2% and 9% of needlestick injuries in A and B hospital reported their injuries to the hospital official, whereas 85.2 % and 87.2% of injured made immediate cleaning of affected area. But less than 3.4% and 4.5% of injured brought their injuries to medical attention such as laboratory test for suspected disease and treatment. 6. Hepatitis was most worried disease after needlestick injuries in both hospital (A:75.8% , B:77.4%) and the most needed type of preventive measure for the safety and prevention of future needlestick injury was different among job category. While the highest percent of needed preventive measure was written protocol for the preventive measure in medical doctor(60.0%) and registered nursing group (58.3%), it was regular education and actual demonstration at the site in assistant nursing group(79.8%). With above results, more effort is needed to prevent unwanted needlestick injuries in hospital setting with proper reporting system of injuries, dissemination of proper information about possible accident in various situation and development of on-going monitoring system to analyse cause of injuries and proper action to avoid the unwanted sequelae from injuries.

일개 상급종합병원 의료종사자의 주사침 자상 노출 특성 및 추적 현황

신화영(Shin, Hwa Young),장금성(Jang, Keum-Seong) 전남대학교 간호과학연구소 2021 Nursing and Health Issues(NHI) Vol.26 No.2

Purpose: Through a descriptive study, we aimed to identify characteristics and trace status of needlestick injuries of health care workers in a tertiary hospital in Korea. Methods: The subjects were an analysis of secondary data on reports and medical records of 267 health care workers who were injured by needlesticks between January 1, 2014 and December 31, 2018. Data were analyzed using the SPSS 25.0 program. The subjects’ general characteristics and outcomes were analyzed by descriptive statistics and statistical differences of post exposure management were analyzed by qui-square test. Results: Out of those cases 59.9% of needlestick injured health care workers were female and 58.1% were 20∼29 years old. 29.6% of needlestick injuries occurred from March to May, 42.7% were doctors and 51.7% had less than a year of career. 39.0% of needlestick injuries occured in clinical ward and 22.8% were during injection process. The most exposed area was the left hand(59.9%) and source instruments of needlestick injuries were needles(80.5%). In addition, the association between follow-up rate and exposed patients’ infection status and occupation were statistically significant. Conclusion: Based on our finding, we conclude there is a need for intensive education, follow-up, and prevention management of needlestick injuries for health care workers who are frequently exposed to such injuries in medical institutions. It is also essential to develop and implement a needlestick injury surveillance system to track, treat and prevent such injuries.

일개 종합병원에서 최근 5년간 의료종사자들의 주사침 자상에 관한 연구

하경임,김문연,이동욱,정휘수 동국대학교 의학연구소 2009 東國醫學 Vol.16 No.1

병원의 업무와 관련된 상해는 오염된 주사바늘에 의한 주사침 자상(needle-stick injury)이 가장 흔하다. 이는 B형 간염, C형 간염, 후천성면역결핍증 등과 같은 혈액 전파 감염성질환의 위험을 증가시켜 의료종사자들에게 심각한 위험이 된다. 동국대 경주병원에서 최근 5년간 주사침 자상을 보고한 직원들은 49명 이었는데 48명 (97.9%)이 날카로운 주사침이나 의료기구에 찔려서 발생되었다. 이들 중 83.7%는 5년 이하의 근무경력자이었고 간호사가 49.0% 인턴 28.6% 전공의 14.3% 임상교수 6.1% 간호조무사가 2.0% 였다. 주사침 자상의 발생 경위는 직접 의료행위를 하거나 시행하면서 발생한 예가 87.8% 였고 나머지 12.2%는 의료기구를 정리하는 과정에서 발생하였다. 주사침 자상이 발생한 직원돌의 95.9%는 본인의 B형 간염 항체 유무에 대하여 제대로 알고 있었고, 75.5%는 B형 간염 예방접종 과거력이 있었다. 본원에서 주사침 자상에 의해 혈액전파감염성질환에 이환된 예는 없었다. 이는 직원감염 예방에 대한 본원의 적극적인 감염관리프로그램의 효과로 생각되며, 향후 주사침 자상 예방에 대한 교육과 흥보를 지속적으로 시행하여야 할 것이다. Needlestick injury by contaminated needles is the most common hospital related injury. This elevates the risks, of blood transmitted disease such as hepatitis B, hepatitis C, AIDS and can be a serious threat health care workers. In dongguk university gyeongju hospital, out of 49 needle sticks in a recent 5 years study, 48(97.9%) cases were due to injuries by sharp needles or medical equipments. The 83.7% of those were under 5 years of experience. Out of those cases 49% were nurses, 28.6% were interns, 14.3% were residents, 6.1% were clinical professors, and 2.9% were assistant nurses. Their activities associated with needlestick injuries was as follows; 87.8% of those occurred during medical practices and 12.2% during organizing medical equipments. Among of our hospital personnels who had needle stick injuries, 95.9% accurately knew of their prevalence of hepatitis B antibody and 75.5% had history of hepatitis B vaccination. There were no cases of blood transmitted disease due to needlestick injuries in our hospital. This is thought to be due to an active infection control program, and continuous eduction for occupational hazards of hospital personnel is needed to prevent needlestick injuries.

