| Summary: | 碩士 === 高雄醫學大學 === 職業安全衛生研究所碩士班 === 93 === Needlestick injuries are one of the most important occupational injuries for healthcare workers. According to the investigation, the percentage of healthcare workers who ever sustain a needlestick injury at workplace is about 87.3% in Taiwan. Needlestick injuries have a substantially greater risk of almost 20 types of disease transmission, such as HBV、HCV、HIV/AIDS、syphilis. In addition, it can cause negative effect psychologically and physically, not mentioning the vast amount of medical cost. Therefore, it is suggested that timely analyzing the data of needlestick injuries and assessing the cost can effectively prevent and control the incidence of needlestick injuries. In view of this, this study investigated a medical center, using epidemiology of needlestick injuries, statistics of medical cost, and investigation of special group-cleaner as indication for the related unit to improve needlestick injuries.
A cross-sectional study was conducted among 452 reported healthcare workers who sustained needlestick injures at a medical center in the midland during 2001 to 2003. Not only the cause of needlestick injury was investigated, but also the occurred medical cost as well as injury tracking time was calculated. In December 2004, a questionnaire was used as a tool to assess the actual situation of needlestick injuries on cleaners and the difference among knowledge、attitude and behavior of them.
The result showed that among all needlestick injury workers, the mean age was 29.2, and the mean service seniority was 4.0 years. The majority occupation were nurses(54.0%)、followed by medical doctors (12.8%)、medical students(7.5%), and cleaners(6.4%). Most injuries was happened in general wards (38%) and operation rooms (23%). The incidence of needlestick injury among medical doctors was 3%, nurses 0.4%, medical students 3.6%, and in-house cleaners 0.3%. 90% of overall injured healthcare workers were not effected Hepatitis B and had antibody for hepatitis B virus. The study shows occupation has significant difference among cause、time、place、service seniority, and etc (P<0.05).
In view of medical cost, the average outpatient visits caused by needlestick injuries are 2.3 per person and mean examination was 2.0 per person. Average time spent on tracking down the cause was 43.5 minutes and medical cost was NT$2,869/per person. Considering different transmitted diseases on tracking cost, NT$1,840/per person was cost when no diseases occurred on needlestick injuries, NT$2,017 was cost when the source was Hepatitis B patients, NT$2,553 for syphilis positive, and NT$8,096 for HIV/AIDS positive.
As for the questionnaire by cleaners, 190 out of 206 questionnaires were effective (or response rate 92%). Among 190 effective questionnaires, the mean age was 46.5 and 90.5% were women. Mean service seniority was 5.2 years. In-house cleaners were 34.7%, while outsourced cleaners were 65.3%. Most of their education was primary school level, accounting for 56.2% of 190 cleaners. Only 30.3% of the cleaners had hepatitis B virus antibodies. Besides, 68.8% had been accepted on-the-job training to avoid needlestick injuries. 17 persons had reported needlestick injury, accounting for 8.9% of the group. Most injuries were occurred in general wards, which is 52.9%. There were significant difference among sex、age、unit、service seniority、education、religion、knowledge and attitude of needlestick injuries as risk factors in work status (P<0.05)。
Conclusion：This study showed that encouraging the injection of hepatitis B vaccines on healthcare workers not only can effectively prevent incidence of hepatitis B transmission through needlestick injuries but also decrease related medical cost. Therefore, the administration unit should consider the possibility to accomplish hepatitis B vaccine on healthcare workers to reduce risk of infected diseases. Furthermore, the result showed high risk of needlestick injuries on cleaners, which may be due to the low level of education and knowledge of needlestick injuries. It is suggested that enhancing management and further education are important keys to avoid this type of injuries.
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