| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 103 === Abstract
Needlestick and sharp injuries (NSIs) are a common occupational hazard and the main cause of infectious blood and body-fluid transmitted disease for hospital medical staff. Risks of NSIs in physicians, however, have long been neglected while physicians often act as a team leader during clinical practice. The purpose of this study is to update the prevalence of NSIs in physicians and identify their underlying risk factors. A nationwide survey of “Workplace health and safety needs in hospitals” conducted in 70,622 medical staffs (including physicians, nurses and other medical professionals) at 100 hospitals by the National Health Department in Ministry of Health and Welfare of Taiwan between May to August of 2011 was adapted. Among which the survey questionnaires returned by 4,310 physicians were the foci of the current study. As a result, 912 (21.2%) needlestick injuries and 698 (16.2%) sharp injuries were reported respectively in the total 4,310 questionnaires. Further analysis revealed that the risk factors of occupational NSIs were heightened by age (<35 y), education level (college or underneath), years in practice (between 2 to 5 years), total working hours in the most recent week (>84 hrs), places of practice (operational room, delivery room, general ward or emergency room), hospital levels of service (medical center), daily sleep time (≦5 hrs), having habits of smoking and/or drinking and being in a high work pressures or strong depressed moods. In conclusion, the present study shows that the actual rate of NSI incidence in physicians might be higher than that notified in the Exposure Prevention Information Network (EPINet) or inferred from data in previous retrospective studies. The affecting factors of NSI events involve physician’s clinical experiences, extent of risk exposure, compliance of preventive measures and work overload. In addition to encouraging hospitals to impose NSI incidence report and audit of preventive measures, it is suggested that hospitals should dedicate in removing the obstacles that reduce physician’s compliance of NSI preventive measures during their everyday practices and in developing needle protective measures that are customized to the needs of high-risk groups. Hospitals should also strengthen the hands-on skills for needlestick or sharp protection in physician’s early stages of career, and pay attention to physician’s over workload underlying NSI events for sake of both physicians’ and patients’ safety. Future researchers should conduct both qualitative and quantitative study, in which in-depth interviews need to be done immediately after NSI events in order to understand the reasons behind so as to identify behavioral predictors and countermeasures of NSI.
Key words: Needlestick injury, sharp injury, physicians
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