간호대학생의 자상사고 실태 조사 연구

박선남,김경미,한숙정 대한의료관련감염관리학회 2010 의료관련감염관리 Vol.15 No.1

Background: The purpose of this study was to examine the frequency and characteristics of needlestick/sharps injuries (NSIs) in nursing students in Korea. Methods: The study was based on a survey of questionnaires completed by 341 nursing students who had sustained at least one NSI during clinical practice in hospitals. Results: The NSI incidence rate was 36.4%. Approximately half of the students reported two to four NSIs. Most (90.2%) of the NSIs occurred on the fingertips and were caused by a hollow-bore needle (46.8%) or lancet (45.8%). Some students were exposed to used needles contaminated with unknown pathogens (37.3%), HBs Ag (2.3%), Venereal Disease Research Laboratory (VDRL) (0.8%), or HIV (0.6%). Students cited the reason for injury as carelessness,inexperience, hastiness, or recapping. Almost two-thirds of students who reported having experienced an NSI knew about post-exposure treatment. However, only one-third of the students with NSIs completed an official report. Conclusion: Korean nursing students lack knowledge about injury prevention, report procedures, and treatment after NSI. A revised educational approach with emphasis on occupational risk, skill development, and injury reporting is necessary to prevent NSI and to ensure that students obtain post-exposure prophylaxis.

의료종사자의 주사침 자상 관련 특성과 지식 및 표준주의 이행도

유지원,양남영 한국가정간호학회 2017 가정간호학회지 Vol.24 No.3

Purpose: This study was conducted to examine the characteristics and knowledge of needlestick injuries, and compliance with standard precautions, in healthcare workers. Method: The participants were 185 healthcare workers working at university hospitals. Data were collected in May 2016 and analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients using SPSS 18.0 program. Results: It was found that 45.4% of the subjects had experienced needlestick injuries. The most common rate of getting injured was 1 or 2 times, and the most common reason for the occurrence of needlestick injuires was carelessness(66.6%). The mean scores for knowledge of needlestick injuries and compliance with standard precautions were above average. Significant correlations were found between knowledge of needlestick injuries and compliance with standard precautions in health workers, and Characteristics were related to the significant differences seen in both. Conclusion: These findings indicate that standard precautions and guidelines for the use of sharp instruments should be emphasized in order to prevent needlestick injuries in healthcare workers.

