| Summary: | 碩士 === 臺北醫學大學 === 醫務管理學研究所 === 98 === The purpose of this research is to understand the situation of and association between hospital climate and the knowledge, attitude, and handling of piercing injuries and blood and bodily fluid exposure by health care staff. A cross-sectional study used sampling to select staff from seven regional or higher level hospitals in northern Taiwan who were at risk from sharps injuries or exposure to blood/bodily fluids. Research was primarily conducted through self-administered surveys, with a total of 1465 issued and 996 received, recovery rate was 67.9%. Data was analyzed using SPSS 12.0, a statistics software program, and the research findings were as follows:
1. 33.3% of health care staff were pierced by sharp medical objects or exposed to blood/bodily fluids in the last year. 67.5% of these incidents were always reported to the responsible hospital section, 19.9% were sometimes reported, and 12.6% were never reported. Reasons for failing to report included believing that the patient was not contagious or feeling that the reporting process was too troublesome or time-consuming.
2. Health care staff correctly answered an average of 79% of the survey questions pertaining to piercing injuries from sharp medical objects and blood/bodily fluid exposure, while cleaning staff correctly answered an average of 67.3%. Questions most frequently answered correctly concerned potential HIV infection, reporting to the proper unit, and immediate hospitalization/periodic follow-up services, while the question least frequently answered correctly concerned potential tuberculosis infection. Multi-factor analysis showed that knowledge of piercing injuries and blood/bodily fluid exposure was influenced by factors such as hospital level, age, job title, educational level, seniority, experience being exposed to blood/bodily fluids, and position held.
3. Health care staff’s feeling about hospital safety was affected by factors such as hospital level, age, educational level, and job title.
4. Knowledge, attitude, and handling of piercing injuries and exposure to blood/bodily fluids among health care workers is associated with and influenced by how they feel about hospital safety. A better knowledge of piercing injuries and blood/bodily fluid exposure corresponded to higher awareness of the importance of reporting incidents and staying alert. On the other hand, those who had trouble with these questions were more likely to display negative handling behavior and have negative feelings about hospital safety. Finally, staff members who felt better about hospital safety were more likely to display positive attitudes and handling behavior.
5. Personal characteristics are a reliable way to predict health care staff’s knowledge, attitude, and handling of piercing injuries and blood/bodily fluid exposure. Hospital safety is also a reliable predictor of attitude and behavior. Hospital safety is the most reliable variable for predicting health care staff’s handling of piercing injuries, and it is the most important factor for preventing piercing injuries and exposure to blood/bodily fluids.
In consideration of these conclusions, the following measures are proposed: 1. Assessment standards established by the responsible section should not take a reduction in the number of piercing injuries as an indication that the hospital is necessarily doing a better job of preventing piercing injuries and exposure to blood/bodily fluid. 2. Hospital administrators need to be concerned about safety and should express their commitment to doing so. 3. Follow-up research should examine this topic in more depth and include data from more hospitals of different levels.
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