Clinical, Electrophysiological, and Sonographic Findings in Patients With Nerve Injury After Vessel Puncture

Min Seok Kang,박홍범,김서현,Ihyun Kim,김동휘 대한신경과학회 2023 Journal of Clinical Neurology Vol.19 No.4

Background and Purpose This study aimed to describe the clinical, electrophysiological, and ultrasonographic findings of patients with nerve injury after vessel puncture. Methods Data on ten patients (three males and seven females) with nerve injury after vessel puncture were reviewed. Demographic and clinical data were analyzed retrospectively. Bilateral electrophysiological studies were performed based on clinical findings. Ultrasonographic examinations were performed on both the affected and unaffected sides of the injured nerve. Results The nerves of nine patients were injured following vein puncture, and injury occurred following arterial sampling in one patient. Seven patients had superficial radial sensory nerve injury: five medial, one lateral, and one at both branches. One patient had injury to the dorsal ulnar cutaneous nerve, one to the lateral antebrachial cutaneous nerve, and one to the median nerve. Nerve conduction studies produced abnormal findings in 80% of patients, whereas ultrasonographic examinations produced abnormal findings in all of the patients. Spearman’s coefficient for the correlation between the amplitude ratio and nerve cross-sectional area ratio was not significant, at -0.127 (95% confidence interval=-0.701 to 0.546, p=0.721). Conclusions Ultrasonography supported by electrodiagnosis was found to be a useful method for identifying the lesion location and structural abnormalities of vessel-puncture-related neuropathy.

Laboratory-acquired dengue virus infection by needlestick injury

Changhwan Lee,Eun Jung,Donghyok Kwon,Heun Choi,Jung Wan Park,Geun-Ryang Bae 대한직업환경의학회 2016 대한직업환경의학회지 Vol.28 No.-

Background: Dengue fever is one of the most dominant vector-borne diseases, putting approximately 3.9 billion people at risk worldwide. While it is generally vector-borne, other routes of transmission such as needlestick injury are possible. Laboratory workers can be exposed to dengue virus transcutaneously by needlestick injury. This is the first case, to our knowledge, of dengue virus infection by needlestick injury in a laboratory environment. This paper evaluates the risk and related health concerns of laboratory workers exposed to dengue virus. Case presentation: We evaluated a 30-year-old female laboratory worker exposed to the dengue virus by needlestick injury while conducting virus filtering. During admission, she showed symptoms of fever, nausea, myalgia, and a characteristic maculopapular rash with elevated aspartate aminotransferase (AST) of 235 IU/L and alanine aminotransferase (ALT) of 269 IU/L. She had been diagnosed by a positive nonstructural protein 1 (NS1) antigen (Ag) rapid test one day prior to symptom onset along with positive immunoglobulin M (IgM) enzymelinked immunosorbent assay (ELISA) on the ninth day of symptom onset. Reverse transcription polymerase chain reaction (RT-PCR), also conducted on the ninth day, was negative. After proper symptomatic treatment, she recovered without any sequelae. As a result of thorough epidemiologic investigation, it was determined that she had tried to recap the needle during the virus filtering procedure and a subsequent needlestick injury occurred. Conclusions: In the context of health promotion of laboratory workers, we suggest that the laboratory biosafety manual be revised and reinforced, and related prevention measures be implemented. Furthermore, health authorities and health care providers in Korea should be fully informed of proper dengue fever management.

치과진료실에서 주사바늘 찔림 사고 예방을 위한 가이드라인 연구

전정미 ( Jeong Mi Jeon ),임순연 ( Soon Ryun Lim ),조영식 ( Young Sik Cho ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.3

The purpose of this study is to investigate guidelines and safety and precautionary devices for prevention of needlestick injuries in dental offices. This study conducted comparative analysis on the domestic and overseas guidelines for infection control and surveyed safety and precautionary devices for prevention of needlestick injuries. Based on the result of analysis and survey, this study suggests safety and precautionary guidelines to prevent needlestick injuries. To prevent needlestick injuries, staff in dental offices should be well aware of the guidelines for infection control and how to use safety and precautionary devices.

Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran

Hamed Akbari,Fakhradin Ghasemi 한국역학회 2018 Epidemiology and Health Vol.40 No.-

OBJECTIVES: Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries. METHODS: This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended. RESULTS: The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors’ attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed. CONCLUSIONS: To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.